I am a 66-year-old male with a weight of 90 kg and a height of 175 cms. For the last four months, I am continuously facing the following problems.
Moderate sore throat, feeling like a lump in my deep throat, gastric reflux, poor digestion, a feeling of air blocked in both the ears and popping sound on swallowing.
After treatment, these symptoms subside for some time. But now I have deviated septum. Presently I have sticky mucus discharge from the nose in postnasal mode. Sometimes I also feel stress in the jaws.
Due to continuous popping in ears (mostly left ear) and lump feeling in the throat, I am unable to sleep properly. This is having an adverse effect on my health.
I am on medication for almost three months on and off, including Levocetirizine one tablet twice daily and Fluticasone spray. I also take Rabeprazole DSR for the reflux issue, steam inhalation, and saline gargles. But symptoms sometimes abate and again come up. I regularly take Bisoprolol and Metformin and glimperamide for few years.
Due to soreness in the throat, popping in the ears, and continuous cough, I am unable to sleep. The sticky mucus is viscous and salty in taste and discharges in the throat. RTF test showed partial dysfunction of the left eustachian tube. What could be the likely causes and line of treatment to get rid of this? Could it be due to air pollution or some other allergy source? Due to continuous coughing, my abdominal muscles are paining, and there is a split voice in my throat. It appears like there is an overproduction of mucus all over the respiratory tract. I have started taking antibiotic Augmentin eight hours once for the last four days, but no relief. Please advise.
Welcome to icliniq.com.
Can you take a picture of the back of the throat, showing details of the affected area and send it to us? Which area do you live in? Do you drive a two-wheeler on the roads of Delhi? Did this worsen during the Diwali season? Do you smoke or drink?
Thank you doctor,
I do not smoke neither do I drink. I stay at Indirapuram Ghaziabad. I had this chronic problem but that used to get resolved after some treatment. But this time, the problem is prolonged for the last three to four months despite treatment going on.
My current problem is as I mentioned soreness in my deep throat area, pain and burning, and as if something is stuck up. Continuous coughing to bring up the mucus, excessive formation of viscous white or light grey mucous, especially in the left side of the nose and blocked ears popping or clicking on swallowing with a burning sensation in the ear passages. I could not sleep last night due to these problems. The problem is just not responding to treatments, including nasal spray use, Digene tablets, Rabeprazole DSR, Monton-L, steam inhalation, and saline gargles.The intensity keeps changing from time to time. I do have a gastro reflux issue, which too is chronic. I have started Augmentin 625 mg three times a day, and today is the fifth day but no improvement yet. I do not drive two-wheeler and, most of the time, stay indoors. Since the problem is going on for a few months repeatedly, the seasonal effect may not apply. I have taken the best possible picture from close range but without using a spatula. Kindly note I have just completed a three weeks course on Terbinafine 250 mg for skin infection.
Welcome to icliniq.com.
Your throat is not clear in the picture. (attachment removed to protect patient identity).
Nevertheless, with your detailed description, I can make some conclusions, but I need some more details.
1. Did you start the antibiotic on your own, or did some doctor prescribe it?
2. Along with the antibiotic, did you take the Rabeprazole, Domperidone, and Montelukast cetirizine tablets as well?
3. Did you take any medicines for lightening and liquidating the mucus?
4. Do you have a fever?
5. Has some doctor done laryngoscopy on you to rule out any growth or abnormality in the larynx?
6. Is there any wheezing or breathing trouble?
With the preliminary information, I feel it is more of Rhinitis with laryngopharyngeal reflux. You need a macrolide antibiotic for five days and a macrolide anti-inflammatory drug for another five weeks. It will take some long time to get rid of the problem. But you need a good lifestyle and dietary advice. You would have to follow the same sincerely to find benefits. Please provide us all the details sought. Desist from having spicy oily and masala rich foods. Tell us about your dietary habits more.
Thank you doctor,
1. I started Amoxycillin four days ago since things were not improving.
2. I am taking Rabeprazole, Domperidone DSR, once daily.
3. I am using Fluticasone spray twice a day and Montin-L once daily along with steam।nhalation for liquidating the mucus
4. I had a fever but only for one day, two days ago.
5. I got laryngoscopy done just now, and there is no growth, but LPR is positive.
6. No breathing trouble. I have two problems, continuous accumulation of mucus in the throat, forcing periodic coughing and spitting, and clogged ears feeling of dryness or irritation.
What is macrolide?
My food habits are a simple, pure vegetarian diet and about three cups of tea in a day. Such severe symptoms did not occur in the past for so long period, and I am unable to sleep due to irritation in a deep throat and ear canals too much phlegm generation and coughing. Congestion is seen more in the left nostril, and the taste is salty with whitish viscous discharge. I hope you will be able to draw a conclusion and chart the outline of treatment.
Welcome to icliniq.com.
I would like to say a few things. 1. The self-prescription of antibiotics was unnecessary. You have again chosen the wrong medicine yourself. Complete the full course and stop it.
2. Macrolides are a particular class of antibiotics that have some action against microfilms. I would suggest you take twice daily dosage of 500 mg of Clarithromycin for one week, followed by once daily of 250 mg Clarithromycin for the next five weeks.
3. Take Esomeprazole 40 mg with Domperidone 10 mg in the morning on an empty stomach and take plain Pantoprazole 40 mg in an empty stomach in the night for a month.
4. Continue Montek LC (Montelukast sodium and Levocetirizine) in the evening for a month.
5. Start on Allegra 120 (Fexofenadine) tablet once daily in the morning for seven days.
6. Take Mucinac (Acetylcysteine) 600 mg dispersible tablet, twice daily, mixed in a glass of water.
7. Stop gargles and steam.
8. Avoid exposure to sun, dust, smoke, pollution. Get an air purifier at home. Stay away from pollens.
9. Take regular diet. Do not fast. Do not drink a lot of water immediately after food. Do not lie down for two hours after any meal. Do not drink late in the evening. Drink adequate water but not immediately before or after meals.
Check these. Do some regular exercises like brisk walking, etc., indoors.
I hope this helps.
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