Q. Suffering from sore throat with post nasal drip and lymph node enlargement. What is causing it?

Answered by
Dr. Shyam Kalyan N
and medically reviewed by iCliniq medical review team.

Hi doctor,

I am 19 years old and from the last two years, my sore throat is not going away. I am having a lot of post nasal drip. I tried taking OTC anti-histamines, nothing helped. Today I noticed a hard lump under the chin at right side right at the point where throat begins. What is causing it?

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Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)


Welcome to icliniq.com.

The symptoms listed by you point to chronic tonsillopharyngitis mostly secondary to the post nasal drip. Delving into the details, the constant post nasal drip is causing inflammation of the posterior pharyngeal wall and the tonsils in the throat. When these get infected the adjacent lymph node (the jugulodigastric node), palpable under the angle of the jaw where the throat begins, gets swollen. I checked the picture you have sent. It shows enlarged tonsils with granular congestion of posterior pharyngeal wall.

We need to investigate you as to why there is chronic tonsillopharyngitis. We must evaluate the cause for post nasal drip. Most probably the post nasal drip could be due to some inflammation inside the sinuses. To rule out the same we must do a non-contrast CT scan of paranasal sinuses. At the same time, it will be prudent to get a monospot and streptoccal test done for the throat. Routine blood investigations will be helpful to check for agranulocytosis, infectious mononucleosis, lymphocytosis, anemia, etc. In the meantime, avoid spicy and cold food products. Desist from smoking and drinking. Drink plenty of fluids. I suggest you take a course of anti-inflammatory medicines, Chymotrypsin-Trypsin-Bromelain, taken twice daily in empty stomach for five days. I would also suggest taking Omeprazole 40 mg twice daily before meals for 10 days. In the meantime, you would get the tests done and get back to us with the reports.

If the diagnosis is in the lines that I have thought, you would require treatment for the sinusitis which would remove the causative factor for chronic tonsillitis. In any case, the investigations will help us arrive at the most decisive diagnosis. Do revert back for further support and help.

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