From the Guidelines
I strongly advise against using sour candies to manage parotid gland swelling from purging, as they may exacerbate the condition by stimulating more saliva production. Parotid gland swelling associated with purging behaviors is known as sialadenosis and is caused by repeated activation of the salivary glands during vomiting. While non-pharmacological glandular stimulation using gustatory stimulants like sugar-free acidic candies is recommended for patients with mild glandular dysfunction, such as those with Sjögren's syndrome 1, this approach may not be suitable for parotid gland swelling caused by purging. In fact, stimulating saliva production with sour candies could potentially worsen the swelling.
Instead, consider the following management strategies:
- Apply warm compresses to the affected area several times daily
- Stay well-hydrated
- Practice good oral hygiene
- Most importantly, work toward reducing or stopping purging behaviors, as the swelling typically resolves within days to weeks after purging stops. If the swelling is painful, over-the-counter anti-inflammatory medications like ibuprofen (400-600mg every 6-8 hours with food) may help reduce discomfort. However, if swelling persists beyond 2-3 weeks after stopping purging, becomes increasingly painful, or is accompanied by fever, seek medical attention as this could indicate an infection or other complications.
From the Research
Parotid Gland Swelling from Purging
- The parotid gland swelling associated with bulimia nervosa, or BN, can present a diagnostic dilemma 2.
- Patients with BN who have parotid gland swelling usually are secretive about their purging, making diagnosis challenging 2.
- The use of sour candies is not mentioned in the provided studies as a treatment for parotid gland swelling from purging.
- However, a study suggests that a cholinomimetic medication, such as pilocarpine hydrochloride, may help resolve parotid gland enlargement associated with self-induced vomiting in bulimic patients 3.
Treatment Options
- Pilocarpine hydrochloride has been shown to be beneficial in the treatment of sialadenosis in bulimic patients, with a marked diminution in the size of the parotid gland enlargement 3.
- Early diagnosis, adequate evaluation, and proper management are crucial in achieving optimal treatment outcomes for salivary gland trauma, including parotid gland and duct injuries 4.
- Treatment of parotid duct injuries varies with the anatomic location and the type of injury involved, and may include surgical intervention 5, 4.
Diagnosis and Management
- A clinical examination and a serum electrolyte study can help confirm the diagnosis of parotid gland swelling associated with BN 2.
- Assessment of the disease process should differentiate local primary parotid infection from systemic infection when this gland is also involved as part of a generalized inflammatory condition 6.
- Prompt diagnosis and treatment can help avoid serious medical complications, such as dehydration, malnutrition, and infections 2, 6.