What is the treatment for granular pharyngitis and tonsillitis?

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Granular pharyngitis occurs because of chronic irritation to the pharynx. It is commonly seen in patients with chronic rhinosinusitis, smokers, and nowadays, one of the most common cause for granular pharyngitis is laryngopharyngeal reflux disorder. The usual symptoms of laryngopharyngeal reflux disorder are a mild burning type of throat pain, especially, on swallowing, foreign body sensation in lower part of throat, constant throat clearing, and sometimes early morning voice change. There may not be any symptoms of gastroesophageal reflux disorder, such as heartburn and abdominal pain. It is common to have recurrent attacks of throat pain which mimic bacterial pharyngotonsillitis in patients with laryngopharyngitis reflux disorder. I suggest taking anti-reflux medications, at least for three weeks. You can take tablet Pan D (Pantoprazole and Domperidone) 40 mg twice daily for three weeks.

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As I have already mentioned, LPRD can occur without signs of gastritis or GERD (gastroesophageal reflux disease). I have seen the attached report (attachment removed to protect patient identity). A CT PNS reported by a radiologist is not very reliable as clinical signs should match CT findings. Minimal thickening of the mucosa of sinus cavities is not really an abnormal finding. It can occur in any person with a minimal allergy. Treatment of LPRD is not only with medicines, but dietary modifications play an important role. Along with medications, you should have food at regular timings, and do not sleep soon after having dinner. Wait for at least two hours. I suggest taking medicines with anti motility drugs, such as Domperidone or Levosulpiride. Medicine such as Nexpro RD or Nexpro L 40 mg works very well if taken two times daily. Last cause for granular pharyngitis can be environmental pollution, which needs to be avoided by use of masks. As per your CT, you have very minimal changes. If you are asymptomatic as far as nose symptoms are concerned, then you need not worry. Such CT findings are common even if you have minimal mucous in your nose during CT scan.

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It is a simple pharyngeal inflammation. My medical advice to you is as follows: 1. Tablet Nexpro RD (Domperidone and Esomeprazole) 40 mg, two times daily before food for three weeks. 2. Furamist nasal spray (Fluticasone) once in the night in both the nostrils for a month. It is a steroid nasal spray, which will take care of the sinus inflammation. It is absolutely safe to use. 3. Oxum solution for mouth gargling two times daily for a week. It is a Hydrogen peroxide solution, which has to be diluted 1:4 with clean water before gargling. It will take care of already formed granules over the pharynx. Granular pharyngitis is nothing to worry about. Once predisposing factors are treated, it will go on its own.