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What Causes Sore Throat And Inflamed Tonsils With Acid Reflux?
Question: For the last 5 months I am having sore throat. I have visited multiple ENT specialist and Gastroenterology specialists. Initially I was detected to have H. Pylori and endoscopy report showed mild gastritis. Doctor told me of acid reflux. I was given azirthomycin 7 days and Parriet (rabeprazol 40 mg) for one week. I made my my head side up by 6 inches and stopped eating spicy, citus, carbonated food and even stopped tea and coffee.
I went to another ENT specialist who had done fibre optic laryngeoscopy (FOL) which said some observations like DNS right with spur, GERD feature, chonsabullosa, sinonasal disease, vocal cord odematus gerd features etc. (please see the reports). he prescribed me some medicin like anti inflammatory, mucain and omeprazole etc. He told me my nasal duct blockage (picture attached) and advised me surgery. He even told me that since I am living in a dusty city (in Dubai) hence will have some allergic issues.
Now after six month, I am still having my sore throat. One of my previous doctor told me to CT PNS scan. it came more or less normal only showing DNS. Whenever, I wake up in the morning I have some dryness in my throat and constantly there are some mild irritation in my throat. When i give presentation or speak for long time, i feel pain in my throat. Sometimes my throat lymph nodes are swollen. I am scared of cancer although all my doctors said negative about it after physical as well as after fibric optic laryngeoscopy or endoscopy. My recent test showed negative H. pylori. My C- reactive protein is 1.2. My entire blood work is normal.
I want to know whether I have to live my rest of life like this throat irritation ? Is it curable or not? Do you consider that anything susceptible to throat cancer? Presently taking omeprazole 20 mg in breakfast and mucaine. please suggest me any advice to remove from this.....thanks in advance.
I went to another ENT specialist who had done fibre optic laryngeoscopy (FOL) which said some observations like DNS right with spur, GERD feature, chonsabullosa, sinonasal disease, vocal cord odematus gerd features etc. (please see the reports). he prescribed me some medicin like anti inflammatory, mucain and omeprazole etc. He told me my nasal duct blockage (picture attached) and advised me surgery. He even told me that since I am living in a dusty city (in Dubai) hence will have some allergic issues.
Now after six month, I am still having my sore throat. One of my previous doctor told me to CT PNS scan. it came more or less normal only showing DNS. Whenever, I wake up in the morning I have some dryness in my throat and constantly there are some mild irritation in my throat. When i give presentation or speak for long time, i feel pain in my throat. Sometimes my throat lymph nodes are swollen. I am scared of cancer although all my doctors said negative about it after physical as well as after fibric optic laryngeoscopy or endoscopy. My recent test showed negative H. pylori. My C- reactive protein is 1.2. My entire blood work is normal.
I want to know whether I have to live my rest of life like this throat irritation ? Is it curable or not? Do you consider that anything susceptible to throat cancer? Presently taking omeprazole 20 mg in breakfast and mucaine. please suggest me any advice to remove from this.....thanks in advance.
Brief Answer:
do not worry
Detailed Answer:
Hello and welcome to health care magic,
I am Dr Sriram Nathan and I do understand the problems you are facing. Throat irritation is a bane of the modern lifestyle due to the pollution, allergy and the work pressure. In your case since you also need to give presentations I would assume that you have a vocal strain also.
Let us consider few points before I can assure you that this is perfectly normal and a throat irritation can never lead to cancer so first do not worry.
-Since you wake up with throat dryness and irritation it is obvious that you have nose block and this could be due to the deviated septum and also the reflux. You need to manage the nose block initially by a combination of nasal sprays and antihistamines (which will also take care of your allergies) in consultation with your ENT. If these do not help then you must seriously consider the surgery Septoplasty/ FESS which will cure your nose block in good hands. You can get back to me on this surgery as I have performed more than a thousand of such surgeries with good results.
-Since you have a vocal strain you must practice vocal hygiene. This involves voice rest, avoiding spicy and oily food and also not to whisper or scream. In any case keep your throat hydrated with warm water always and do not frequently clear your throat. If needed consult a speech therapist who will better guide you on the proper use of voice.
-You also have reflux due to the increased amount of stress. You thus need to continue the anti reflux treatments and also follow anti reflux measures. This includes avoiding spicy and oily food and exercise. Take lots of green leafy vegetables and avoid lying down immediately after food. You can search in the net for these measures and follow them religiously.
