Gland Swelling

WHEN TO SEE YOUR DOCTOR

* Your swollen glands persist for more than two weeks after an infection has passed.

* You have swollen glands all over your body.

* You have swollen glands and have not had a recent cold or sinus, ear or upper respiratory infection.

* You have a large, hard gland that doesn't move easily.

* Along with swollen neck glands, you have fever, trouble swallowing, a chronic sore throat or trouble breathing, particularly if you smoke or drink alcohol.

* One of your swollen neck glands is getting larger than the others.

What Your Symptom Is Telling You

Your swollen glands may feel a little like Frankenstein's neck bolts at the moment, but they're actually staging grounds for an army of good guys.

Scattered throughout your body are more than 500 lymph glands. They are gathering places for white bood cells—the cells that your body's immune system uses to fight infection. The glands swell when the white blood cells mount a defense against invading bacteria. The glands are also part of the drainage system that your body uses to cart away the debris that accumulates as it fights infection. The lymph glands drain into larger lymph nodes that are clustered in several areas of the body, including the armpit, groin and jaw. These nodes sometimes swell in response to an infection at a distant site—for example, an infected foot might produce a swollen lymph gland in the groin area.

A normal lymph node is a soft, rubbery, movable mass that is less than ¼ inch in diameter. When glands swell, they become large, hard and tender.

The glands in the neck are most likely to swell—a common response to a cold or upper respiratory infection. Why the neck? Over 30 percent of your body's lymph glands lie above the collarbone in the neck and throat, says Frederick Godley, M.D., an otolaryngologist with the Harvard Community Health Plan in Providence, Rhode Island.

Swollen neck glands may also indicate either a viral sore throat or a bacterial infection, such as strep throat. Infections of the sinuses, ear or skin can also cause your neck glands to swell. And a dental problem can bring on the swelling, as can an infection resulting from a cat scratch. More serious, though less likely, causes of swollen neck glands are illnesses like mononucleosis, tuberculosis, syphilis and some types of cancer, such as Hodgkins' disease.

Symptom Relief

Since swollen glands are most likely caused by an infection, the key to getting rid of them is to treat the underlying infection. Here's what you can do.

Try heat. While treating the infection, you can ease the pain in your swollen glands by applying a warm washcloth or heating pad for 15 minutes three or four times a day, Dr. Godley suggests.

Stamp out strep. It's important to treat strep throat because, left untreated, it could lead to rheumatic fever, a condition that can damage the heart, says Nelson Gantz, M.D., chairman of the Department of Medicine and chief of the Infectious Diseases Division at the Polyclinic Medical Center in Harrisburg, Pennsylvania, and clinical professor of medicine at the Pennsylvania State University College of Medicine in Hershey. That's why, if your swollen glands are accompanied by a persistent sore throat, you'll need to see your doctor. Your doctor will use a throat swab to take sample cells from your throat for a culture. If you do have strep, your doctor will prescribe a course of antibiotics to cure the infection, says Dr. Gantz.

Investigate other infections. Skin infections in the scalp, temple or face as well as sinus and ear infections, can cause your glands to swell, says Randy Oppenheimer, M.D., an otolaryngologist in Encinitas, California. Your doctor will treat these and any other infections with prescription antibiotics, he says.

Expect some tests. If the cause of your swollen glands isn't easy to determine, your doctor may ask you to return for several visits or further tests. In addition to blood tests or x-rays in certain cases, your doctor may sample some of the tissue within the lymph node using a technique called needle aspiration, says Dr. Godley. "In most cases, this is a short and simple in-office procedure," he says. After your skin is numbed with a local anesthetic, a needle is passed into the gland and some of the cells are withdrawn for examination.

Take a closer look at the lymph node. Your doctor may use x-rays to help diagnose the cause of your swollen glands. Or a single lymph node may be surgically removed after needle aspiration. In the unlikely event that you have a malignancy of the lymph system, Dr. Godley says, you would be treated with cancer-fighting drugs.