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Q. I have a burning sensation at the back of my tongue. Why do I have this?

Answered by
Dr. Syed Tehmid
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Nov 14, 2020 and last reviewed on: Feb 01, 2021

Hello doctor,

My doctor thought it was oral thrush, so she prescribed me some antifungal medicine for ten or so days. I finished that medicine around 12 days ago, and the tongue issue did not go away. Five days ago, I went to urgent care, and the doctor prescribed me a 150 mg Fluconazole or Diflucan tablet for oral thrush. That did not do the trick either, so now I know for sure that my tongue issue is not thrush. Even though my tongue does not burn nearly as much as the first two weeks, the appearance of the back of my tongue still looks the same for the most part, and my tongue still feels off and burns a little. Part of the day, I feel it more than others. At this point, I want to know what I have, so I can take the right medicine, etc., and get rid of this issue. I want my tongue to go back to normal. I was hoping you guys can give me your opinion and tell me the possible things that I could have? What does it sound like to you guys? Can you list some strong possibilities of what I may have? I would appreciate help with this. Thanks.

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Hello,

Welcome to icliniq.com.

Since you have been already treated for oral thrush and other possibilities have also been almost ruled out, one is tempted to think about what we call burning mouth syndrome or glossodynia. And among the most important causes for it is acid reflux. Since long-standing gastric problems often cause a burning sensation in the mouth.

  • Have you been using any medicines for a long time?
  • Do you have any other medical conditions?
  • Do you have any pictures that you can attach?
  • Is there any painful swallowing?
  • Are there any neck nodes?
  • Have you been prescribed any antacid medications? Have you used any anesthetic or analgesic sprays?

Hello doctor,

Thanks for your reply.

I have read about burning mouth syndrome online, but I read that it is very rare and also that it is much more common in older women. Not saying that I do not have it, but I feel it is unlikely. But you never know. I hope I do not have that, though, because I read that burning mouth syndrome cannot be cured. I have never been diagnosed with acid reflux, and I have not had gastric problems in the past. I also do not have any heartburn. Is there a possibility that I can have “silent reflux,” though? I read that silent reflux is basically like acid reflux but without heartburn.

No, I have not been on any medicines for long, and I do not have any other medical condition. I did have COVID-19, but it has already been four months since that. But is there a chance that this tongue issue can be an aftermath effect of COVID-19? If so, I wonder why this would occur so long after recovering from that. I am not even sure what to think at this point. I want my tongue back to normal as soon as possible. I am so frustrated.

I do not have any pain swallowing, and I also do not have any swollen neck nodes. This tongue issue seems so random and mysterious. And no, I have not been prescribed any antacid medications. I also have not used any anesthetic or analgesic sprays. I have attached a picture of my tongue. See the attachments. Thanks.

#

Hi,

Welcome back to icliniq.com.

The picture (attachment removed to protect patient identity) you have attached does look like oral thrush. Since you have been treated with antifungals, you do not need any other antifungals, though you can use topical antifungals like candid (Clotrimazole) mouth paint. Of course, nocturnal reflux can be silent, and the patient presents with a lump in the throat or even symptoms like a sore throat or burning mouth. You can use Difflam (Benzydamine) spray or use topical gels containing Choline salicylate and Lignocaine. Burning mouth syndrome is a specific diagnosis rather than a wide term encompassing various entities with no apparent cause. Well, change in taste can be a sequel of COVID-19, but glossodynia has not been reported. You try taking proton pump inhibitors like Pantoprazole 40 mg for a couple of weeks because glossodynia is of gastric origin most of the time.


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