-Some amount of node swellings especially in the throat is natural and this is nothing to worry about. If however they persist then you must consider a cytology examination to put your mind at ease. In majority of cases this will be benign.
The above treatment if done properly and patiently will definitely yield results. Do not expect a miracle cure in a day or two! You need to practice these for a month or so to get a good result and maintain them.
Furthermore I have seen all your results and also since your scopy is normal now you have nothing major to worry about.
Try also to reduce the mental stress by doing yoga or meditation and try to be positive which will help you more than all the medications.
Finally, you must understand that throat irritation is common and not something to be worried about and if you are H Pylori negative there is hardly any chance of it becoming a cancer so just relax. It of course goes without saying that you must avoid smoking, spirits and excess caffeine drinks.
Hope this helps and if you have any more doubts you can be assured I will be there to help you out.
regards
Dr Sriram Nathan
do not worry
Detailed Answer:
Hello and welcome to health care magic,
I am Dr Sriram Nathan and I do understand the problems you are facing. Throat irritation is a bane of the modern lifestyle due to the pollution, allergy and the work pressure. In your case since you also need to give presentations I would assume that you have a vocal strain also.
Let us consider few points before I can assure you that this is perfectly normal and a throat irritation can never lead to cancer so first do not worry.
-Since you wake up with throat dryness and irritation it is obvious that you have nose block and this could be due to the deviated septum and also the reflux. You need to manage the nose block initially by a combination of nasal sprays and antihistamines (which will also take care of your allergies) in consultation with your ENT. If these do not help then you must seriously consider the surgery Septoplasty/ FESS which will cure your nose block in good hands. You can get back to me on this surgery as I have performed more than a thousand of such surgeries with good results.
-Since you have a vocal strain you must practice vocal hygiene. This involves voice rest, avoiding spicy and oily food and also not to whisper or scream. In any case keep your throat hydrated with warm water always and do not frequently clear your throat. If needed consult a speech therapist who will better guide you on the proper use of voice.
-You also have reflux due to the increased amount of stress. You thus need to continue the anti reflux treatments and also follow anti reflux measures. This includes avoiding spicy and oily food and exercise. Take lots of green leafy vegetables and avoid lying down immediately after food. You can search in the net for these measures and follow them religiously.
-Some amount of node swellings especially in the throat is natural and this is nothing to worry about. If however they persist then you must consider a cytology examination to put your mind at ease. In majority of cases this will be benign.
The above treatment if done properly and patiently will definitely yield results. Do not expect a miracle cure in a day or two! You need to practice these for a month or so to get a good result and maintain them.
Furthermore I have seen all your results and also since your scopy is normal now you have nothing major to worry about.
Try also to reduce the mental stress by doing yoga or meditation and try to be positive which will help you more than all the medications.
Finally, you must understand that throat irritation is common and not something to be worried about and if you are H Pylori negative there is hardly any chance of it becoming a cancer so just relax. It of course goes without saying that you must avoid smoking, spirits and excess caffeine drinks.
Hope this helps and if you have any more doubts you can be assured I will be there to help you out.
regards
Dr Sriram Nathan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Sriram,
Thanks for your detailed answer.
Please suggest me following:
1. Can I do exercise? I used to go for gym regularly. Now after this acid reflux, I am going thrice a week and specially avoiding all abdomen exercise. Please suggest me what to do in this aspect?
2. Regarding the nodes in the neck just below the parotid gland. I have performed the soft tissue ultrasonograpgy which according to radiologist is normal. I asked my ENT doc everytime and he says its normal. But I can feel the node. Is it abnormal?
3. Initially I have performed GI endoscopy which said that I have mild gastritis but at that time i was detected H. Pylori. Now after three months I again tested H.pylori in blood. It came as negative. I left smoking 4 years ago. I used to have spirits once in a week but for last 7 months stopped that too also. I dont take coffe, milk tea and any carbonated drinks. I stopped eating other acidic foods. Now my question is that should i have to live like this?
4. I m taking honey with warm water. Is it good?
5. Regarding the medication, I am using fluticasone and montelukast in the bed time along with omeprazole. Should i continue this or any change?
If possible, please provide me your chamber address.
Thanking you in advance,
With best regards,
Thanks for your detailed answer.
