1. Harmful microbes – Our uvula’s location at the back of our throat puts it at the common entrance of our digestive and respiratory system. This places our uvula in the direct path of everything we eat, drink and breathe, including harmful microbes in our food, water and air. However, this critical location of our uvula in such a high-exposure, high-risk region is no coincidence. That’s because our uvula also plays an immuno-defensive role in our body. Just like our tonsils, the uvula acts as sort of a pathogen detector to alert the rest of our body to an incoming microbial threat.

These microbial threats can come from three different types of pathogens:

Viruses – This is one of the most common pathogens our uvula usually comes across. Statistically the average person contracts a viral infection about 3-4 times a year in the uvula/throat region.

Bacteria – These infections tend to be lingering and cause the biggest risk of tissue scarring from prolonged inflammation. Bacterial infections can also easily spread to nearby tissues such as the tonsils, adenoids or even the epiglottis, which can require emergency medical care.

Fungus – Just the way our body maintains a delicate bacterial balance in our gut, it also maintains a similar fungal balance in our mouths. Sometimes this balance is disturbed by medications, stress or poor immunity, causing harmful fungi (such as candida) to suddenly become dominant and cause an infection. What’s worse is that just like bacterial infections, fungal infections can be long lasting and cause extensive damage to our uvula.

Remember, though all three types of microbial infections typically exhibit identical symptoms, the treatment for each type of pathogen is completely different. Choosing the wrong treatment can allow the infection to continue or even make your infection worse.

2. Acid erosion – Not all threats to our uvula come from the outside world. In fact, one in particular comes from the inside – stomach acid. Our uvula hangs directly above the esophagus which in turn leads directly into our stomach where you’ll find gastric fluids so acidic (pH 2) that they are similar in strength to battery acid. While the inner lining of our stomach constantly produces an alkaline fluid which protects it from this acid, there is no such defensive mechanism for our uvula located a mere 10 inches upstream.

The only thing preventing the acid from entering our foodpipe and severely damaging its tissue is a small ring of muscles known as the lower esophageal sphincter (LES). The LES usually remains tightly closed, creating a seal that prevents the backflow of stomach acids towards our throat. Any failure of this sphincter can cause gastric acid to go up into the foodpipe and eat away at sensitive lining of the esophagus and the uvula.

Shockingly the lower esophageal sphincter inherently has a very high failure rate. Over 40% of the adult population suffers from regular bouts of heartburn which is the hallmark of a malfunctioning lower esophageal sphincter. This means almost half the adult population frequently experiences the damaging effects of corrosive acid escaping the stomach and making its way towards the uvula – potentially causing a condition known as erosive uvulitis.

What’s worse is that most people confuse the symptoms of erosive uvulitis with a typical sore throat. This creates a dangerous situation where the sufferer either waits for the problem to clear on its own or treats it for the wrong cause, all the while the acid continues to literally digest away the sensitive lining of the uvula.

3. Physical injury – Consider the makeup of any tissue in our body that comes into contact with the outside world. What you’ll find is that it typically has protective features that shield it from physical damage. For example, the outer layer of our skin is guarded by tough keratin fibers and our eyes have tough collagen fibers embedded into the outer layers (in addition to our eyelids) to protect them from injury.

Now take a closer look at the uvula and you’ll find something quite unexpected…

For a tissue that constantly comes across all sorts of substances from the outside world (some even harmful), the outer surface of our uvula seems unusually bare. It lacks any tough protective histological features and its surface is made up of exposed epithelium that is quite sensitive. Even if you put aside how it stacks against other exposed tissues such as our skin or our eyes and compare it to other structures within the oral cavity, the uvula still seems pretty defenseless.

Let’s see how our uvula matches up to its immediate neighbors…

The tough musculature of our tongue makes it quiet resistant to injury and our inner cheeks are incidentally protected from the simple fact that they are located on the outer perimeters of our mouth behind the guard of our teeth. Even our gums and the roof of our mouth are afforded substantial protection from the bone structure behind it. It isn’t until you get to the uvula at the back of your mouth when the tissue suddenly becomes softer, more fragile and much more sensitive. Add to this the fact that our uvula extends further away from the roof of our mouth and is projected directly into the path of everything we eat, drink or breathe and you begin to grasp its true vulnerability.

