Persistent Throat Pain: Is It Psychological or Physical? - Psychiatry

Feeling fearful and uncomfortable every day?

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Hello Doctor,
I have been experiencing a sensation of a foreign body and pain in my throat and pharyngeal wall for the past four months, which has been getting progressively worse.
Although I do not have difficulty swallowing, swallowing does cause sharp pain, and drinking water also leads to a sensation of something being stuck.
I have been taking medication during this time without any improvement.
Five months ago, I underwent a bilateral tonsillectomy, and since then, the sensation of a foreign body has persisted.
Additionally, I have sharp pain at the base of my left tongue and throat, which is accompanied by ear pain and unilateral tinnitus that has lasted all day for several months.
I have had follow-up appointments after the surgery, about four or five times, but there has been no improvement.
During a previous visit, I mentioned my symptoms to the surgeon, who suspected they were caused by acid reflux.

In early July, I underwent an upper gastrointestinal endoscopy, and the doctor did not find significant issues related to my throat, only very mild gastroesophageal reflux that should not cause severe sensations of a foreign body.
I have been taking some gastrointestinal medications during this time.
On July 26, during a follow-up appointment, I mentioned that I noticed a raised area with white spots on the back of my right tongue.
The doctor said that this is a lingual tonsil, which everyone has, but I only have swelling on the right side.
There is no swelling on the left side, but I have had pain at the base of my left tongue for several months.
The doctor previously diagnosed it as inflammation of the lingual tonsil.
On July 26, the doctor only used a tongue depressor to examine the swelling and suggested that the white spots might be food debris.
However, the raised area and white spots are still present today, which worries me because my throat and pharyngeal wall continue to be very painful, sometimes with sudden, intense pain and a heavy sensation of a foreign body.

I feel like I am in a state of inflammation and often want to touch the area to see what might be causing the sensation.
When I press on the pharyngeal wall, it feels hard and lumpy.
I have also felt the area where I would gag, and it feels bumpy and hard, which frightens me.
My tongue also has many hard lumps.
These symptoms are very distressing, and I am concerned that I might have developed something serious.
Three months ago, during a follow-up for my surgical site, an endoscope was used to examine my throat, and it was noted that the area near my vocal cords was swollen, and there was inflammation at the base of my left tongue.
However, my symptoms seem to be worsening, and even when I am not moving my mouth or swallowing, I still feel sharp pain in my throat and pharyngeal wall, as if there is a sharp bone stuck inside.
I also experience a throbbing sensation that feels inflammatory, which is very frightening.

I have had sudden unilateral tinnitus in my left ear for the past five months, with occasional deep ear pain, and the ear pain has become more frequent recently.
To date, the cause has not been identified, and treatment has not resolved it (I have had a self-paid MRI of my brain that showed no abnormalities).

Now, I would like to ask the doctor if symptoms caused by something serious would lessen after waking up (within about five minutes).
Additionally, every morning I notice a foul smell in my throat, and after a few minutes, the symptoms become pronounced throughout the day, including sharp pain when eating.
Sometimes I feel like there is a metallic taste of blood when swallowing saliva, but there is no blood when I spit it out.
Pressing on certain areas of my neck and throat causes sharp pain, and even when my mouth is closed, I feel pain and a sensation of a foreign body.
When lying down, if I press down on my throat near the collarbone, the sensation of a foreign body and pain becomes more pronounced, and certain head positions exacerbate it.

I have been researching online and found that it could be pharyngitis, but my symptoms seem somewhat different.
I have read that early symptoms of pharyngeal or laryngeal cancer include a sensation of a foreign body, which worsens over time, and I am very scared.
I have been experiencing chronic inflammation and discomfort in the left tonsil and throat area for over a year, which led me to seek medical attention.

At the same hospital, I have seen different doctors, and many of them believe that my issues are psychological, treating me poorly.
I have left appointments in tears, feeling very wronged.
As a result, I have sought care at more distant hospitals, but my discomfort has not improved.
I have also seen a psychiatrist and taken medication for a year without improvement (during which I still sought care at other hospitals or clinics for my discomfort).

Now that I have had my left tonsil removed, I still have symptoms that are worse than before the surgery.
The area between the palatopharyngeal arch and the palatoglossal arch, where I had a biopsy before, is no longer visible after the tonsil surgery, but I still feel persistent inflammation and pain in that area.
I can feel pain even when using a cotton swab.
I am very worried that there might be something wrong inside, and I am genuinely concerned that I might have some form of oral cancer.

Since I have already had bilateral tonsillectomy, I do not understand why I still have these symptoms.
Three months after the surgery, I thought it might be due to incomplete recovery.
Initially, I was worried about chronic inflammation of the tonsils and long-term sensations of a foreign body, which led to my decision to have them removed, fearing potential cancer development.
Now, my condition seems worse, and the surgeon is reluctant to examine me further, only prescribing some emotional medications.
I feel very sad because the pain and discomfort from my symptoms leave me unsure of how to cope, especially since these symptoms have persisted for a long time, most noticeably over the past three months.

I am very worried about whether I might discover a serious problem too late, and I know that oropharyngeal cancer is difficult to treat.
My youngest child is not yet three years old, and I have another child who is almost nine.
I am genuinely scared.
The daily pain and discomfort are very distressing, and I am afraid because I have no family here in this foreign country, and my husband and in-laws are not supportive.

Please help me analyze my situation.
Am I experiencing psychological issues, or should I see an ENT specialist for further examination? How should I communicate with the doctor? Thank you.
I am also afraid to see a doctor because I have felt misunderstood and faced poor treatment, which is very distressing.
Now, even when my mouth is closed, I feel a sensation of a foreign body when I move my tongue, and occasionally I experience sudden sharp pains.
Pressing on the left side of my jaw also causes sharp pain, which feels strange.
I have told my husband about this, but he thinks I am overly anxious about my symptoms.
However, it is the symptoms that make me concerned.
People around me do not understand, and I am genuinely suffering both physically and mentally.

Do my symptoms resemble cancer? My father was diagnosed with breast cancer this year at the age of 82, which makes me even more worried about potential risk factors.
I have read online that even without smoking, drinking, or chewing betel nut, one can still develop oral or throat cancer, which increases my anxiety.
I apologize if I am bothering you with my inquiries.
If I undergo another endoscopic examination of my throat and no significant abnormalities are found, can I be reassured that there is nothing serious? If I consider a self-paid MRI, will it provide a detailed examination? Is a neck ultrasound necessary? Should I ensure that I have no issues before considering psychological problems, illness anxiety disorder, panic disorder, or autonomic nervous system dysregulation?
I hope the doctor can provide me with some advice.
Thank you.
I have attached photos of my oral cavity: https://1drv.ms/f/s!AjPJXu4grsOPghKyfvD9OYCPhHDS

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Miss Lin, 40~49 year old female. Ask Date: 2021/08/07