Throat Pain and Helicobacter Pylori: What You Need to Know

Sore throat and Helicobacter pylori?

Hello Doctor, I have been experiencing pain on the right side of my throat recently, especially when swallowing saliva or in certain positions.
The pain feels sharp, as if there is a wound, and it is a fixed point of pain.
I visited an ENT specialist for an endoscopy, and they noted some swelling in my neck and slightly enlarged lymph nodes, attributing it to esophageal reflux causing irritation.
I was prescribed medication and returned for a follow-up after a week, but there was no significant improvement.
I was then referred to a gastroenterologist, took medication for two weeks, but still saw no improvement.
An upper endoscopy was performed, which showed mild gastroesophageal reflux but no significant issues.
I have been on medication for over two weeks now, and the pain point has not improved.
What should my next steps be? (The pain has persisted for over two months, and I read online that unilateral pain lasting more than a month could indicate tonsil cancer.
Can the ENT doctor rule this out with the endoscopy?) Additionally, I received my company's health report today, which indicated that I have Helicobacter pylori (standard range is 0-6, my result is 7).
Should this be addressed urgently? I have quite a few questions, thank you, Doctor.

Wang, 30~39 year old female. Ask Date: 2019/04/22

Dr. Chen Qifeng reply Gastroenterology and Hepatology

1.
The tonsils fall under the scope of otolaryngology, and an otolaryngology endoscopy can be used for diagnosis.
2.
Helicobacter pylori can be considered for treatment, but it is not urgent.

Reply Date: 2019/04/22

More Info

Throat pain can be a distressing symptom, especially when it persists for an extended period. Based on your description, it seems you have been experiencing localized pain on the right side of your throat, particularly when swallowing, along with some swelling in the lymph nodes and a diagnosis of mild gastroesophageal reflux disease (GERD). You have also mentioned a recent diagnosis of Helicobacter pylori (H. pylori) infection, which adds another layer to your health concerns.

Understanding Your Symptoms
1. Localized Throat Pain: The pain you describe, especially when swallowing, could be due to several factors. While GERD can cause irritation and inflammation in the throat due to acid reflux, other potential causes include infections (viral or bacterial), allergies, or even irritants like smoke or pollution. The fact that you have had this pain for over two months warrants further investigation.

2. Lymph Node Swelling: Swollen lymph nodes can indicate an ongoing infection or inflammation in the body. In your case, the ENT specialist's examination and the use of an endoscope would have helped rule out some serious conditions, including tumors. However, persistent swelling should be monitored.

3. Concerns About Cancer: It is understandable to be concerned about the possibility of cancer, especially with symptoms like unilateral pain lasting more than a month. While the endoscopic examination is a valuable tool for detecting abnormalities, if you still have concerns, seeking a second opinion or further imaging studies (like a CT scan) may provide additional reassurance.

Helicobacter Pylori and Its Implications
H. pylori is a type of bacteria that can infect the stomach and is often associated with peptic ulcers and gastritis. Your report indicates a slightly elevated level of H. pylori, which may require treatment, especially if you are experiencing gastrointestinal symptoms.
1. Treatment for H. Pylori: The standard treatment usually involves a combination of antibiotics and proton pump inhibitors (PPIs) to eradicate the bacteria and reduce stomach acid. It is crucial to follow your healthcare provider's recommendations regarding this treatment, as untreated H. pylori can lead to more severe gastrointestinal issues.

2. Connection to Throat Pain: While H. pylori primarily affects the stomach, there is some evidence suggesting that it may contribute to throat discomfort indirectly, especially if there is significant reflux. Treating the H. pylori infection may help alleviate some of the reflux symptoms, which in turn could reduce throat irritation.

Next Steps
Given that your symptoms have persisted for over two months without significant improvement, here are some recommendations:
1. Follow-Up with Specialists: Since you have already seen an ENT and a gastroenterologist, consider scheduling a follow-up appointment with either specialist to discuss your ongoing symptoms. They may recommend further diagnostic tests, such as imaging studies or a biopsy if deemed necessary.

2. H. Pylori Treatment: If you have not started treatment for H. pylori, it is advisable to do so promptly. Discuss with your doctor the best course of action, including the potential side effects of the medications.

3. Symptom Management: In the meantime, managing your GERD symptoms may help alleviate throat pain. This can include dietary modifications (avoiding spicy, acidic, or fatty foods), eating smaller meals, and not lying down immediately after eating.

4. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their severity, and any associated factors (like diet or stress). This information can be invaluable for your healthcare providers in determining the best course of action.

5. Consider a Second Opinion: If you continue to feel uneasy about your diagnosis or treatment plan, seeking a second opinion from another specialist can provide additional insights and peace of mind.

In summary, while your symptoms are concerning, there are several avenues for further investigation and treatment. Addressing the H. pylori infection and continuing to monitor your throat pain with your healthcare providers will be essential in managing your health effectively.

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