Tongue Pain: Is It Related to Behçet's Disease?

Tongue ulcer

Hello Doctor: My mother has Behçet's disease, so I pay close attention to my own health.
Recently, I have noticed that my tongue often hurts, with a swelling pain similar to when I have a sore on my tongue.
The pain occurs on both sides, usually along the edges of the top and bottom of my tongue, but I often do not notice any visible sores.
Typically, the pain resolves completely within a day or two.
This afternoon, I felt pain on the edges of my tongue again; it doesn’t look like a typical ulcer with a white center, just slightly red.
A couple of days ago, I had cold symptoms and saw a doctor who prescribed medication.
I have carefully observed my lifestyle habits, and I find that this sensation or tongue pain often occurs after staying up late for three consecutive nights until one or two in the morning.
When I get adequate sleep that same night and apply an oral ointment before bed, the pain usually resolves in two to three days.
I would like to ask if this could be related to Behçet's disease? Should I get tested for this? I had a genetic test done two to three years ago, which showed no abnormalities.
Also, does this swelling pain in my tongue qualify as an oral ulcer?

Zhu, 20~29 year old female. Ask Date: 2024/06/11

Dr. Zheng Jueyi reply Otolaryngology

Hello, swelling and pain in the tongue are often related to inflammation.
If the ulcer improves within a week, you can monitor it yourself.
However, if it persists for more than a week or does not improve, it is advisable to seek medical attention for further evaluation.

Reply Date: 2024/06/11

More Info

Tongue pain can be a perplexing symptom, especially for individuals with a family history of conditions like Behçet's disease. Behçet's disease is a systemic vasculitis that can cause recurrent oral ulcers, genital ulcers, and ocular inflammation, among other symptoms. Given your mother's diagnosis, it is understandable that you are concerned about your own symptoms.

The pain you describe on the edges of your tongue, which feels similar to the discomfort associated with ulcers but without visible lesions, could potentially be related to several factors. First, it is important to note that Behçet's disease can manifest in various ways, and oral ulcers are a common symptom. However, the absence of visible ulcers does not rule out the possibility of an underlying condition. Your symptoms could also be indicative of other oral health issues, such as:
1. Oral Candidiasis: A fungal infection that can cause pain and discomfort in the mouth, often presenting as white patches or redness.

2. Nutritional Deficiencies: Deficiencies in vitamins such as B12, folate, or iron can lead to glossitis (inflammation of the tongue) and pain.

3. Allergic Reactions: Certain foods or dental products can cause localized reactions, leading to pain or discomfort.

4. Stress and Fatigue: As you mentioned, your symptoms tend to flare up after periods of sleep deprivation. Stress and lack of sleep can weaken the immune system and exacerbate oral discomfort.

5. Burning Mouth Syndrome: This condition is characterized by a burning sensation in the tongue or mouth without an obvious cause, and it can be associated with anxiety or hormonal changes.

Regarding your question about whether your tongue pain could be related to Behçet's disease, it is essential to consider the overall clinical picture. While your symptoms may not currently align with the classic manifestations of Behçet's, it is advisable to consult a healthcare professional, particularly a rheumatologist or an oral medicine specialist, who can evaluate your symptoms in the context of your family history.

In terms of diagnostic steps, the following may be recommended:
- Clinical Evaluation: A thorough examination of your oral cavity to check for any signs of ulcers, lesions, or other abnormalities.

- Blood Tests: To assess for nutritional deficiencies, inflammatory markers, or other underlying conditions.

- Referral to a Specialist: If your symptoms persist or worsen, a referral to a rheumatologist may be warranted to rule out Behçet's disease or other autoimmune conditions.

As for your question about whether the sensation of tongue pain qualifies as an oral ulcer, it is important to clarify that oral ulcers are typically defined as painful lesions that can be seen in the mouth, often with a white or yellow center and a red halo. If you are experiencing pain without visible lesions, it may not be classified as an ulcer but could still be a sign of irritation or inflammation.

In conclusion, while your tongue pain may not currently indicate Behçet's disease, it is essential to monitor your symptoms closely and seek medical advice, especially given your family history. Maintaining a healthy lifestyle, managing stress, and ensuring adequate sleep can also contribute positively to your oral health. If your symptoms persist or worsen, do not hesitate to seek further evaluation to ensure appropriate management and peace of mind.

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