Please suggest me following:
1. Can I do exercise? I used to go for gym regularly. Now after this acid reflux, I am going thrice a week and specially avoiding all abdomen exercise. Please suggest me what to do in this aspect?
2. Regarding the nodes in the neck just below the parotid gland. I have performed the soft tissue ultrasonograpgy which according to radiologist is normal. I asked my ENT doc everytime and he says its normal. But I can feel the node. Is it abnormal?
3. Initially I have performed GI endoscopy which said that I have mild gastritis but at that time i was detected H. Pylori. Now after three months I again tested H.pylori in blood. It came as negative. I left smoking 4 years ago. I used to have spirits once in a week but for last 7 months stopped that too also. I dont take coffe, milk tea and any carbonated drinks. I stopped eating other acidic foods. Now my question is that should i have to live like this?
4. I m taking honey with warm water. Is it good?
5. Regarding the medication, I am using fluticasone and montelukast in the bed time along with omeprazole. Should i continue this or any change?
If possible, please provide me your chamber address.
Thanking you in advance,
With best regards,
Brief Answer:
you are welcome
Detailed Answer:
hello again and glad to be of any help to you.
Regarding your very apt questions, let me answer them one by one in sequence:
1. Exercise is never bad and you can very well do them but remember to start slow and do not stop suddenly. My advice is to do an exercise which you can continue and maintain for long time and this is more important. If you do vigorous exercise for a short time and then stop it will be causing more harm than good. The best exercise is of course a brisk walk which you can maintain for long time!
In any case if you are going for abdomen exercises then it is imperative that you do it under guidance and do not do the extreme ones. Of course till your irritation persists it is advisable to avoid abdomen exercises.
2. Ultrasound is a good tool to rule out any ominous lesion and if that has come as normal then you have nothing to worry about. If however the node increases in size and is having secondary symptoms like pain and pressure effects then you can go for a simple investigation like cytology which is very sensitive in ruling out the cause of the swelling.
3. You do not have to live like a saint your whole life but you must also not over do the opposite. You can have spicy and other foods once in a while and that to in little quantity. Just make sure you do it only once in a while and compensatory you must take a course of bland diet subsequently. Once your problems are controlled with medications and other measures which I have explained then you can take anything once in a while but for the time being be careful.
4. If the honey is of good quality and since you do not have diabetes then you can very well take this once in a while with warm water which will soothe your throat.
5. The medication seems to be fine though I would prefer somprazole-l for my patients instead of omeprazole which is an old drug. You must consult with your doctor regarding this.
Finally just click on my profile and you will get the address of my time and clinic which is not a secret anyway! You can also check out my website www.entdoctorsriram.com for further details.
Hope this helps
regards
Dr Sriram Nathan
you are welcome
Detailed Answer:
hello again and glad to be of any help to you.
Regarding your very apt questions, let me answer them one by one in sequence:
1. Exercise is never bad and you can very well do them but remember to start slow and do not stop suddenly. My advice is to do an exercise which you can continue and maintain for long time and this is more important. If you do vigorous exercise for a short time and then stop it will be causing more harm than good. The best exercise is of course a brisk walk which you can maintain for long time!
In any case if you are going for abdomen exercises then it is imperative that you do it under guidance and do not do the extreme ones. Of course till your irritation persists it is advisable to avoid abdomen exercises.
2. Ultrasound is a good tool to rule out any ominous lesion and if that has come as normal then you have nothing to worry about. If however the node increases in size and is having secondary symptoms like pain and pressure effects then you can go for a simple investigation like cytology which is very sensitive in ruling out the cause of the swelling.
3. You do not have to live like a saint your whole life but you must also not over do the opposite. You can have spicy and other foods once in a while and that to in little quantity. Just make sure you do it only once in a while and compensatory you must take a course of bland diet subsequently. Once your problems are controlled with medications and other measures which I have explained then you can take anything once in a while but for the time being be careful.
4. If the honey is of good quality and since you do not have diabetes then you can very well take this once in a while with warm water which will soothe your throat.
5. The medication seems to be fine though I would prefer somprazole-l for my patients instead of omeprazole which is an old drug. You must consult with your doctor regarding this.
Finally just click on my profile and you will get the address of my time and clinic which is not a secret anyway! You can also check out my website www.entdoctorsriram.com for further details.
Hope this helps
regards
Dr Sriram Nathan
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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