What is Uvula?
Uvula is a bell shaped tissue that appears like a dangling grape like structure at the back of the throat.
Picture 1: Uvula.
Image Source: google.com image
It is made up of connective tissue, muscle fiber, and a number of glands.
Researchers are still baffled about the exact function of the uvula.  They have attributed various functions to uvula –
- Uvula helps in preventing the food from going into the nose while swallowing by effectively sealing off the opening between the nasal cavity and the pharynx.
- Uvula is believed to be an accessory organ of speech. It influences the tone of the voice, that is, it is required to bring out the guttural sound of a few consonants, for example, K or G in languages such as French, Arabic, or German where the palate and the uvula work together to produce what is called the ‘uvular consonants’.
- However, the most important function attributed to the uvula so far is its ability to produce copious thin and watery saliva. A literature review by Gary Back and his colleagues at York District Hospital, York, revealed that a common complication of uvulectomy (surgical removal of the uvula) is dryness of the throat. The researchers thus proposed the theory that the uvula bastes the throat and thereby helps keep it moist and well lubricated. 
Causes of Enlarged or Swollen uvula
Enlarged uvula or swollen uvula is medically termed uvulitis. In most cases when the uvula swells the surrounding structures such as the epiglottis and tonsils are also affected. Many people with swollen uvula may feel that their uvula is touching their tongue or sticking to the tonsils. Sore throat because of swollen uvula is of common occurrence.
The swollen uvula can be pale and translucent in which case it is termed uvular hydrops.  It is usually a self-limiting idiopathic condition that may cause (but rarely) acute airway obstruction.
The swollen uvula can also be red or skin colored accompanied by pain and tenderness. This is called angioedema.
Although swollen uvula is more common in middle-aged men, in over 50 percent of cases there is no known cause of the condition.  However, in general, the following conditions can cause swollen uvula.
- Infection: Infections can be viral or bacterial including group A streptococci, Haemophilus influenzae, and Streptococcus pneumoniae.  Strep throat, a contagious disease caused by streptococcal bacteria, is a common cause of swollen uvula. Uvula can enlarge because of tonsillitis or epiglottitis as well. The known infectious causes of uvulitis.
- Allergic reactions: Allergic reactions in the throat and mouth can spread to the uvula and cause it to swell. This however may be a sign of food induced anaphylaxis especially if accompanied by difficulty in breathing or wheezing (dyspnea, bronchospasm, stridor), and sudden drop in blood pressure.  This condition requires immediate medical attention.
- Quincke’s disease: It is also known as angioedema or angioneurotic edema. Angioedema is of four types –
- Acute allergic occurring almost always with hives
- Non-allergic drug reaction which is ACE inhibitor induced
- Idiopathic in which case the cause is yet unknown
- Hereditary and recurring periodically
- Snoring. 
- Physical trauma to the throat or mouth, for example, during an endoscopy or after intubation. Sometimes, tonsillectomy too can cause swollen uvula.
- Thyroid problems. 
- Smoking, drug abuse, excessive alcohol consumption.
- Prescription drugs and opioids. For example, a case study from Albert Einstein Medical Center, Philadelphia, revealed that a patient developed opioid induced uvular hydrops when she was given morphine after a Caesarean delivery. The doctors found it to be an inflammatory response caused by opioid-induced direct degranulation of mast cells and basophils. 
Symptoms of Swollen Uvula
- Difficulty in swallowing or drinking
- Sore, dry, throat
- Fever, headache
- Uvula touching the tongue
- White spots or patch on the uvula
- Inflamed tonsils
- Cold and cough
- Hoarseness, difficulty speaking
Treatment of swollen uvula
- Antihistamines: Hydroxazine 50-100mg im or diphenhydramine 25-50mg iv along with cimetidine 300mg iv or orally, or ranitidine 50mg iv or 150mg orally. 
- In severe cases, repeated doses of epinephrine are given. Nebulized isomeric or racemic epinephrine or albuterol are also effective.
- Corticosteroids such as SoluMedrol 125mg iv are also typically used, although efficacy is not yet proven. 
- Treatment for angioedema includes intravenous methylprednisolone, diphenhydramine, and intramuscular epinephrine. Patients who do not respond to these medication may have a complement deficiency and should also receive plasminogen inhibitor ε-aminocaproic acid. 
- Surgical removal of uvula in cases of obstructive sleep apnea or to prevent sudden infant death syndrome (SIDS).
Home Remedies for swollen uvula
- Taking OTC medication for pain is the first line of treatment for the pain associated with the swelling of uvula.
- Gargling with salt water helps reduce the swelling.
- Drinking warm beverage with added honey.
- If the swollen uvula is not due to cold or cough, consuming iced tea, ice cream, or cold drinks may alleviate the swelling.
- Stop drinking till the swelling subsides, if the swollen uvula is the result of excessive drinking or being allergic to alcohol.
Swollen uvula is not a fatal condition and one can recover pretty quickly with home remedies and basic treatment for the swelling.
- Adoga AA, Nimkur TL. The Traditionally Amputated Uvula amongst Nigerians: Still an Ongoing Practice. ISRN Otolaryngology. 2011;2011:704924.
- Back GW, Nadig S, Uppal S, Coatesworth AP. Why do we have a uvula?: literature review and a new theory. Clinical Otolaryngology and Allied Sciences. 2004;29(6):689–693.
- National Center For Emergency Medicine Informatics. ‘Quincke’s Disease. Uvular edema’. http://www.ncemi.org/cse/cse0412.htm
- Cianferoni A, Muraro A. Food-Induced Anaphylaxis. Immunology and allergy clinics of North America. 2012;32(1):165-195.
- Pande SA, Raghav K, Mehta S, Babbar G, Kandpal S. ‘A Woman With A Swollen Uvula’. Cleveland Clinic Journal of Medicine. 2012 Sep;79(9):600-1.
- Alcoceba, E. Edema Of The Uvula: Etiology, Risk Factors, Diagnosis, And Treatment. Journal of Investigational Allergology and Clinical Immunology. 2010; Vol. 20(1): 80-83
- Johnson, Warren, Nirav Shastri, and Milton Fowler. ‘Quincke’s Disease – The Western Journal Of Emergency Medicine’. The Western Journal of Emergency Medicine. N.p., 2011.