What are the purple bumps in my throat?

Question

Hello, Doctor,

For the past eight months, I have had a sensation in my throat on the right side that comes and goes and gets better when I eat. I saw an ENT specialist three months ago, who performed a scope examination. Everything looked normal except for some cobblestoning and a tonsil stone. My GI doctor also ordered a barium swallow, which was negative.

The throat sensation is still present. It has not worsened, but it has not improved much either. I tried Omeprazole for 12 weeks, but it had little effect.

Today I used a small camera to look at the back of my mouth, and I saw one or two small dark purple bumps.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your question, and I can understand your concern.

Based on the photos you uploaded (attachment removed to protect patient’s identity), everything looks totally normal and reassuring. The dark purplish spots you noticed appear to be normal tiny blood vessels (veins) close to the surface of the mucous membrane, which is a perfectly normal anatomical feature. They could also represent minor scratches caused by inserting the camera. There are no obvious signs of cancer or any concerning growths in the images.

Given that the ENT (ear, nose, and throat) specialist found nothing abnormal during the scope examination and your GI (gastrointestinal) doctor’s barium swallow was also normal, the cause of your long-standing throat sensation is unlikely to be related to a structural throat problem, especially since a 12-week course of Omeprazole provided little improvement.

To help narrow down the possible cause and guide the next steps, could you please let me know:

Have you ever had a formal upper endoscopy (gastroscopy) to examine your esophagus, stomach, and the first part of your small intestine?
Have you been tested for Helicobacter pylori (H. pylori) infection?
Do you notice whether the throat discomfort becomes worse or changes in any way when you are lying down?

Revert with the answer to assist further.

Thank you and take care.

Regards.

Answer 2

Hello,

Welcome back to icliniq.com.

The fact that the sensation disappears when you are active and improves when you lie down is very telling and actually quite reassuring.

Since your ENT exam was completely normal, our next logical focus is the stomach, so proceeding with the gastroscopy next month is an excellent step, and in the meantime, you can easily buy a rapid H. pylori stool antigen test at a local pharmacy to check for this infection at home.

If your upcoming stomach evaluation and this test both turn out completely normal, the next step would be to rule out any thyroid issues by getting a thyroid ultrasound and simple blood tests for TSH (thyroid-stimulating hormone) and free T4 (thyroxine).

Finally, if all of these physical checks come back clear, it strongly confirms a psychosomatic factor, often called a globus sensation, which is a completely harmless but very real tightness in the throat muscles that naturally intensifies when you focus on it and fades away when your mind is occupied.

I hope this helps you.

Take care.