Persistent Throat Irritation and Foul-Smelling Phlegm: When to See an ENT?

Itchy throat with foul-smelling phlegm?

Hello doctor, for the past month or two, I have been experiencing intermittent phlegm in my throat, and sometimes the phlegm has a foul odor (similar to the smell of tonsil stones).
However, the phlegm does not always have a smell.
My throat also feels a bit itchy, and I have a mild urge to cough.
Recently, due to discomfort in my stomach and a sensation of something foreign in my throat, I visited a gastroenterology clinic.
The doctor suggested it might be gastroesophageal reflux disease (GERD) and noted some redness in my throat during the examination.
I took medication, but it did not improve my condition.
Later, I went to the hospital where the doctor prescribed medication for GERD and throat reflux.
The symptoms related to my stomach and the sensation of a foreign body have almost resolved, but my throat still feels itchy and has phlegm (which occasionally still has a foul odor).
The hospital doctor mentioned that the throat symptoms are not related to my stomach issues.
Should I consider seeing an otolaryngologist for this?

Ajiu, 10~19 year old female. Ask Date: 2018/11/05

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the situation you described may be chronic pharyngitis, but it is still recommended to undergo a laryngoscopy to rule out any masses and to receive medication treatment.
In addition to medication, please pay attention to the following daily life precautions: avoid lying down for two hours after eating, and refrain from coffee, tea, cigarettes, alcohol, fried foods, and spicy foods, as these can help improve symptoms.
Wishing you safety and health.
Sincerely, Chi Chao-Yun, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/11/05

More Info

Persistent throat irritation accompanied by foul-smelling phlegm can be concerning, especially if it has been ongoing for a couple of months. Given your symptoms, it is advisable to consult an Ear, Nose, and Throat (ENT) specialist for a thorough evaluation.
Your description of the phlegm having a foul odor, similar to that associated with tonsil stones, suggests that there may be an underlying issue in the throat or upper respiratory tract. The presence of bad-smelling phlegm can be indicative of several conditions, including chronic sinusitis, post-nasal drip, or even an infection. The fact that you also experience throat irritation and a sensation of something being stuck in your throat further supports the need for an ENT evaluation.

While your gastroenterologist has addressed the potential for gastroesophageal reflux disease (GERD) as a contributing factor to your throat symptoms, it is important to note that GERD can lead to throat irritation and post-nasal drip, which may exacerbate throat symptoms. However, if the medications prescribed for GERD have not alleviated your throat symptoms, it may indicate that there is another issue at play.

In addition to the conditions mentioned, the foul-smelling phlegm could also be related to chronic tonsillitis or the presence of tonsil stones (tonsilloliths), which can harbor bacteria and produce a foul odor. An ENT specialist can perform a thorough examination of your throat, including the tonsils, and may recommend imaging studies or cultures to identify any infections or abnormalities.

Moreover, if you have been experiencing a persistent cough or throat irritation, it is essential to rule out any other potential causes, such as allergies, environmental irritants, or even more serious conditions like throat cancer, especially if you are a smoker or have other risk factors.
In summary, given the persistence of your symptoms and the presence of foul-smelling phlegm, it is prudent to seek an evaluation from an ENT specialist. They can provide a comprehensive assessment and determine the appropriate course of action, which may include further diagnostic testing or treatment options tailored to your specific condition. Early intervention can help prevent potential complications and improve your quality of life.

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