Certainly it doesn’t take much to irritate or even permanently damage your uvula. Swallow anything too big, too sharp, too hot or too cold and your uvula is likely to encounter the threat even before it gets to your throat. In fact, this is partly why the uvula is there in front of your throat in the first place. The uvula is extremely sensitive to touch sensations. This ensures that anything that poses a physical threat to our foodpipe or windpipe activates the gag reflex and forcibly pushes the threat back out. While this prevents the potential threat from entering our throat, it doesn’t prevent injury to our uvula.

In many ways the uvula’s protective role is almost a sacrificial one because it prevents bigger harm (injury to the throat or choking) at the cost of a “smaller” harm (uvula injury). The ultimate irony of this is that a damaged uvula can be equally devastating to your health and even your life in the long run.

4. Flow-over inflammation – Surprisingly, our uvula can even experience tissue damage when it isn’t being directly threatened by an infection, acid erosion or injury. That’s because the outer lining of the uvula forms a continuum with many other oral structures such as the throat, tonsils, gums and adenoids. Since these tissues share the same local blood vessel and lymphatic vessel supply, any kind of immune response to an injury or infection rarely remains confined to just the primarily affected tissue.

This also means that when any of these neighboring structures experiences inflammation, it can quickly flow-over into the uvula and cause secondary uvulitis. Oddly enough, since the uvula has very limited defensive capabilities, this flow-over inflammation can actually cause more damage to the uvula sitting on the sidelines than the very tissue where the inflammation first began.

This highlights the unique predicament our uvula is always in. Though each structure in our oral cavity faces its own particular set of threats, the uvula by default is forced share in with all these risks with them because of the flow-over effect. This is precisely why it is so important to protect your uvula even when it is your throat, gums, tonsils or adenoids that are inflamed or irritated simply because the problem can easily spread to the uvula. The main reason why your uvula needs the additional protection is because even if these other tissues come out of the infection unharmed, your uvula may not.

5. Allergic response – Our uvula’s role as an immune-defense tissue is not always a helpful one. Sometimes our body misrecognizes harmless substances as a threat and launches an unnecessarily harsh immune attack on the very tissue that encounters this harmless substance. This is your typical allergic response. For some people the trigger for this allergic response can be something in the air they breathe (dust or pollen) and for others it could be something they ate or drank. However, our uvula’s peculiar location at the junction of our foodpipe and windpipe means that regardless of how this potential allergen enters our oral cavity it will most likely encounter our uvula’s surface.

Now consider this…

Our uvula’s surface is comprised of a sensitive mucousal membrane that has highly active immune surveillance. When an allergen comes into contact with this membrane it initiates a domino effect that results in the release of inflammation-causing histamines. While this kind of inflammation doesn’t usually cause any lasting damage in other parts of our body, that’s not the case with our uvula.

Here’s a perfect example of how the sensitive nature of our uvula tissue can turn a typically harmless irritation into something much more damaging. Even brief episodes of inflammation can significantly injure the uvula. The fact that exposure to certain allergens is almost unavoidable combined with the fact that the inflammation remains persistent as long as the allergen exposure does, means that your immune system can sustain a relentless attack on your uvula for days to weeks at a time – long enough to cause permanent tissue damage.

Finally, add to this the fact that most people consider allergies as nothing more a tolerable nuisance and rarely treat it aggressively also means that an allergic response is one of the common ways a lot of people unknowingly damage their uvula.

6. Uvula ulcers – A uvula ulcer is a deep erosion of its mucosal surface. Quite often this ulceration can eat into the outer lining of the uvula to the point of affecting its function. Unfortunately, uvula ulcers are often treated improperly because most over-the-counter treatments are nothing more than analgesics that simply numb the pain while allowing the lesion to remain exposed and the underlying problem to remain untreated.

Ulcers of the uvula can form as a result of viral infections, acid reflux, physical injuries and even an allergic reaction. Did you notice the common thread here? Yes, every single one of the other uvulitis causes mentioned above can also trigger an ulceration of the uvula. Even worse, because uvula ulcers can be self sustaining, they can take a short term problem (infection, allergy, etc.) and turn it into a chronic, long term condition where damage to the uvula continues even after the original problem has resolved.

