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What Increases Sinus Issues Create A Breeding Ground For Bad Breath, Bacteria And A Likelihood Of Infections?

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Posted on Wed, 13 Sep 2023
Question: I was to an ENT specialist but didn't get answers to all my questions regarding my nose, tonsils and very long term chronic halitosis problem:

If my halitosis problem is caused by postnasal drip or sinus allergy like rhinitis that then builds up in the small caveties of tonsils, would removing the tonsils likely help solve the problem, or will the bacteria still be able to 'hide' within back of throat or tongue?

My nose always needs clearing in the morning and usually again in evening and I often need to clear my throat. Given that this happens every single day for many years, is it likely to be caused by some kind of allergy? Reason is that I have tried two nasal sprays (Mometasone furoate based 1 and fluticasone furoate based 1) and both had no effect when I used them independetly as described by GP for over 6 weeks.

Since October last year, I have been getting ill frequently with 3 clear tonsilitius cases, 1 mild case and many flus that didn't develop to tonsilitius.

Overall, I'm just very confused as to what could be causing what - i.e. is my sinus increasing my likelyhood of infections and breeding ground for bad breath bacteria, or are tonsils or something else causing my sinus problems. I want to see if there is anything else I can try before paying to get my tonsils removed privately.



doctor
Answered by Dr. Dr. Naveen Kumar Nanjasetty (2 hours later)
Brief Answer:
Laryngopharyngeal reflux...

Detailed Answer:
Hi

Thanks for posting the query

I have gone through your query and understood your problem, I will try my best to help you.

1. The symptoms you have described seem to be related to a condition called Laryngopharyngeal reflux secondary to the acid reflux.

2. The recurrent regurgitation of the acid from the stomach into the throat causes irritation of the mucosa creating a sensation of post-nasal drip and recurrent throat infections.

3. You would require a course of proton pump inhibitors and antacids for reducing the symptoms.

4. I would not advise tonsillectomy unless the underlying cause has been treated.

5. Drink frequent sips of warm water, avoid coffee/fizzy drinks/greasy food/smoking (if any)/chilled food and beverages.

Hope this answers your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Naveen Kumar Nanjasetty (19 hours later)
I don't drink fizzy drinks, coffee or smoke and don't drink too much alcohol.

I'm wondering if Laryngopharyngeal reflux can easily be identified as the underling cause for my condition as I'm not sure what to expect if I was to start taking proton pump inhibitors and antacids and for how long? I assume the PPIs are also prescription only.

The reason for my time urgency is this summer may be one of my only good opportunities to remove my tonsils and I'm not sure if I can find the underlying cause before then
doctor
Answered by Dr. Dr. Naveen Kumar Nanjasetty (4 hours later)
Brief Answer:
Need to get evaluated for Laryngopharyngeal reflux before tonisllectomy...

Detailed Answer:
Hi

Thanks for writing back

Most of the time the innocent tonsils get penalized for no fault of theirs. Unless we do not identify the actual cause of a recurrent sore throat, tonsillectomy may not be beneficial. Tonsillectomy is not an emergency procedure. You can always wait.

Before sacrificing the tonsils try to get evaluated for Laryngopharyngeal reflux. Below is the link which may be beneficial to you. https://my.clevelandclinic.org/health/diseases/15024-laryngopharyngeal-reflux-lpr

Proton pump inhibitors for at least 2 months, may help in alleviating your symptoms. In some places, it is available over the counter. If you are not better with the above medications, then, you can get tonsillectomy done.

Hope this clarifies your doubts. Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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. Prasad
doctor
Answered by
Dr.
Dr. Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2545 Questions

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What Increases Sinus Issues Create A Breeding Ground For Bad Breath, Bacteria And A Likelihood Of Infections?

Brief Answer: Laryngopharyngeal reflux... Detailed Answer: Hi Thanks for posting the query I have gone through your query and understood your problem, I will try my best to help you. 1. The symptoms you have described seem to be related to a condition called Laryngopharyngeal reflux secondary to the acid reflux. 2. The recurrent regurgitation of the acid from the stomach into the throat causes irritation of the mucosa creating a sensation of post-nasal drip and recurrent throat infections. 3. You would require a course of proton pump inhibitors and antacids for reducing the symptoms. 4. I would not advise tonsillectomy unless the underlying cause has been treated. 5. Drink frequent sips of warm water, avoid coffee/fizzy drinks/greasy food/smoking (if any)/chilled food and beverages. Hope this answers your query; I will be available for the follow-up queries. Regards Dr. Naveen Kumar N ENT and Head & Neck Surgeon