A swollen uvula is a symptom of uvulitis, or inflammation of the small fleshy part of the soft palate (the uvula) that hangs down from the roof of the mouth at the back of the the throat.
A swollen uvula can be caused by conditions like gastroesophageal reflux disease (GERD), mononucleosis, hereditary angioedema, or tonsillitis and may be accompanied by other symptoms like sore throat, cough, fever, and a burning sensation in the back of the throat.
A primary care provider or an otolaryngologist (ENT) should be consulted for further workup of a swollen uvula. Treatment may include rest, salt water gargles, or medications like antibiotics, antihistamines, or analgesics.
Main causes
The main causes of a swollen uvula are:
1. Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is a condition characterized by the involuntary return of the stomach contents to the esophagus, causing irritation and symptoms like a swollen uvula, burning in the back of the throat, heartburn, a bad taste in the mouth, and a feeling like there is a lump in your throat.
Treatment options: Non-pharmacological treatment of GERD includes following a healthy diet, reducing consumption of alcohol and foods high in fat, and avoiding smoking.
A provider may also prescribe medications like omeprazole (Prilosec) or esomeprazole (Nexium) that reduce the production of stomach acid.
2. Mononucleosis
Mononucleosis, also known as the kissing disease, is an infection caused by the Epstein-Barr virus that causes symptoms like a swollen uvula, high fever, throat pain and inflammation, and white patches on the throat.
Treatment options: Treatment of mononucleosis involves rest, pushing fluids, and taking medications like anti-inflammatories and analgesics prescribed by a healthcare provider to relieve symptoms like sore throat, fatigue, or fever.
3. Strep throat
Streptococcal pharyngitis, also known as strep throat, is a throat infection caused by Streptococcus bacteria. Symptoms include a swollen uvula, sore throat, white patches on the back of the throat, difficulty swallowing, and fever.
Treatment options: Treatment of strep throat is managed by a primary care provider and involves the use of antibiotics, anti-inflammatories, and analgesics to combat bacteria, reduce throat inflammation, relieve pain, and lower fever. More severe cases may require antibiotics administered directly into the vein.
Foods with a liquid or creamy consistency, such as oatmeal, soups, fresh juices, and purees, can also help relieve pain and discomfort in the throat.
4. Hereditary angioedema
A less common cause of a swollen uvula is hereditary angioedema (HAE), which is a rare genetic disease characterized by recurrent episodes of fluid accumulation outside the blood vessels that blocks the normal flow of blood and lymphatic fluid, causing rapid swelling of the hands, feet, limbs, face, or airways.
Treatment options: An immunologist, allergist, or general practitioner can prescribe medications like icatibant, danazol, or tranexamic acid to help prevent or treat a crisis.
Swelling of the throat, however, requires immediate medical attention at the nearest emergency department to avoid obstruction of the airways that can cause difficulty breathing.
5. Tonsillitis
Tonsillitis is an infection of the tonsils caused by viruses or bacteria leading to inflammation of the tonsils that can also affect the uvula. Symptoms include sore throat, a swollen uvula, difficulty swallowing, and fever.
Treatment options: Treatment varies based on the cause of the infection and may involve rest, oral hydration, antibiotics, or anti-inflammatories to relieve pain and lower fever. A primary care provider or ENT can recommend the best treatment.
Home remedies like salt water gargles or star anise tea can also help alleviate symptoms.
6. Allergies
Allergies to medications, pollen, or certain foods can cause an accumulation of fluid in the mouth and the back of the throat, leading to a swollen uvula. Other symptoms include itching and redness of the skin, sneezing, cough, and headache.
Treatment options: An allergist or primary care provider can prescribe medications like antihistamines, decongestants, and corticosteroids.
Symptoms of a severe allergic reaction, or anaphylaxis, include difficulty breathing, throat closure, and swelling of the mouth, tongue, or face. These cases require immediate treatment at the closest emergency department, which typically involves the administration of adrenaline, corticosteroids, and antihistamines by injection and continuous monitoring of vital signs.
7. Smoking
Smoking can cause a swollen uvula from substances present in tobacco that can irritate the tissues in the throat, including the uvula, causing inflammation.
Treatment options: Medications like varenicline or bupropion can be used to help decrease the urge to smoke and alleviate symptoms like anxiety, irritability, or weight gain that can be associated with quitting smoking.
8. Roseola
A swollen uvula can also be caused by roseola, or sixth disease, which is a viral infection with symptoms like a high fever, cough, and throat pain and irritation.
Treatment options: Treatment of roseola should be done by a pediatrician and involves managing symptoms with medications like acetaminophen to reduce fever and prevent febrile seizures.
When to see a doctor
Reasons to see a doctor include a swollen uvula that does not get better within a few days or is accompanied by fever, pus, or worsening pain, swelling, heat, or redness.
Symptoms like difficulty breathing, blue skin or lips, or swelling of the tongue, lips, face, or throat require immediate medical attention at the closest emergency department.