Swollen Uvula (Throat)

Uvulitis is the medical term for an inflamed uvula. The process of inflammation causes swelling of the uvula and this may also be accompanied by pain and redness. Since the uvula is a suspended organ, inflammation will cause it to hang down more than usual or even touch the tongue apart from its horizontal  expansion.

The uvula may swell for a number of reasons and this is usually associated with inflammation of the neighboring mouth and throat structures.

Presentation of a Swollen Uvula

At times it is difficult to identify a swollen uvula from a normal uvula just based on its size and length. Anatomical variations may mean that the uvula is naturally long or big in some people. When elongated due to swelling, the uvula may appear to touch the tongue, however it is important to take note if the uvula is swollen or if it is the tongue that is inflamed (glossitis). In obese or overweight patients, the tongue may be raised upwards making the distance between the tongue and palate much smaller. In this case, the structures at the back of the throat, like the uvula,  may not be clearly visible.

Other signs and symptoms may help with identifying an enlarged uvula due to swelling and these include :

• Redness of the uvula.
• Pain which aggravates when the uvula is touched or during swallowing.
• Sensation of a foreign body at the back of the mouth or throat.
• Changes in the voice quality  from the normal tone.
• Gagging.

In a case where the uvula become swollen due to edema without an infection or inflammation, then the uvula may appear enlarged and pale. This uvula edema is known as uvular hydrops or Quincke’s edema and typically occurs due to non-infectious causes like an allergy.

Causes of a Swollen Uvula

When identifying the cause of a swollen uvula, it is important to take note of other concomitant signs and symptoms. This will assist with a correct diagnosis as a swollen uvula is usually a symptom of an underlying condition rather than being a disorder on its own. Some causes of a swollen uvula include :

• Infection. Throat infections like a strep throat will cause inflammation of the uvula along with surrounding throat structures like the the tonsils (tonsillitis) and pharynx (pharyngitis).
• Allergy. Angioedema causes the uvula to swell (Quincke’s disease) and other signs and symptoms of an allergic reaction will also be evident, like swelling of the cheek, upper lip, around the eye, itchy throat, skin or eyes and/or an itchy skin rash.
• Chemical trauma. Certain ingested substances, either food or drink, can cause irritation of the mouth and throat structures including the uvula. This includes acidic, spicy and hot substances or other known irritants. like alcohol. Mouth washes made of herbs and other chemicals that may cause irritation of the lining of the mouth and throat and may result in uvulitis.
• Physical trauma to the mouth or throat by the deep insertion of large foreign bodies into the mouth – example endoscope or after intubation.
• Gastroesophageal reflux disease (GERD). In severe cases, the rising gastric acid pools in the back of the throat, especially during sleep, and can inflame the structures at the back of the throat.
• Nasal congestion or any other cause of mouth breathing will cause edema of the uvula where it will appear pale, yet swollen.
• Dehydration may also cause a pale swelling of the uvula.
• Snoring.
• Uvula piercing.
• Vomiting.
• Mouth sores that may affect the uvula.
• Post nasal drip.
• Persistent coughing.
• Peritonsillar abscess.
• Cigarette smoking.
• Narcotic use – smoking or ‘snorting’ narcotic drugs.
• Prescription drugs.

The uvula tends to hang downwards (vertically) but may deviate laterally (to the side). The deviation of the uvula, along with swelling, may be a strong indication of a peritonsillar abscess or parapharyngeal abscess. A deviated uvula with no evident swelling may be due to a lesion of the vagus nerve, which is the cranial nerve that innervates the uvula.