Chronic Pharyngitis and the Sensation of a Throat Lump - Otolaryngology

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Chronic pharyngitis, sensation of a foreign body in the throat?


Hello, Doctor.
Two months ago, I initially had a mild cold and consumed spicy food.
My throat lost its voice for about a day, and then I started feeling a persistent sensation of mucus in my throat.
It gradually worsened, and in the mornings, I felt like my throat was filled with phlegm.
At one point, I was suddenly awakened by a burning sensation in my throat.
I went for an endoscopy, and the doctor diagnosed me with gastroesophageal reflux disease (GERD).
I then consulted an ENT specialist who suggested it might be pharyngeal reflux.
I have been controlling my diet for almost a month now.
Although I no longer clear my throat as frequently as before, I still feel like there is a lump of phlegm in my throat, and I can feel it when swallowing saliva.
I experience less discomfort while sleeping, but when I stand up, my throat feels swollen and constricted.
The doctor performed an endoscopy and noted some redness in my esophagus and throat.
I would like to ask the doctor if this is truly gastroesophageal reflux, or could it be another condition?

A Long, 20~29 year old female. Ask Date: 2020/04/21

Dr. Zheng Jueyi reply Otolaryngology


Hello, it is likely that you are experiencing gastroesophageal reflux disease (GERD) combined with chronic laryngitis.
It is recommended to continue medication treatment and dietary control.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/04/21

More Info


Chronic pharyngitis, often characterized by a persistent sensation of a lump in the throat, can be a frustrating condition for many patients. Your symptoms, which began after a mild cold and were exacerbated by spicy foods, suggest a possible link to gastroesophageal reflux disease (GERD) and post-nasal drip, both of which can contribute to throat irritation and discomfort.

The initial onset of your symptoms following a cold indicates that your throat may have been inflamed due to viral infection. This inflammation can lead to increased sensitivity and a sensation of mucus accumulation, which is often described as a "lump" in the throat. The fact that you experienced a burning sensation and were subsequently diagnosed with GERD adds another layer to your condition. GERD occurs when stomach acid flows back into the esophagus, leading to irritation of the throat and esophagus, which can manifest as a sore throat, cough, and the sensation of a lump.

Your ongoing symptoms, particularly the feeling of mucus in your throat and the need to clear it frequently, could also be attributed to post-nasal drip. This condition occurs when excess mucus accumulates in the back of the throat, often due to allergies, sinus infections, or other irritants. The combination of GERD and post-nasal drip can create a cycle of irritation, where one condition exacerbates the other.

Despite dietary modifications aimed at controlling your GERD, it’s important to consider that the throat may remain sensitive for some time after the initial inflammation. The redness observed during the endoscopy suggests ongoing irritation, which could be due to residual effects of reflux or chronic inflammation from post-nasal drip.

To address your concerns, it would be beneficial to explore the following:
1. Continued Management of GERD: Ensure that you are adhering to a GERD-friendly diet, avoiding trigger foods (such as spicy, fatty, or acidic foods), and considering medications like proton pump inhibitors (PPIs) or H2 blockers to reduce stomach acid production. If you are already on these medications, discuss with your physician whether adjustments are necessary.

2. Post-Nasal Drip Treatment: If allergies or sinus issues are contributing to your symptoms, consider using saline nasal sprays or antihistamines to help reduce mucus production. Nasal corticosteroids may also be beneficial if inflammation is significant.

3. Hydration and Humidification: Staying well-hydrated can help thin mucus, making it easier to clear. Using a humidifier, especially at night, can also alleviate throat dryness and irritation.

4. Voice Rest: If your throat feels strained, giving your voice a break can help reduce irritation. Avoid whispering, as it can strain the vocal cords more than normal speaking.

5. Follow-Up with Specialists: If symptoms persist despite these measures, consider follow-up appointments with both your gastroenterologist and an ear, nose, and throat (ENT) specialist. They may recommend further evaluations, such as a 24-hour pH monitoring test to assess acid reflux severity or imaging studies to evaluate for other potential causes of your symptoms.

In summary, your symptoms are likely related to a combination of GERD and post-nasal drip, both of which can lead to chronic throat irritation. By addressing both conditions through dietary management, medication, and possibly further evaluation, you can work towards alleviating the sensation of a lump in your throat and improving your overall comfort.

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