Dr. Vinay. S. Bhat
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am facing some problem in my throat for about two months now. It is something that always present in the back wall of the throat. But there is no pain but sometimes it feels in the upper esophagus, other time it feels on the back wall of the throat. My ENT doctor examined my throat and suggested me that there is no lump or anything stuck in the throat but said some redness and many little bumps on the back wall and said pharyngitis. I have done the blood test and CT of the pharynx. There was no abnormality. I was prescribed Amoxicillin and anti-fungal and antihistamine (Levocetirizine and Montelukast tablets) for 15 days. But the hidden problem persists. Most annoying is that I feel some difficulty in the throat but cannot figure it out as there is no pain and also cannot figure the exact location of the problem. As a whole, the problem is on the back wall of the throat. Please suggest me some other test that might be required and some medication to reduce this problem.
Hi,
Welcome to icliniq.com.
I have gone through your history and all the blood reports (attachment removed to protect patient identity)and they are all normal. Your CT (computed tomography) scan basically rules out any mass lesion in your neck or throat. The problem you are suffering from is known as globus pharyngeus which means the sensation of a lump in the throat or foreign body sensation in the throat. Most common cause for such a problem is reflux laryngopharyngitis which is a type of acidity related disorder. In this condition your gastric acid refluxes back inside your throat causing swelling, dryness, postnasal discharge (this causes a sensation of something in the back of your throat), redness, reddish lesions in the pharynx (which is known as granular pharyngitis) and feeling of lump down the throat while swallowing. Causes for such condition includes untimely food habits, stress, sleeplessness, and sometimes no cause can be identified. Taking any other medicines other than anti-reflux medications will increase your symptoms. You need to take anti-reflux medications for a minimum of three weeks to three months. Recovery is usually slow and three weeks are usually necessary to observe any significant improvement. You also need to avoid spicy food, tea, chocolate, eat regularly at fixed timings, avoid salt water gargling. Take tablet Nexpro RD (Domperidone and Esomeprazole) 40 mg two times daily before food for three weeks. If you see a significant improvement you can even continue it for up to three months.
Patient's Query
Hi doctor,
Thank you for the reply, I took the tablet Pantoprazole 40 mg for three week but the problem persists. I think it is not gas problem. I attached a picture of my throat. Please take a look at those picture, and provide me some remedy of that problem.
Hello,
Welcome back to icliniq.com.
The image you have attached (attachment removed to protect the patient's identity) shows granulations in the posterior pharyngeal wall which is known as granular pharyngitis. One of the most common cause for this condition is reflux laryngopharyngitis. So this basically confirms the diagnosis of reflux laryngopharyngitis. I suggest you take the tablet Pantoprazole with Domperidone twice daily. Consult a specialist doctor, discuss with them, and take medications with their consent. Reflux laryngopharyngitis may require upto three months of treatment If you are scared about anything inside your throat, then you can consider undergoing upper gastro intestinal endoscopy
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Otolaryngology (E.N.T)
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