I have burning sensation on one side of the throat with white patch on the tonsils. Please help.

Hi,

Welcome to icliniq.com.

I had a detailed look at the picture (attachment removed to protect patient identity) you have sent and there is absolutely nothing that you need to worry about. The white patch is due to chronic irritation which is definitely a feature of chronic silent GERD with LPR (gastroesophageal reflux with laryngopharyngeal reflux). Even though you might be asymptomatic or never had gastric issues in between, the inflammation in the throat often exists in the hidden form and 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 in nature. 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, eating on time. 2. Avoid spicy, oily, and cold food/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. Saltwater gargling 8 to 10 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: Take tablet Pan D 40 mg (Pantoprazole and Domperidone) once in the morning before breakfast for one month, syrup Mucaine gel one teaspoon 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 will not fetch a 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 happens there. There is a possibility that the white patch might persist even after four to six weeks and it does not indicate cancer or any malignancy. There is absolutely nothing that you need to worry about as this is a treatable entity and things will be fine. I hope this helps.

Hi,

Welcome back to icliniq.com.

I had a detailed look at the pictures you have sent (attachment removed to protect patient identity). The structure you are mentioning below your tongue is a sublingual duct from the sublingual gland which secretes saliva into your mouth. It is slightly increased in size, but I do not see any signs of cancer or malignancy and hence there is absolutely nothing that you need to worry about. Burning sensations will only come down after you follow the precautionary measures as healing occurs in phases and medications just contribute to 20% of the treatment that you have taken. It takes around four to six weeks before things resolve and get back to normal and I advise and urge you to follow all the precautionary measures mentioned in our earlier conversations. I am sure there is nothing that you need to worry about as this is nothing lethal and a treatable entity and you need to wait and be patient for healing to start and take its effect. I would advise you to follow all that is mentioned above and wait for at least six weeks before you decide to take a consult in person from a specialist. I hope this helps.