What could be causing excessive belching, swelling under the tongue, and tenderness when applying pressure under the jaw, possibly indicating a lump?

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Differential Diagnosis

  • Single most likely diagnosis
    • Gastroesophageal reflux disease (GERD): The symptom of burping a lot could be related to GERD, which is a common condition where stomach acid flows back into the esophagus. The swelling and pain underneath the tongue could be referred pain from the esophagus or stomach.
  • Other Likely diagnoses
    • Tonsillitis or peritonsillar abscess: The swelling and pain underneath the tongue, especially when pushing up from underneath the jaw, could be related to an infection of the tonsils.
    • Salivary gland stone or infection: A stone or infection in the submandibular salivary gland could cause swelling and pain in the area underneath the tongue.
    • Dental abscess or infection: An infection of a tooth or the surrounding tissue could cause referred pain to the area underneath the tongue.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Ludwig's angina: A severe infection of the tissues in the neck, which could cause swelling and pain in the area underneath the tongue. If left untreated, it could lead to airway obstruction and be life-threatening.
    • Submandibular space infection or abscess: A severe infection in the submandibular space could cause swelling and pain in the area underneath the tongue and could lead to airway obstruction if left untreated.
    • Cancer of the tongue, floor of mouth, or salivary gland: Although less likely, cancer in the head and neck region could cause a lump or swelling in the area underneath the tongue.
  • Rare diagnoses
    • Actinomycosis: A rare bacterial infection that could cause swelling and pain in the area underneath the tongue.
    • Sialadenitis (inflammation of the salivary gland): A rare condition that could cause swelling and pain in the area underneath the tongue.
    • Ranula (a type of mucous cyst): A rare condition that could cause a lump or swelling in the area underneath the tongue.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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