Swollen Glands

Swollen glands refer to the swelling of the lymph glands or nodes, particularly the one present in the throat. Lymph glands are distributed throughout the body and play an important role in fighting diseases.

Lymph glands are present singly or in groups, and are visible only when swollen or enlarged. A group of lymph nodes is present in the neck, groin, and armpit. Swelling of lymph nodes is known as lymphadenopathy.

Lymph glands present in the neck, armpit and behind the ears are easily visible when compared to others. They store white blood cells and destroy the foreign particles that gain access into the body.

They stop or fight bacteria and viruses and act as a checkpoint for these organisms. At the time of an infection, dead cells, bacteria, viruses, and other organisms accumulate in the glands. These glands swell, few centimeters in diameter, during an infection.

One of the most common causes of the swollen gland is an infection. Inflammation and cancer may also lead to swelling in the gland, though not as frequently as an infection.

Cancer that originates in other parts of the body may spread to the lymph gland. Apart from swelling, other symptoms are seen accompanying this condition. Other symptoms depend on the underlying cause of the swelling.

Some common symptoms seen with swollen glands are: 

• Runny nose
• Sore throat
• Swelling in limbs
• Hard, enlarged nodes
• Fever
• Night sweats

Swelling of glands may be localized or general. Generalized swelling is usually seen in the case of HIV infection or immune system disorders like lupus.

Swollen lymph nodes in the limbs indicate blockage of lymphatic channels in the region. Enlargement of nodes is rapid when caused by a tumor. Swelling in glands may reduce when the associated infection is resolved.

But in some cases, swollen gland may warrant medical attention, particularly if:

• The swelling has a sudden onset
• Growth of gland continues
• Swollen glands are hard and not flexible
• Other symptoms include fever, night sweats, and weight loss
• Is associated with difficulty in swallowing
• Is associated with a sore throat

Medical history, physical examination, blood tests, and imaging studies are all used in the diagnosis of the underlying cause for the swelling. Lymph node biopsy may be recommended in some rare cases for confirmation of diagnosis.

Treatment of swollen glands also depends on the actual cause of the symptom. No specific treatment is required for a viral infection that leads to swollen glands. The swelling may resolve once the infection is through.

Swelling reduces with the help of medications and therapies that control the underlying condition. Mild forms of lymphadenopathy can be alleviated with simple home remedies and treatment.

If left untreated, swelling in glands may lead to complications like abscess formation. Bacterial infection may lead to sepsis, a condition characterized by blood stream infection. Sepsis is a potentially life-threatening condition and requires hospitalization for treatment.

Increased activity of the lymph gland due to triggers like infection and inflammation lead to swollen glands. During an infection, the lymph nodes filter the lymphatic fluid and launch a fight against the foreign object.

During this process, the nodes accumulate debris that contains dead bacteria or other invading organisms, and dead cells. Swollen glands may be caused by bacterial, viral, and fungal infections. The common cold is one of the most common causes of swelling in the glands.

Other causes include:

• Viral infections like chickenpox, infectious mononucleosis, adenoviral infections, measles, herpes, and HIV may all result in swollen lymph glands.
• Streptococcus, tuberculosis, chlamydia, syphilis, staphylococcus, cat scratch disease, and sexually transmitted bacterial infections also cause enlargement of lymph glands.
• Some parasitic infections like toxoplasmosis and leishmaniasis have swollen lymph glands as one of the associated symptoms.
• Fungal infections that cause swollen lymph nodes include coccidiomyosis and histoplasmosis.
• Swollen lymph glands may also be caused by head lice infestation and infections of the tooth.
• Inflammatory diseases systemic lupus erythematosus and rheumatoid arthritis are also implicated in the enlargement of the glands.
• Certain cancers may also result in swollen lymph glands. Lymphomas that originate in the lymph glands are leukemia that originates in the blood cells are common ones that lead to swelling in the nodes. Cancers that originate in another part of the body may spread to the lymph node. Breast cancer usually spread to the lymph node present in the axilla.
• Transplant graft rejection and genetic lipid storage disease may also lead to swollen glands, though not as frequently as other diseases.
• Certain medications are known to cause swelling of glands. This includes anti-seizure and antimalarial drugs.

