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Swollen glands: When should you worry?

Most of us have experienced sore, puffed-up glands when we’re run-down or battling lurgy - but if they don’t go down after two weeks, you’d best get them checked
Most of us have experienced sore, puffed-up glands when we’re run-down or battling lurgy - but if they don’t go down after two weeks, you’d best get them checked

With cold and flu ‘season’ now in full swing, chances are, you’ve already been struck with your first winter bug.

But have you ever wondered why your glands swell up when you’re run-down, or battling a stinking cold?

“We use the term glands, but what we’re talking about here is lymph glands, they’re the glands that help fight infection,” explains Matthew Trotter, an ear, nose and throat (ENT) surgeon at Spire Parkway Hospital in Solihull. “They swell up when we’re exposed to any sort of infection – so coughs, viruses, sore throats, urine, bowel and bladder infections, etc – your glands will swell up.”

Ear, nose and throat surgeon Matthew Trotter
Ear, nose and throat surgeon Matthew Trotter

The medical term for this swelling is ‘lymphadenopathy’, and while it generally indicates that you’ve picked up an infection – in other words, you’re unwell – it’s also a sign your immune system is doing its job, cranking into action and sending a stream of bug-busting white blood cells around your body. “So at this time of year, when you start to get more coughs and colds, you may notice the glands swelling more,” adds Trotter.

However, there are also occasions when swollen glands can themselves be a cause for concern, and may need to be investigated more thoroughly…

Are lymph glands only in our throats?

No – as Trotter points out, these glands can be found “all around the body”, and we actually have hundreds of them, some of which are internal and can’t be felt. The sides of the neck/throat area is perhaps most commonly where people notice their glands swelling, but it’s also common to spot swollen lymph glands in the armpits and groin.

Do some people’s lymph glands tend to swell more than others?

Some people may notice swelling more than others. It could be that they are simply exposed to – and pick up – more infections, and some people’s bodies respond more acutely to infection, so they may be more prone to noticeably swollen glands. “You’re also more likely to feel and be aware of glands going up and down if you’re a very thin person, particularly in the neck area, where it’s easy for glands to stand out against the muscle and skin,” adds Trotter.

When should the swelling go down?

“We usually say, if you’ve been unwell for any reason, you’ve had a cold or cough or whatever, and the glands have popped up, we’d generally expect them to settle within 10 days to a couple of weeks,” says Trotter. “If they haven’t settled and sunk within a couple of weeks, then we might be concerned.”

And what if I’m not unwell but my glands are swollen?

“If you’ve got glands that have come up without any previous recent history of colds, coughs etc, then they’d perhaps need investigating,” says Trotter. Though more rare, swollen glands can sometimes indicate a more deep-seated infection that needs looking into.

They could also be associated with rheumatoid arthritis and be a sign of cancer – specifically certain forms of lymphoma, or possibly secondary cancers that have spread from elsewhere in the body. “We shouldn’t ever just ignore glands,” Trotter stresses.

“Glands that haven’t gone down after two weeks following being unwell, or glands that have popped up for no reason, they need to be checked out. You’d expect your GP to do a full history, and some routine blood tests, and if they are concerned, refer you to a specialist who’ll carry out an assessment, and possibly scans and a biopsy.”

Are there any other possible signs of lymphoma to be aware of?

Painless, swollen lymph glands – usually in the neck, armpit and groin – are the most common symptom of non-Hodgkin lymphoma. However, if you’re also experiencing weight loss, sweats at night – “which are drenching” – and itching of the skin, see your doctor to get things checked out.

Is it only a concern if the swelling is constant?

If the swelling is going up and down, then usually “it’s not as worrying” as constant, unchanging swelling, notes Trotter – providing there is a background of coughs and colds, etc. “Say you’re otherwise completely fit and well, and you’ve got a gland that’s going up and down, up and down, then you’d still be concerned as to why that’s happening,” he adds. “We generally say that glands that are less than 1cm, aren’t anything to worry about – but we do need to check these things and get people reassured, so I would never ignore glands that are fluctuating in size.”