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Q. I feel choking with swelling and irritation in the tongue. Please help.

Answered by
Dr. Syed Tehmid
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 13, 2020

Hi doctor,

I have had this issue for two to three months now and my symptoms are changing. It started with my throat feeling like it was closing every now and again and between my ears and jaw was sore for weeks. My tongue feels swollen and irritated all the time with little red dots around the edges. My tongue also gets sore around the edges mostly in the morning. I have had blood test and after that one doctor told me it was in my head but my recent GP says it is definitely not. I cannot get to see a specialist due to this Covid-19 mess and my symptoms are worsening and now my throat around my glandular area is sore and throat feels restricted and swollen. I do not have trouble swallowing food or drink but just swallowing saliva sometimes gives a choking feeling. No one so far can tell me what is going on. Please help.

I am currently on Pantoprazole 20 mg and Advil.

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Hello,

Welcome to icliniq.com.

Having read through your symptoms I think, if any of doctors could not find any particular cause it might be what we call as burning mouth syndrome with globus sensation. It may be due to certain local conditions like ill fitting dentures, jagged sharp or carious teeth. It may occur due to acid reflux or in disease like diabetes. Even post nasal drip due to sinusitis can cause burning in mouth.Prolonged intake of any medicine can cause this. However, do you have any of these? Of these gastric acid reflux is often the most important cause. Do you smoke? Can you attach a picture of your throat and tongue lesions.

Thank you doctor,

Yes, I have just recently quit because this is scary and I am thinking the worst. Some of my teeth are jagged. I do take the Pantoprazole for acid reflux. The thing that bothers me most is the swollen feeling or closed feeling of my throat and still to swallow. The tongue is not showing as bad today but is still bigger than usual.

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Hello,

Welcome back to icliniq.com.

It will be really helpful if you could attach a picture of your tongue and throat. One more thing I would like to ask is if there is any swollen lymph node in the neck? What about the difficulty in swallowing? Is it progressive or intermittent? Is it for solids, liquids or both? How is your voice? Did your doctor did an indirect laryngoscopy i.e. examination of the throat with mirror or fiberoptic laryngoscopy? If everything is normal then it is most likely due to reflux. Pantoprazole 20 is inadequate you need Pantoprapole 40 plus, Domperidone 30 combination. You will also need to avoid taking heavy meals at night. Avoid hot and spicy, oily, and fried foods. Also, try elevating your head end of the bed by using extra pillows if it does not cause discomfort. Do you snore?

Thank you doctor,

My cameras are not great. My neck feels swollen and a bit stiff. My voice has not changed, I do not think but some times I think I am slurring my words. Swallowing food and drink are normal but just swallowing saliva, in general, feels strange with minor pain all around. Today it is worse than ever. It would flair up worse at times but now my throat is sore and feels like it is closing up and I get a choking feeling. Lips and tongue are tingling, numb, and burning at times. It does feel like my throat is swollen around my lymph glands. There has been no throat examination. They will not look down anyone’s throat at the moment. I cannot get into the specialist for that for a while. My tongue is swollen and I cannot get a good photo of my throat.

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Hi,

Welcome back to icliniq.com.

To be honest your tongue seems fine to me. (attachment removed to protect patient identity).

It is not swollen. You might have a feeling but it is not. You most likely are suffering from globus pharyngeus since dry swallow is more problematic than swallowing actual fluids and solids. And at times it can be severe. I would suggest you stop taking pain medications it can worsen your reflux and globus sensation. If at all the feeling of tingling and pain is severe use topical medicines for tongue like Dologel (Choline salicylate plus Lidocaine) topical ointment to be applied to the tongue.

Take Pantoprazole and Domperidone twice a day half an hour before meals. Use Chlorhexidine mouthwashes after each meal twice or thrice a day. Also, you can try lozenges like Cofsils, Strepsils or whatever you get. To me, it does not seem to be sinister unless you actually develop shortness of breath or effortful breathing or any difficulty or pain swallowing? Further, you also have to control your anxiety. It is important to understand that our brain reinforces our feelings. If you have any urge to cough you try it to avoid it because it often causes more cough. Take plenty of water. Do not let your mouth and throat to dry.

Thank you doctor,

This morning I have tried Valium and my throat has definitely relaxed but my tongue still feels swollen. A few weeks before all this I did have a week off work for a bronchial infection. But that cleared up a couple of weeks before this started. I will take your advice and hope that it works.

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Hi,

Welcome back to icliniq.com.

It will. Have patience. Trying too many GPs will not help. They will run a battery of tests which may not be even required. Bring changes in your diet, lifestyle, and maintain an overall active lifestyle. This will go.


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