I have a lump behind my left tonsil and a sore throat, which is not responding to the prescribed medicine. What could it be?

Q. What does a persistent lump behind the tonsil, along with a sore throat, indicate?

Answered by
Dr. Bhadragiri Vageesh Padiyar
and medically reviewed by Dr.Sowmiya
This is a premium question & answer published on Apr 10, 2023 and last reviewed on: Sep 10, 2023

Hello doctor,

I have had a sore throat on and off for weeks and a lump behind my left tonsil. It is about the same size as my tonsil and similar in color. I went to the doctor and was given Prednisone to reduce the swelling. However, it did not help at all. What could it be? Currently, I am also taking 10 mg of Propanolol. Kindly help. Thank you.



Welcome to icliniq.com.

I had a look at the picture you sent (attachment removed to protect the patient's identity). The structure mentioned as swelling is, in fact, a normal structure called the tonsil, which has slightly increased in size than normal and is not exactly pathological. Steroids given to you will never reduce such swelling. The reason for recurrent sore throat could be due to an ongoing reflux which creates inflammation in the throat and creates this trouble. No matter what you do (except for undergoing surgery) is going to reduce the size of this tonsil, and its existence is not going to make any negative impact. This swelling will persist and will never create any trouble, but you need to treat the cause of the recurrent sore throat, which is severe GERD with LPR (gastroesophageal reflux disease with laryngopharyngeal reflux). Below are a few things to treat recurrent sore throats due to reflux. 1. Maintain a strict diet, eating on time. 2. Avoid spicy, oily, and cold food or drinks. 3. Keep a gap of two hours between meals and going to bed. 4. Do not overeat; rather, keep your stomach half empty and have regular intermittent light food like fresh-cut fruits in between major meals. 5. Do salt water gargling eight to ten times a day for 15 days. 6. Avoid alcohol and smoking, as they can potentiate reflux. 7. Try to maintain a left lateral position while sleeping to reduce the chance of reflux. My advice: Consult your specialist doctor, talk to them and take the medication with their consent. 1. Take Pantoprazole and Domperidone prolonged-release capsules 40 mg once daily before breakfast for a month. 2. Take a teaspoon of Mucaine gel syrup (Oxetacaine, Aluminium hydroxide, and Milk of magnesia) three times a day, 20 minutes before meals, for one month. Make sure you follow the precautionary measures as much as possible, as mere medications would not fetch long-term relief. Please understand that this typically takes four to six weeks to normalize and for the symptoms to subside. And also depends on how much you have been able to follow the precautions mentioned above, as 80 percent of the treatment lies there. There is absolutely nothing that you need to worry about, as this is treatable. You may also take an online consultation from a primary care physician. Hope this helps. Kindly revert for further queries. Thank you.

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