How long lasting and damaging can these ulcers be? Take for instance one of the most common types of oral ulcers, called apthous ulcers…

This illustrates how even small, seemingly mild uvula irritations have the potential of spiraling out of control and become chronic problems that keep injuring the uvula on an ongoing basis.

7. Uvula tissue dehydration – Ever notice what happens to your skin when it dries up? It gets itchy, begins to crack up and if its moisture barrier gets depleted, it becomes vulnerable to irritation, inflammation and skin infections. The same thing happens to our uvula, except the end result is much worse.

While the top layer of our skin is composed of dead, flattened cells that physically shield its moisture loss, the surface of our uvula is made up of exposed epithelial tissue. What’s worse is that since our uvula hangs right above our windpipe it also has to constantly contend with the evaporative effect of air repeatedly gushing past it.

In essence our uvula has two tough tasks…

Remarkably, our uvula utilizes a simple yet ingenious method to accomplish both these tasks. It uses a combination of a watery fluid and a thick, gluey substance to maintain its moisture barrier:

The combination of saliva and mucus plays a vital role in protecting our uvula in many different ways:

Since saliva is 99.5% water, it is an ideal hydrating agent while the thick consistency of mucus makes it an ideal waterproofing agent that prevents our uvula from drying out

Both saliva and mucus also contain antibodies, antiseptic enzymes and proteins that help protect our uvula from viruses, bacteria and fungi

This thick fluid coating also has a shielding effect on the uvula because it acts as a cushioning lubricant that prevents micro-trauma

As sensitive as the outer lining of our uvula is, imagine how much more defenseless it would be if something were to disrupt this protective hydration system.

Inflammation during uvulitis interferes with the proper functioning of the salivary and seromucous glands located on our uvula. This quickly results in the dehydration of the uvula tissue, leaving it extremely exposed without its moisture barrier.

In this state of extreme vulnerability, almost anything can set off a new round of uvula problems and further damage its tissue:

Once the uvula has lost its moisture barrier, it is stripped bare of its last defense mechanism and the only way to return it back to good health is to quickly reestablish this moisture barrier. Unfortunately, this kind of dehydration cannot be reversed by simply drinking more water.

Remember, our uvula is a self hydrating structure and its moisture has to come from within. Since this kind of dehydration arises when inflammation interrupts the salivary and seromucous glands from working properly, the problem can only be reversed when you treat the underlying cause of the inflammation.

And what if your uvula problems aren’t caused by any of the 7 causes mentioned above?

8. Age-Related Uvula Dysfunction – So far all of the 7 causes mentioned above are known as pathological causes of uvulitis. In other words, they happen when the normal function of your uvula is interrupted by a harmful substance, organism or injury. However, uvula problems can also arise from physiological causes. In other words, these problems can result from our body’s natural aging process. It is important to note that age-related uvula problems can be just as harmful as any of the 7 pathological causes of uvulitis mentioned above.

Consider the effect that aging has on our uvula and you can see why it naturally begins to malfunction and becomes prone to problems…

Let’s first look at the makeup of our uvula tissue. A young, healthy uvula is held tightly together by its connective tissue and muscle fibers on the inside and a well toned epithelial layer on the outside. Now let’s see how aging affects this structural makeup:

As we age…

The combined effect of all these things is that

Microbes – Recent studies point to an increase in the number of oral cancers due to the prevalence of HPV in the general population. It is estimated that over 80% of the adult population is exposed to this virus at some point in their lives. What makes this statistic disturbing is that HPV is one of the first viruses that was discovered to be oncogenic (cancer-causing). This is why HPV is not only one of the leading causes of oropharyngeal cancers but also uvula cancer.

Acid erosion – Almost 60% of adults experience acid reflux in any given year and over half of these adults experience it on a daily basis. It is one of the leading causes of oral cancers and over 30% of esophageal cancers are related to acid reflux. Since our uvula is often also exposed to acid during acid reflux, it is just as serious a cancer threat to our uvula as it is to our esophagus.

Ulcers – This is the primary way most uvula cancers are caught. In fact, up to 30% of all ulcerating tumors develop in the head and neck region. If you have an uvula ulcer that hasn’t healed in 3 weeks, it is important to go see a doctor to have it closely examined.