I have rheumatoid arthritis and parotid glad swelling? weird!?

I've had rheumatoid arthritis for about 10 yrs but have just recently (1.5 yrs) had swelling of my parotid glands. I hate it so much and would do anything to get rid of this swelling on both sides of my face, right underneath my cheeks and ears. Any suggestions? I know it's secondary Schogren's Disease, but I do not have dry eyes or mouth, just swollen parotid glands!

sounds like you to need to talk to your rheumatologist and your ENT for a definite diagnosis and the proper treatment.

You need to talk to your doctor.


.Recurrent, painful swelling of the parotid gland (located on the side of the face, in front of the ear) is known as "chronic sialadenitis," and Sjogren's syndrome is only one of many possible causes. In all cases, there is obstruction of the flow of saliva through the parotid duct (the tube that channels saliva from the parotid gland into the mouth). With Sjogren's syndrome, obstruction presumably occurs because swelling of the gland puts pressure on the duct.


Conservative treatment of chronic sialadenitis involves the following measures:

Staying well hydrated. I recommend that patients drink eight to 10 eight-ounce glasses per day of nonalcoholic, noncaffeinated beverages. Avoiding any alcohol or caffeine is helpful.

Stimulating the flow of saliva. I often recommend that patients suck on sour candies, but this is damaging to the teeth in the long run. A safer course is to chew sugar-free gum frequently throughout the day. FIRM massage of the parotid gland (no bruises, please) can also help stimulate salivary flow.

Using soothing warm packs when the glands are particularly tender.

Watching for infection. If one or both parotids becomes very swollen, tender and red, I worry about bacterial infection. A staphylococcus species is the usual culprit. Antibiotics are necessary, and it is imperative that the antibiotic kill staphylococcus. Penicillin, ampicillin (Omnipen) and amoxicillin (Amoxil) are NOT appropriate antibiotics.


If your parotid swelling is related to Sjogren's syndrome, you may want to ask your doctor about more aggressive treatment of Sjogren's syndrome. Ask him or her about the drug hydroxychloroquine (Plaquenil) and about drugs to suppress the immune system. All of these medicines have associated risks and side effects, so you will need to have a careful discussion with your doctor before you can knowledgeably weigh your options.

If conservative treatment consistently fails to help you, and if more aggressive treatment of your Sjogren's disease is ineffective, surgical removal of the parotid(s) is an effective option OF LAST RESORT. This operation (called "total parotidectomy") carries with it risk to the nerve that controls the muscles of facial expression and will inevitably leave you with a much drier mouth.