Cobblestone Throat - Cause, Symptoms, and Management

Introduction:

A lumpy, rough surface at the back of the throat is known as a cobblestone throat. It is associated with pharyngitis (infection of the pharynx). This results in swelling of lymphoid tissue (a part of the immune system), leading to a rough surface and elevation at the site. Infections, allergies, irritants, and acid reflux are possible reasons for cobblestone throat, it is also known as pharyngitis.

What Is Cobblestone Throat?

Cobblestone throat occurs due to repeated infections in the pharynx resulting in difficulty swallowing and a sore and scratchy throat. Cobblestones are fluid-filled tissue developing in the body as a response to infection or irritation of the body. There are two types of pharyngitis:

• Acute Pharyngitis: In the case of acute pharyngitis, it lasts for a few days to a few weeks. It is an indication of upper respiratory tract infection. In a year, some individuals may experience throat infections two to three times.

• Chronic Pharyngitis: If the throat is affected for a longer time, that is, several weeks, then it is called chronic pharyngitis. Reasons may be irritants like smoking cigarettes or vaping, acid reflux in the stomach, exposure to other smoke, and excess mucus.

What Are the Causes of Cobblestone Throat?

Cobblestone throat is caused due to bacterial and viral infections. Bacterial infections are caused in the winter and spring seasons, and viral infections are caused in the summer and fall.

• Blockage in the airway.

• Allergic rhinitis (irritation of the nose due to allergen), dust, mold, or dander allergens may cause post-nasal discharge of mucus.

• Cancers of head and neck.

• Gastroesophageal reflux disease ( GERD) - a severe form of acid reflux. The acid may enter the esophagus, throat, and mouth while sleeping resulting in a sore throat. Sore throat caused because of nighttime acid reflux may also wear enamel which is a protective layer of the tooth.

• Peritonsillar abscess - pus-filled tissue at the back of the throat.

• Diphtheria - A bacterial infection: Strep throat is caused by group A streptococcus. Arcanobacterium haemolyticum can cause throat pain and rashes. In case of strep throat, if not treated may end up with complications like heart and kidney damage.

• Herpes simplex virus ( A viral infection) - Viral infections include flu, covid 19, measles, chicken pox, and mononucleosis (Contagious infection due to Epstein Barr virus).

• Sinus infection -Infection of sinuses (hollow cavities in the skull) with bacteria, viral, or fungus may lead to post-nasal drip ( drainage of mucus at the back of the throat).

• Environmental irritants: Dry air, chemicals, and cigarette smoke can result in sore throat. Mouth breathing is also a risk factor for sore throat.

What Are the Symptoms of Cobblestone Throat?

Cobblestone throat itself is a symptom rather than a diagnosis.

Symptoms include

• Difficulty in swallowing.

• Fever.

• Rashes.

• Pus in the throat.

• Headache.

• Pain in the abdomen.

• Nausea and vomiting.

• Speech problem.

• Swelling in the throat.

• Coughing blood.

• Hoarseness of the voice or loss of voice.

• Fatigue.

What Are the Complications of Cobblestone Throat?

Pharyngitis occurring due to streptococcus, if left untreated may result in complications like

• Rheumatic Fever: Inflammation of multiple organs, especially the heart.

• Kidney Disease: Kidney problems like kidney stones may be seen.

• Peritonsillar abscess.

• Heart Problem: Inflammation of the heart muscle leads to heart failure.

• Weight Loss: Difficulty in swallowing may lead to weight loss or malnutrition.

• Dehydration: Difficulty in swallowing may lead to dehydration and other symptoms like vomiting or diarrhea may lead to dehydration.

• Cobblestone Throat Cancer: Generally affects smokers. It is a rare and aggressive form of cancer. Cancerous cells form tumors in the throat that result in difficulty in breathing and swallowing.

How to Diagnose Cobblestone Throat?

Swelling and redness at the back of the throat can be diagnosed by using the following tests.

• Complete medical history to be taken.

• A clinical complete examination of the throat by a physician.

• A complete blood test for assessing how serious is the infection.

• Throat culture for streptococcus bacteria which cause strep throat and may cause complications if not treated on time.

• Throat culture to test other viruses and bacteria.

• A rapid antigen test is done to see if group A streptococcus is present.

• Computed tomography and MRI may be done to rule out the other causes.

What Is the Treatment for Cobblestone Throat?

When a severe form of pharyngitis occurs one should take the help of a healthcare provider.

All cases of pharyngitis do not require treatment.

Medical:

• Viral infection resolves itself.

• Bacterial infections may need to be given antibiotics to resolve.

• Steroids are used to relieve inflammation at the site. Steroid nasal spray, antihistamines, and decongestants may be used in excess mucus.

Some remedies to ease the discomfort are

• Drink warm liquids or tea with honey.

• Drink plenty of fluids.

• Use of candy or lozenges. Lozenges containing menthol, pectin, zinc, and other contents may relieve sore throat.

• Gargling of mouth with warm salt water.

• Use of humidifier to add moisture to the air.

• Painkillers may be used to relieve pain.

Surgery:

In some cases, surgery may be necessary to remove the obstruction in the throat. Surgery, such as tonsillectomy is done to remove the tonsils, and tissue from the back of the throat. This option is used only if other treatments are of no use to treat the condition.

How to Prevent Cobblestone Throat?

It is always necessary to have a healthy throat. The following is to be done to have a healthy throat thereby preventing the cobblestone throat.

• Hydration: It is always better to keep our body hydrated and also to avoid sugary beverages and drinks.

• Stop Smoking: Strictly quit the smoking habit and avoid getting exposed to passive ( standing near the smoker during smoking) smoking.

• Limit Exposure to Pollution: Avoid getting exposed to dust, chemicals, or fumes. During exposure, make use of masks and respirators.

• Use Of Mouthwashes and Gargle: Gargling with water and salt may help. Mouthwashes and lozenges may also be used.

• Vaccination: Get vaccinated for flu and other respiratory viruses.

• Diet: Eating smaller meals with good nutrition may help.

Is Cobblestone Throat Contagious?

Yes, it is found that the saliva of an affected person may cause cobblestone throat.

Conclusion:

Cobblestone throat is swelling and redness present at the back of the throat. It is not a serious condition but painful and affects day to day life of an individual. Though it may not cause any serious complications, should not be neglected. If it persists for weeks together, one should seek help from the healthcare provider. It is always better to know in detail about any condition. This helps to identify and seek help at the earliest. Early diagnosis helps in giving effective treatment.