Q. Why do I have a bloody spot near the back of my throat?

Hello,

Welcome to icliniq.com.

I have seen the picture (attachment removed to protect patient identity).

• I can see inflamed and enlarged tonsils with a congested posterior pharyngeal wall (back of the throat).

• A post-nasal drip running for a couple of months suggests some sinonasal inflammation as well, a chronic or acute sinusitis. The same is producing plenty of mucus in the mornings which drain off as the day progresses.

• First, I would like to rule out any infection. The redness and bloody spot with tightness and post-nasal drip are suggestive of an infection. I suggest you try taking the following. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent.

1. A course of Clarithromycin 250 mg, one tablet, twice daily.
2. Acetylcysteine 600 mg, twice daily on an empty stomach. This will remove the phlegm.
3. Trypsin or Chymotrypsin, for three days. It is an anti-inflammatory medicine.
4. Levocetirizine 5 mg, taken once in the night for 3 to 5 days. This is an antihistamine.

• Next, I want to know if you suffer from the throat problem repeatedly. The tonsillar enlargement could be a result of chronic sinus infection or a recurrent throat infection (independent of nasal pathology) or due to reflux laryngitis. Whereas the first two can be treated similarly, reflux laryngitis requires slightly different management. So, to cover that as well I suggest you take Pantoprazole 40 mg, one tablet twice daily before meals for a week.

• If the symptoms have been bothering you for more than a few months, then we must do a CT scan of paranasal sinuses, to see if there is any lingering infection in sinuses, also understand if there is any abnormality in the sinuses or nose that is predisposing to tonsillitis.

• However, the non-contrast CT that we require should not be done now, we recommend that after the acute phase (that you are suffering now) gets cured. We prefer CT scan to plain radiographs, as they are superior and give more precise information.

• During your course, I would like you to do the following.

1. Restrict smoking, alcohol, spicy foods, cold foods, and dust exposure.
2. You may also avoid excessive intake of coffee and tea, which stirs acidity in the stomach.
3. Maintain adequate humidity inside the room to enable better mucociliary clearance of the mucus inside the sinonasal cavities.
4. Set the air conditioner temperature to an appropriate level, not excessively cold or dry.
5. Drink plenty of fluids and eat nutritious food.
6. You may take multivitamins rich in zinc and other trace elements as well temporarily, to help you out of this condition.

Do revert back to me if you require any further support. Hope to see you in good health soon.

For further queries consult an ENT otolaryngologist online --> https://www.icliniq.com/ask-a-doctor-online/ENT-Otolaryngologist

Hi,

Welcome back to icliniq.com.

• No, it does not change my answer. The infectivity is dependent on the organism concerned, which in your case seems to be bacterial. Hence the need for an antibiotic.

• I like to add warm saline gargles every morning to soothe the throat as well as to remove the phlegm pent up. You may take steam also.

• A word of caution, if you suffer from allergies like a runny nose, itching, watering of the eyes, or sneezing, then it is better to avoid steam and warm saline gargles.

• If you prefer medicated gargles, you may take Benzydamine gargles, diluted with plain water, thrice daily, preferably after meals.

For more information consult an ENT otolaryngologist online --> https://www.icliniq.com/ask-a-doctor-online/ENT-Otolaryngologist

Hello,

Welcome back to icliniq.com.

I am giving you the local names of the drugs I mentioned in my answer to your query.

• To cover your reflux symptoms, I had mentioned Pantoprazole 40 mg. You may find it in the name of Protonix 40 mg, Prilosec, or Zegerid 40 mg.

• Clarithromycin is the generic name for Biaxin. You need 250 mg dosage, to be taken twice daily for about five days.

• N-Acetyl Cysteine comes in the brand name of Cetylev. It is effervescent and should be mixed with a glass of water. The drug is also used as an antidote for Paracetamol poisoning and to stop hair pulling. However, you need not worry about that. Its effervescent form is an excellent mucolytic agent.

• Levocetirizine is Xyzal, if not available you may use Allegra (Fexofenadine, 120 mg) or Claritin (Desloratadine 10 mg or 5 mg) or Zyrtec (Cetirizine 10 mg)

• For anti-inflammatory drugs, Trypsin and Chymotrypsin. These need to be used only for three days to remove swelling, congestion, and edema.

• Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent.

Hope this helps.

For further queries consult an ENT otolaryngologist online --> https://www.icliniq.com/ask-a-doctor-online/ENT-Otolaryngologist