Bulimia and Swollen Parotid Salivary Glands

By January 10, 2013

I am writing most immediately because of a response Dr. Brenda Woods gave to a question about Bulimia and swollen parotid salivary glands. You gave one of the only direct responses I have been able to find in my research and I appreciated it so much that I had to contact you. I will make this very brief because I know you are extremely busy. I am just hoping you can answer a couple of questions. I was bulimic for 2 years and in denial for most of it. I am a young high school teacher (24), so the problem, which developed, I believe, in response to stress and some significant unhappiness, was compounded by the cognitive dissonance of having such a problem while trying to set a good example for my wonderful kids. Anyhow, I had a moment of “NO MORE” in December, and have now neither binged nor purged for nearly 3 months. However, my glands are still very swollen, and they even seem to swell and tingle more at various points in the day, as they might have when I was purging a lot, but stopped for a day or two. I am lucky in not feeling other terrible things such as bleeding or digestive pain, but the glands are troubling. They are not painful, but the “awareness” of them on my face is like mild torture. Again, they just tingle a lot and feel puffy, and it is unbelievably disconcerting. My habit was pretty serious – I purged fully twice a day most days. From what I have read, I probably seriously disrupted the electrolyte balances in my body and the swelling of the glands is a real response to acute dehydration. So, it makes sense that my body would take a significant time to recalibrate, even though I did not suffer as long as some with the disorder. 1) My first question is just this: is it normal for it to take a significant number of months for glands to resolve? Almost no responses I have read on this subject have indicated a time period for resolution, remaining very broad about them resolving only after “not purging for a lengthy time” or something to that effect. 2) My other question is: have you heard of the use of Salagen to relieve the swelling and aid in resolution of the parotid glands? I have read of this in a few places. I know there are side effects, but if the glands are extremely troubling for me, would it be worth trying this medication? 3) Finally, my main concern is the medical question of my glands, but I cannot figure out for the life of me what kind of medical doctor I might try to contact about this. It seems that many would not know what to do. Again, thank you so very, very much for your time. I feel strong and confident that I am well on my way to recovery, that I pulled strength from within, but I would appreciate your insight into these questions more than you can imagine.

Dear Visitor,

I am glad that you are moving toward recovery. Congrats on three months of no purging! This is a great accomplishment!

First of all, I would have a medical professional check your glands. Sometimes prominent jaw muscles are mistaken for parotids even by people who work with ED patients. It would also be important to have an exam to be sure that if it is your parotids, that there is no mass or growth on them.

Additionally, sometimes a person can develop stones in their salivary ducts that lead to dramatic swelling. Please tell your doctor about your ED history if they don’t already know. It’s hard, but it will help them know what to look for.

When my patients leave treatment, even after 2 months, many have some parotid enlargement, although better than when they were admitted. At three months, I would expect the swelling to be nearly resolved, although it is not beyond the normal time frame for this to normalize.

I am not familiar with the use of Salagen for this purpose. Something simple and with no risk of ill effects is lemon juice or lemon drops. This promotes the release of saliva and can help if the parotids are congested.

Another question you should consider: are the parotids truly enlarged or are you experiencing some body image issues with regard to your face shape? Many patients I have treated with bulimia say they always think their face “looks fat.” This is another reason why I have suggested that a medical professional check out the parotids to be sure that it truly is the gland you are noticing.

I wish you the best in your ongoing recovery!

Brenda K. Woods, MD, FAAFP