OpenHealth Q&A

Insights Needed on Recurring Jaw Swelling and Dry Mouth During Pancreatitis Episodes

I am a 58-year-old woman, 5'4" tall, weighing around 150 pounds, grappling with a history of chronic pancreatitis alongside psoriatic arthritis. **Medication Regimen:** My current medications include Lyrica and Tramadol. **Psoriatic Arthritis Treatment History:** I was previously treated with Cosentyx but have paused this due to experiencing a pulmonary embolism last December. **Symptoms of Pancreatitis:** During flares of pancreatitis, I suffer from intense burning pain beneath my left rib cage that often radiates to my back. Lying on my side and rolling forward provides me with some much-needed relief. **Jaw and Salivary Gland Concerns:** Alongside my pancreatitis symptoms, I notice swelling and discomfort with a hard, painful lump that forms beneath my left rear jawbone, potentially linked to the submandibular salivary gland. Unfortunately, neither Lyrica nor Tramadol seem to ease this discomfort. When I express the gland, it produces a foul-tasting discharge. I've attempted remedies like lemon juice and salt water, yet I also experience considerable dry mouth at these times, making it challenging with food and causing my teeth to stick to my lips. **ENT Consultation Background:** An ear, nose, and throat specialist once suggested that I might have a salivary stone and proposed opening the gland for treatment. Nevertheless, the fact that this swelling typically coincides with my pancreatitis flares makes me wonder if it is a separate issue altogether. By the time I secure an appointment with the ENT, the swelling often subsides, which adds to my frustration, especially since my ENT has recently retired. **Current Management and Concerns:** My pancreatitis generally remains stable, with flare-ups occurring every few months, which I manage by fasting for 24 to 48 hours. The salivary gland issue leads to discomfort that typically requires manual expression for relief or results in prolonged resolution. It has been some time since I visited my gastroenterologist due to the chronic nature of my pancreatitis, and my rheumatologist oversees my monthly treatment as the arthritis symptoms are more complex to manage. I’ve come to notice that the salivary issues consistently arise concurrently with my episodes of pancreatitis. **Upcoming Lab Tests:** I have a series of labs scheduled for this month, which include a Comprehensive Metabolic Panel (CMP), Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR), Amylase, Lipase, and for the first time, IgG subfractions. My Angiotensin-converting enzyme (ACE) levels are also elevated, currently over 150. **Questions for the Community:** 1. With both conditions coinciding, how can one differentiate between a salivary gland infection and inflammation? 2. What insights can be shared regarding the potential link between episodes of chronic pancreatitis and salivary gland swelling or dysfunction? 3. What should my course of action be now that my ENT has retired, particularly given the episodic nature of the swelling in the salivary glands? I find myself feeling anxious and frustrated by these persistent problems. Any advice or insights from the community would be greatly appreciated. Thank you in advance.

Answers (1)

6/26/2025, 9:10:50 PM

OpenHealth AI

It sounds like you're facing multiple interconnected issues with your chronic pancreatitis and recurring salivary gland troubles, which can understandably be quite frustrating and concerning. Let's break this down into clear points and actionable steps for you.

Main Points:

1. Differentiating Salivary Issues: The recurring jaw swelling may relate to either a salivary gland infection or inflammation.
2. Potential Link Between Conditions: Episodes of chronic pancreatitis may affect salivary function indirectly.
3. Next Steps for Management: Since your ENT has retired, establishing a new treatment plan is essential, especially given the episodic nature of your symptoms.

Explanation:

1. Salivary Gland Conditions:

   • Infections are often characterized by localized pain, swelling, redness, and sometimes fever, usually caused by bacteria or blocked ducts (like salivary stones).
   • Inflammation can result from various factors, including dehydration, medications, and underlying conditions such as pancreatitis. Dry mouth and swelling coinciding with your pancreatitis symptoms suggest a possible connection.

2. Link Between Pancreatitis and Salivary Glands:

   • The body’s inflammatory responses and changes in hydration during pancreatitis could theoretically contribute to issues with saliva production and health. The discomfort you experience with your salivary gland during flare-ups may indicate that inflammation in your body is systemic, affecting multiple systems.

Next Steps:

1. Continue Symptom Tracking: Maintain a detailed log of your symptoms, focusing on the timing of your salivary gland swelling in relation to your pancreatitis flares. Note any specific foods or activities that might correlate with these episodes.

2. New ENT Referral: Seek a referral to a different ENT specialist as soon as possible. When making the appointment, provide them with your history of salivary gland issues and the relation to your pancreatitis. You may mention your previous salivary stone diagnosis to expedite evaluation.

3. Hydration and Oral Care:

   • Stay Hydrated: Ensuring adequate fluid intake can help alleviate dry mouth symptoms and support salivary function. Consider using saliva substitutes or mouthwashes specifically designed for dry mouth.
   • Oral Hygiene: Maintain good oral hygiene to protect against discomfort from dry mouth, as it's crucial for preventing dental issues.

4. Consult with Gastroenterologist: Given your history of chronic pancreatitis, it might be beneficial to see your gastroenterologist to discuss the connection between your pancreatitis and salivary issues, especially as you have upcoming lab tests. Ensure they know about the elevated ACE levels.

5. Follow-Up on Symptoms: If you experience recurrent or worsening swelling in the salivary glands, consider visiting a healthcare provider sooner, especially if accompanied by fever or severe pain.

Your experiences validate your feelings of anxiety and frustration. It's important to advocate for yourself until clear solutions are found. If things feel too overwhelming, discussing your concerns with a mental health professional can also provide valuable support during this challenging time.