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Seeking Guidance on Recurring Sialadenitis

9/9/2025, 9:01:03 PMMale25-34

Let me lay out my situation as concisely as I can. I am a 24-year-old female experiencing what I believe to be repeated instances of sialadenitis for several years now. These episodes occur multiple times a month and can persist for as long as a week. During these episodes, I experience significant discomfort in my jaw, which radiates down my neck to my shoulder, specifically on the left side. The inside of my mouth becomes quite sensitive and tends to bleed easily during these flare-ups. Moreover, the lymph nodes on the affected side also become enlarged. Recently, I consulted with an oral surgeon for an unrelated issue, and he observed that my salivary flow on the left side was noticeably reduced. Unfortunately, I've reached an impasse with my primary care physician. Back in 2021, when this all began, she referred me to an ENT specialist who performed an ultrasound, but the results were inconclusive. Now, she is reluctant to refer me to another specialist, even as my condition worsens. A few months ago, my blood tests showed that my white blood cell count was slightly low, bilirubin levels were high (which has been a consistent issue), and vitamin D was below normal, while all other results were within the acceptable range. Which type of specialist would be best suited to address this condition?

LupusInternal MedicineRheumatology

Answers (1)

Cony

9/9/2025, 9:01:41 PM

OpenHealth AI

It sounds like you are dealing with uncomfortable and recurrent episodes of sialadenitis, alongside some concerning blood test results. Your symptoms and history suggest the need for a more specialized approach to your care.

Main Points:

  1. Recurrent sialadenitis can indicate underlying issues, such as duct obstructions, autoimmune conditions, or infections.
  2. Your symptoms and lab results may be relevant to a broader systemic condition.
  3. A rheumatologist would likely be the most appropriate specialist to evaluate your situation.

Explanation:

Sialadenitis is inflammation of the salivary glands and can be caused by several factors, including infection, blockage from salivary stones, or even autoimmune diseases, where your body mistakenly attacks its own tissues. The discomfort you feel in your jaw and neck, the sensitivity in your mouth, and swollen lymph nodes are all signs that your body is reacting to an underlying issue.

The fact that your oral surgeon noted reduced salivary flow is significant. Coupled with your lab results—particularly the high bilirubin and low vitamin D levels—it may point to an underlying health concern that requires further investigation.

Next Steps:

  1. Consult a Rheumatologist: Given your symptoms and the possibility of an autoimmune condition, a rheumatologist can conduct a thorough evaluation. They might even test for conditions such as lupus or Sjögren's syndrome, which can affect salivary glands.

  2. Document Symptoms: Keep a detailed diary of your symptoms, including when they occur, their duration, any triggers or associated factors, and how they affect your daily life. This will provide valuable information for your specialist.

  3. Request Comprehensive Testing: During your consultation with the rheumatologist, express concerns about your recurring symptoms and past lab results. Ask if additional tests, such as imaging or specific autoimmune markers, are warranted.

  4. Self-Care Strategies: While waiting for your specialist appointment, you can manage your symptoms. Increase your hydration, as good fluid intake can stimulate salivary flow. Applying warm compresses to the affected area may also help alleviate discomfort.

  5. Discuss Vitamin D Deficiency: Consider discussing your low vitamin D levels with your primary care physician. This can usually be addressed through supplements and lifestyle changes.

While facing such a health challenge can be frustrating, it’s important to remain proactive. If you feel your primary care physician is not addressing your needs, it is within your rights to seek a second opinion or directly consult a specialist.

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