Chronic Pharyngitis: Symptoms, Causes, and Treatment Options

Q: Chronic Pharyngitis: Symptoms, Causes, and Treatment Options

Hello： Your symptoms do indeed suggest chronic pharyngitis. <br>If there is no improvement, it is recommended to consult with an otolaryngologist and a gastroenterologist for further evaluation. <br>Wishing you peace and good health. <br>Sincerely, Dr. <br>Cheng Jue-Yi, Director

Chronic pharyngitis

Hello Doctor, here is my medical history.
I am not sure if I am a patient with chronic pharyngitis, but after researching related knowledge online, I feel that my symptoms align quite well.
Around the end of August, one Saturday afternoon, I suddenly developed a fever while I was in the military.
That afternoon, I went to a clinic and took medication, which helped reduce the fever.
However, when I returned to my unit that week, I started coughing at night, which I suspect turned into a cold and bronchitis (I was producing dark-colored phlegm at that time).
For the next two weeks, during my time off, I went to another clinic to get medication.
Eventually, I slept in a dormitory without air conditioning, but due to the military environment, I still encountered air conditioning to some extent.
When I started feeling a bit better, I returned home during my time off and began to experience a tight sensation in my throat, so I visited the clinic again and took more medication, but there was still no improvement.
When the Double Tenth holiday finally allowed me to go to the hospital for an examination, the doctor mentioned that it might be affected by gastroesophageal reflux and chronic rhinitis (during September, I actually did not have much nasal congestion or runny nose).
I occasionally felt a sour sensation in my esophagus due to gastroesophageal reflux, but it was not severe.
I suspect this is related to my military schedule (after lunch, I would lie down to sleep shortly after eating).
After taking the prescribed medications, I honestly did not finish them because I had to take three different pills: one for throat inflammation, one to prevent gastroesophageal reflux, and one for nasal congestion before bed.
However, after taking the throat inflammation medication, I felt that my throat was even tighter.
Finally, after completing my military service, I no longer had to deal with air conditioning.
Now, I make sure not to lie down immediately after eating, and I avoid eating before bed.
Since the end of August in the military, I have not consumed cold drinks and have almost eliminated them from my diet.
I drink at least 2000 ml of warm water daily, but it seems that my symptoms have not been completely resolved.
Therefore, I visited a nearby clinic again, where the doctor mostly prescribed gastric and anti-inflammatory medications (I do not have a daily bowel movement habit).
However, to this day, my symptoms persist.
Currently, my symptoms include voice changes (slight hoarseness, fluctuating), a tight sensation around my chest near the first rib (initially it was in my throat, and eating did not affect it), morning nasal discharge, and slight nasal congestion.
Recently, I often feel the need to clear my throat, and when I do, I feel phlegm, but it is always clear (like saliva).
After my military service, I have rarely experienced the sensation of gastroesophageal reflux.
I have been controlling my diet, avoiding spicy, fried, and sweet foods, etc.
I have completely stopped coughing (actually, since I stopped being exposed to cold air in the military, I have not coughed).
Additionally, since mid-September, I have noticed slight lesions in the mucosa of the upper part of my oral cavity, which have not healed yet (my tongue feels uneven when it passes over them).
I would like to ask the doctor if I need to see an otolaryngologist for a more in-depth examination or if I should go to a pulmonologist for an X-ray (because I currently feel a bit of chest tightness).
In the past, whether I had a cold or a fever, I never coughed; it was only during those few days when I was exposed to cold air that I coughed.
I can say that I have never had symptoms that required me to see so many doctors without improvement.

Breeze, 20~29 year old female. Ask Date: 2017/10/28

Dr. Zheng Jueyi reply Otolaryngology

Hello: Your symptoms do indeed suggest chronic pharyngitis.
If there is no improvement, it is recommended to consult with an otolaryngologist and a gastroenterologist for further evaluation.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/10/28

More Info

Chronic pharyngitis is a condition characterized by persistent inflammation of the pharynx, which can lead to a variety of symptoms including a sore throat, difficulty swallowing, and a sensation of a lump in the throat. Understanding the symptoms, causes, and treatment options for chronic pharyngitis is essential for effective management.

Symptoms
The symptoms of chronic pharyngitis can vary but often include:
- Sore throat: A persistent pain or discomfort in the throat.

- Dry throat: A feeling of dryness that may worsen at night or upon waking.

- Difficulty swallowing: Pain or discomfort when swallowing food or liquids.

- Hoarseness: Changes in voice quality, often described as raspy or strained.

- Cough: A dry cough that may be persistent.

- Postnasal drip: Mucus dripping down the back of the throat, which can cause irritation.

- Throat clearing: A frequent need to clear the throat due to irritation.

Causes
Chronic pharyngitis can be caused by a variety of factors:
- Infections: Recurrent viral or bacterial infections can lead to chronic inflammation.

- Allergies: Allergic reactions to environmental factors such as pollen, dust, or pet dander can cause throat irritation.

- Gastroesophageal reflux disease (GERD): Stomach acid can irritate the throat, leading to inflammation.

- Environmental irritants: Exposure to smoke, pollution, or chemicals can contribute to throat irritation.

- Chronic sinusitis: Ongoing sinus infections can lead to postnasal drip, which irritates the throat.

- Dehydration: Insufficient fluid intake can lead to a dry throat and exacerbate symptoms.

Treatment Options
Managing chronic pharyngitis typically involves addressing the underlying causes and alleviating symptoms. Here are some common treatment options:
1. Medications:
- Antihistamines: If allergies are a contributing factor, antihistamines like cetirizine or levocetirizine can help reduce symptoms.

- Proton pump inhibitors (PPIs): For those with GERD, medications like omeprazole can reduce stomach acid production and alleviate throat irritation.

- Corticosteroids: In some cases, a doctor may prescribe corticosteroids to reduce inflammation in the throat.

- Pain relievers: Over-the-counter medications like acetaminophen or ibuprofen can help relieve pain and discomfort.

2. Lifestyle Modifications:
- Hydration: Drinking plenty of fluids can help keep the throat moist and reduce irritation.

- Humidifiers: Using a humidifier in your home can add moisture to the air, which may alleviate dryness in the throat.

- Avoid irritants: Steering clear of smoke, strong odors, and other environmental irritants can help reduce symptoms.

- Dietary changes: Avoiding spicy, acidic, or irritating foods can help minimize throat discomfort.

3. Home Remedies:
- Gargling salt water: Gargling with warm salt water can help soothe a sore throat.

- Throat lozenges: Sucking on lozenges can provide temporary relief from throat irritation.

- Warm teas: Herbal teas with honey can be soothing for the throat.

When to Seek Further Evaluation
If symptoms persist despite treatment, or if you experience additional symptoms such as difficulty breathing, severe pain, or swelling, it is important to seek further evaluation from a healthcare provider. An ear, nose, and throat (ENT) specialist can conduct a thorough examination and may recommend additional tests, such as imaging studies or endoscopy, to assess the condition of the throat and surrounding structures.

In your case, given the history of symptoms and the potential involvement of gastroesophageal reflux, it would be advisable to consult with an ENT specialist for a comprehensive evaluation. They can help determine if there are any underlying issues that require specific treatment, such as chronic sinusitis or other conditions that may be contributing to your symptoms. Additionally, if you are experiencing chest tightness or discomfort, a consultation with a pulmonologist may also be warranted to rule out any respiratory issues.

In summary, chronic pharyngitis can be a multifaceted condition requiring a comprehensive approach to diagnosis and management. By understanding the symptoms, causes, and treatment options, you can work towards finding relief and improving your quality of life.

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