I have had strep throat with white spots, but it never lasts so long. Please help.

Hi,

Welcome to icliniq.com.

Thanks for briefing about the problem in concern. The white spots in the throat could be lymphoid follicles, which would have increased in size due to earlier infection or persisting noninfectious inflammation. They do not indicate nor tend towards cancer or malignancy and might sometimes last for as long as possible. The most common cause of the other symptoms that you have mentioned could be due to chronic silent GERD with LPR (gastroesophageal reflux with laryngopharyngeal reflux). Even though you might be asymptomatic or never had gastric issues in between, the throat's inflammation often exists in the hidden form. It can resurface when adequate care is not taken. Why does hidden acid reflux become so problematic? As you know, the stomach usually has got cells that release hydrochloric acid and thus keep the gastric environment acidic. Your entire mucosal lining from the mouth, throat, and food pipe (esophagus) is not meant to handle anything acidic. Of the three structures, the throat is the most sensitive due to its rich nerve supply. If, in a given situation, your mouth, throat, or food pipe chronically comes in contact with acidic contents, an inflammation starts, which the body initially takes care of, but once this compensation wears out, you start developing symptoms that you have mentioned. Please try to follow the advice mentioned below: 1. Maintain a strict diet by eating on time. 2. Avoid spicy, oily, and cold food or drinks. 3. Keep a gap of two hours between meals and before going to bed. 4. Do not overeat; rather, keep your stomach half empty and have regular intermittent light food like fresh-cut fruits between significant meals. 5. Saltwater gargling eight to ten times a day for 15 days. 6. Avoid alcohol and smoking as it can potentiate reflux. 7. Try to maintain a left lateral position while sleeping to reduce the chance of reflux. Treatment plan: Tablet Pan D (Pantoprazole) 40 mg once in the morning before breakfast for one month. Syrup Mucaine gel one tablespoon three times a day 20 minutes before meals for one month. Ensure you follow the precautionary measures as much as possible as mere medications will not fetch long term relief. Please understand that this typically takes four to six weeks for things to normalize and for symptoms to subside and chiefly depends on how much you have been able to follow the precautions mentioned above, as 80 percent of the treatment lies there. You need not worry about anything as this is a treatable entity, and things will be fine. I hope I have answered your query in detail. If there is anything more you need to know or enquire, please let us know, and we will get back. Warm regards.

Hello,

Welcome back to icliniq.com.

You need to worry about absolutely nothing as these white spots are not just due to streptococcal infections; it could be due to any underlying inflammation. We often see many patients having such white spots in their throat, and it does persist for quite a while before it goes away, while in many other patients, it has never disappeared. They are under regular follow-up, and no one has developed any malignancy or cancer related to the white spot. Please consider the advice mentioned in our previous conversation, and I am sure that there is a very subtle change of having recurring strep throat. As precautionary measures from most of the treatment, do not rely too much on medications as all of them have some of the other negative side effects on your body. I hope this answers your query. Please do let us know if there is anything more you need to know or enquire about. Warm regards.

Hi,

Welcome back to icliniq.com.

Wonderful to hear from you again! I had a detailed look at the picture (attachment removed to protect patient identity). The small white structure that I can see out there looks like a lymphoid follicle, which has increased in size. It has nothing to do with an abscess nor has anything to do with cellulitis as both are characterized by severe swelling, inflammation, pain, and fever, all of which are not there in your case. I am sure there is absolutely nothing that you need to worry about. You can consider all the instructions given in our earlier conversations, and this will ensure that you do not develop recurrent throat infections. Do not worry about that little white follicle in the tonsillar pillar as it does not indicate an abscess or any form of cellulitis. I hope this answers your query. If there is anything more that you need to enquire about, please do let us know, and we will get back to you as soon as possible. Warm regards.