In some people, a slight swelling in the glands is not considered abnormal. Small, flat and slightly enlarged lymph gland under the jaw is normal in some children and adults. Swelling in the lymph nodes of the groin is also normal in some young adults. In some rare cases, the underlying cause of the symptom may not be determined.

Cancer is the suspected cause of the swelling if the swelling:

• grows and persists for more than two to three weeks
• is painless and hard to touch
• does not move flexibly when touched
• is associated with night sweats and unexplained weight loss

As mentioned earlier, nodes or glands may be present singly or in groups. Each lymph node or group drains the lymphatic vessel present in the specific region. Thus swelling of specific glands indicates inflammation or infection in that region.

For example, infections of tonsils and throat, and common cold lead to swelling of lymph nodes in the neck. Scalp conditions like head lice lead to swelling of the lymph gland at the back of the head.

Skin infections lead to swelling of lymph nodes in the armpit. Swelling of groin nodes is caused by leg infections and nappy rash. Viral infections generally affect the whole body. Thus flu and chicken pox may result in swelling of lymph glands in the neck, groin, and armpits.

The swelling of the gland may be as small as a pea or as large as a cherry. The swelling may be flexible and may move when touched. It may be painful or painless.

During the physical examination, the doctor may feel the nodes that are present closer to the surface of the body. This helps in identifying the most probable cause of the condition.

Nodes present in the sides of the neck, groin, and underarms can be felt easily and are evaluated for the cause of swelling. The most visible lymph node in the body is the tonsil, present at the back of the throat. Nodes present deep inside the body are checked with the help of imaging techniques.

The underlying cause of the condition is evaluated with the help of medical history and a thorough physical examination. Information on other symptoms associated with the swelling is also of help.

This includes details of a sore throat, fever, chills, medications, weight loss, and travel history. Location of swelling also provides a clue regarding the cause of the symptom as lymph nodes respond to the disturbance in the location. Thus the presence of swollen glands under the arms may be due to a localized skin infection.

Swollen lymph nodes are categorized on the basis of tenderness, size, mobility, hardness and firmness. These features also help in the identification of the most probable cause of swelling.

Hard, immovable, and consistently growing nodes may be caused by cancer in a node, while small, tender, and movable swellings may be caused by infections. Lymph node biopsy is the recommended investigation technique if the suspected cause is cancer. A biopsy helps to identify the type of cancer.

In most of the cases, swollen glands are harmless and resolve without any specific treatment. Swelling caused by any underlying condition can be reduced by treating the condition as such.

Monitoring is the conventional method followed in the treatment of swollen glands. Swelling caused by viral infection may resolve when the infection is resolved. Bacterial infections are treated with antibiotics and help to reduce the swelling in the gland.

Specific treatment focusing immune disorders like rheumatoid arthritis and lupus helps to control the swelling indirectly. Cancer is treated by chemotherapy, surgery, or radiotherapy.

Surgery to remove lymph node is suggested if the lymph node is large and is associated with other findings like enlarged liver or spleen. Abnormal blood count and enlarged nodes in x-ray also indicate the need for surgical removal of nodes.

The nodes may remain swollen for some time even after the infection is resolved or condition is treated. This is more prominent in children in which the swelling may remain for few weeks even after the successful treatment of the underlying condition.

Swollen lymph glands are associated with certain complications like abscess formation. This is particularly true if the underlying infection is not treated. Abscess formation is treated by drainage and antibiotics. An enlarged lymph node above the collar bone is a sign of more serious condition like Hodgkin’s disease.

Basic home care for swollen glands includes painkillers like ibuprofen and paracetamol. Adequate rest and drinking plenty of fluids also help. Swollen glands caused by bacterial infection can be prevented to a certain extent. Early antibiotic treatment and properly cleaning the wounds are effective in preventing infection.