Salivary Gland Stones: Symptoms, Management, and Concerns

Salivary gland stones

I visited an ENT specialist on May 10 and 12 due to swelling of my right salivary gland, which was not painful.
The doctor diagnosed it as a salivary stone and advised me to drink plenty of water.
I was prescribed medication and informed that there might still be slight swelling, but maintaining hydration would help.
After finishing the medication, although there was still some swelling, I didn't pay much attention to it.
Around May 21, I noticed that the swelling had almost subsided when I checked before bed, so I didn't think much of it.
However, during the week of May 26, I observed that the swelling seemed to increase after meals.
On May 29, I forgot to drink water in the morning, and after eating McDonald's for lunch, I suddenly noticed the swelling had returned.
I then drank a lot of water, and the swelling gradually decreased again.
Since then, I've been very mindful of staying hydrated and noticed that there is some swelling after eating, but it is not as pronounced as it was initially.
The swelling is least noticeable before bed, but it is still larger than the normal side.
I would like to know if it is normal for the affected side to remain swollen compared to the normal side, and can I leave the stone there indefinitely? Thank you for your response.

YTF, 30~39 year old female. Ask Date: 2021/06/02

Dr. Zheng Jueyi reply Otolaryngology

Hello, if there is no obvious inflammation or pain, it is advisable to drink plenty of water and monitor the situation during the pandemic.
However, if there is inflammation, swelling, and pain, it is recommended to seek medical attention for medication treatment.
Generally, smaller stones may pass naturally, but larger stones that cause recurrent swelling symptoms may require surgical intervention.
You can wait until the pandemic subsides to return to the hospital for further examination and evaluation.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/06/02

More Info

Salivary gland stones, also known as sialolithiasis, can be a source of discomfort and concern for many individuals. These stones form in the salivary glands, typically in the submandibular gland, and can lead to swelling, pain, and other symptoms. Your experience with swelling and discomfort after meals, particularly when you forget to hydrate, is quite common among those with salivary stones.

Symptoms of Salivary Gland Stones
The primary symptoms of salivary gland stones include:
1. Swelling: This is often most noticeable during meals when saliva production increases. The swelling may subside after eating or with hydration.

2. Pain: While you mentioned that your swelling is not painful, many individuals experience pain or tenderness in the affected area, especially when the stone obstructs the duct.

3. Dry Mouth: If the stone blocks saliva flow, it can lead to a dry mouth, which may exacerbate the problem.

4. Infection: In some cases, if the stone causes prolonged blockage, it can lead to infection, resulting in fever, pus, or increased pain.

Management of Salivary Gland Stones
The management of salivary gland stones often depends on the size and location of the stone, as well as the severity of symptoms. Here are some common approaches:
1. Hydration: As your doctor advised, drinking plenty of water can help facilitate saliva flow, which may help dislodge smaller stones.

2. Sour Candies: Sucking on sour candies can stimulate saliva production, potentially helping to move the stone.

3. Massage: Gently massaging the affected gland can sometimes help to encourage the stone to pass.

4. Medications: If there is swelling or infection, your doctor may prescribe anti-inflammatory medications or antibiotics.

5. Surgical Intervention: If the stone is large or causing significant symptoms, surgical removal may be necessary. This can often be done through minimally invasive techniques.

Concerns About Leaving Stones Untreated
Regarding your question about leaving the stone untreated, it is generally possible for small stones to remain in the gland without causing significant issues. However, there are potential risks:
- Infection: A stone can lead to recurrent infections, which may require more aggressive treatment.

- Chronic Symptoms: You may continue to experience intermittent swelling and discomfort, particularly after meals.

- Larger Stones: Over time, smaller stones can grow larger or new stones can form, potentially leading to more severe complications.

When to Seek Further Medical Attention
If you notice any of the following, it would be wise to consult your healthcare provider:
- Increased pain or swelling that does not subside with hydration.

- Signs of infection, such as fever, redness, or pus.

- Difficulty opening your mouth or swallowing.

- Persistent dry mouth or changes in taste.

Conclusion
In summary, while it is possible to manage salivary gland stones conservatively through hydration and dietary adjustments, it is essential to monitor your symptoms closely. If you experience any worsening of your condition or develop new symptoms, seeking further evaluation from an ENT specialist or your primary care physician is advisable. They can provide a more tailored approach based on your specific situation and may recommend imaging studies or surgical options if necessary.

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