HomeAnswersOtolaryngology (E.N.T)sore throatHow to cure a sore throat that exaggerates while talking?

Are sore throat and ear pain related to chronic gastritis that I have?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Ranjit Peter

Medically reviewed by

Dr. P. C. Pavithra Pattu

Published At December 13, 2021
Reviewed AtAugust 29, 2023

Patient's Query

Hello doctor,

I have been having a sore throat that comes and goes for probably around three months now. If I talk a little bit more than usual, my throat will hurt for hours. Sometimes my left ear hurts too. It feels dry and painful, and I cannot talk much as my voice fades. Then it comes back to normal after a few hours. This keeps happening, and today I decided to take pictures to figure out if there was something visibly wrong, and I found the arch behind my uvula looks swollen or bumpy. It does not look like other people’s throats. Also, the roof of my mouth is yellowish. I have had chronic gastritis, IBS, and also chronic sinusitis for years now. Could that be the cause? Are these cancer symptoms? I have attached pictures. My throat looks very pale overall. I do not smoke or drink. Please help.

Answered by Dr. Ranjit Peter

Hello,

Welcome to icliniq.com.

Based on your clinical history and the photographs you shared (attachments removed to protect the patient's identity), let me assure you that these are not cancer symptoms. The clinical history and findings are consistent with recurrent gastroesophageal reflux disease or laryngopharyngeal reflux disease causing a recurrent sore throat. Let me clarify further. Your throat gets inflamed due to the acid from your stomach coming up when you lie down. Chronic sinusitis (that you mentioned) would also contribute to throat inflammation. The side of the throat inflammation may depend on the side to which you lie down at night. The ear ache that you mentioned has two possible mechanisms: 1) It is generally referred pain (meaning pain referred to the ear due to the same nerve supply). 2) It is due to inflammation of the eustachian tube (the tube connecting the back of your nose to the ear). Generally, the voice also changes due to the swelling caused by throat inflammation. Conservative line of management would include giving three hours gap between dinner and sleeping at night. Avoid spicy and oily foods at night. Medical management generally does start on a six weeks regimen of Nexium (Esomeprazole) with Domperidone. However, I suggest you start on oral suspension of Gaviscon (Aluminium hydroxide and Magnesium trisilicate) 10 mL at night after dinner, just before you go to bed, for at least 14 days. Few clarifications that I would need: 1) Has anyone at home observed you snoring? 2) Does your throat get dry at night, needing to wake up to drink water? 3) Do you wake up several times during a night's sleep? 4) Do you feel tired, or do you feel fresh after a night's sleep? Any feedback on the status of your chronic sinusitis would be helpful. I will suggest you do a flexible nasopharyngolaryngoscopy and review after two weeks.

Patient's Query

Thank you doctor,

Thank you so much for your reply. No one has ever heard me snore. My throat does not get dry at night, and it becomes dry only when I talk a bit more than usual. I feel good after a night of sleep. Regarding my sinusitis, I have had it for years now. I have headaches (mainly in my forehead) every week and sometimes multiple days a week. I also have a constantly congested nose, to the point that I do not even realize that my nose is congested because I am so used to it. I cannot smell things like other people do. Just one thing you did not mention, is the yellowish color at the roof of my throat normal? Thank you so much again.

Answered by Dr. Ranjit Peter

Hi,

Welcome back to icliniq.com.

Yes, your clinical history suggests chronic rhinosinusitis (CRS). The fact that you have a reduced sense of smell could be attributed to chronic inflammation and the possibility of nasal polyps. Generally, people with nasal allergies have pale nasal mucosa. The yellowish color on the roof of your mouth that you mentioned is not of particular significance. If you do not have symptoms of nasal allergy: 1) recurrent bouts of sneezing in the mornings, 2) running nose, 3) itchy eyes or nose or throat, then other causes for CRS need to be ruled out. Occasionally there may be fungal elements associated. Again a CT (computed tomography) scan of the paranasal sinuses has to be taken after taking maximal medical therapy. It is usually a combination of oral antibiotics, topical nasal steroid sprays (Fluticasone Furoate), and sometimes steroid Budecort nasal alkaline douches. So the question is, have you ever had your Chronic sinusitis assessed by a local ENT (ear, nose, throat) doctor? Have they done a nasal endoscopy or been assessed radiologically (CT scan of the paranasal sinuses)? Have you taken treatment for the management of CRS?

Treatment plan

After nasal evaluation by nasal endoscopy and radiological evaluation using CT (computed tomography) scan of paranasal sinuses can be done.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ranjit Peter
Dr. Ranjit Peter

Otolaryngology (E.N.T)

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