Persistent Throat Discomfort: Seeking Solutions for Chronic Symptoms

Persistent discomfort in the throat with a slight sensation of a foreign body?

Hello, Doctor: Since around May of this year, I have been experiencing a sensation of a foreign body in my throat, along with alternating nasal congestion.
I tend to get congested in cooler environments.
From June until now in November, I have had several episodes of tonsillitis.
When I visited a large hospital, the doctor told me that everything was due to tonsillitis and suggested that I undergo a tonsillectomy.
Later, around October, I went to a clinic where the doctor drained the pus, and I experienced significantly less inflammation.
However, I still have a prominent discomfort in my throat.
When I open my mouth and look at my throat, I can see noticeable streaks of blood and small blisters that resemble bubbles.
After doing some research online, it seems like it could be "follicular pharyngitis." I have visited two or three clinics and had two nasal endoscopies, but the doctors all told me that my throat looks fine.
Currently, my symptoms include occasional sensations of a foreign body and a need to clear my throat, as well as occasional discomfort in one ear.
The clinic doctor mentioned that there is inflammation throughout the ENT area, which could also affect my ears.
He advised me to avoid tea, spicy foods, and herbal supplements, and said that if there is no improvement in six months, I should see a rheumatologist, as there may be an issue with my immune system.
I would like to ask for your opinion on what I should do next.
Should I switch clinics or go to the hospital for further examination?

Jerry, 20~29 year old female. Ask Date: 2021/11/06

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the situation you described may be chronic pharyngitis or chronic tonsillitis.
It is recommended to seek medical attention for a laryngoscopy (to rule out any masses) and to consider medication treatment.
In addition to medication, please pay attention to the following daily life tips: 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 good health.

Reply Date: 2021/11/06

More Info

Persistent throat discomfort can be a frustrating and distressing experience, especially when it is accompanied by other symptoms such as nasal congestion and ear discomfort. Based on your description, it seems that you have been dealing with a combination of issues, including recurrent tonsillitis, throat irritation, and possibly a condition known as follicular pharyngitis. Here’s a comprehensive approach to understanding your symptoms and potential next steps.

Understanding Your Symptoms
1. Chronic Throat Discomfort: The sensation of a foreign body in the throat can be caused by several factors, including inflammation, post-nasal drip, or even anxiety. In your case, the recurrent tonsillitis may contribute to the persistent discomfort.

2. Nasal Congestion: This can often accompany throat issues, especially if there is post-nasal drip, where mucus drips down the back of the throat, leading to irritation and discomfort.

3. Follicular Pharyngitis: This condition is characterized by the presence of small, swollen lymphoid follicles in the throat, which can appear as small bumps or blisters. It is often associated with viral infections or chronic irritation.

4. Ear Discomfort: The ear, nose, and throat (ENT) are interconnected, and inflammation in the throat can lead to referred pain or discomfort in the ears.

Recommendations for Management
1. Consult an ENT Specialist: Since you have already seen multiple doctors without a definitive diagnosis, it may be beneficial to seek a second opinion from an ENT specialist. They can perform a thorough examination, including a laryngoscopy, to visualize the throat and rule out any underlying issues.

2. Consider Allergy Testing: Given your symptoms of nasal congestion, it may be worthwhile to explore whether allergies are contributing to your discomfort. Allergies can lead to chronic inflammation in the nasal passages and throat.

3. Lifestyle Modifications:
- Dietary Changes: Avoid irritants such as spicy foods, caffeine, and alcohol, as these can exacerbate throat discomfort. Instead, focus on a diet rich in fruits, vegetables, and hydration.

- Humidification: Using a humidifier in your home can help keep the air moist, which may alleviate throat irritation, especially in dry environments.

- Avoid Smoking and Pollutants: If you smoke or are exposed to secondhand smoke or other pollutants, consider reducing or eliminating exposure, as these can worsen throat discomfort.

4. Medications: Over-the-counter antihistamines or nasal corticosteroids may help reduce nasal congestion and post-nasal drip. If you have been diagnosed with allergies, your doctor may recommend specific allergy medications.

5. Follow-Up on Tonsillectomy: If your symptoms persist and are significantly impacting your quality of life, discussing the option of a tonsillectomy with your ENT specialist may be warranted. This procedure can be beneficial for individuals with recurrent tonsillitis.

6. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their severity, and any potential triggers. This information can be valuable for your healthcare provider in determining the best course of action.

7. Consider Immune System Evaluation: If your symptoms do not improve with the above measures, your doctor’s suggestion to see an immunologist may be appropriate. They can assess whether there is an underlying immune issue contributing to your recurrent infections.

Conclusion
Chronic throat discomfort can be multifactorial, and it often requires a comprehensive approach to diagnosis and management. By consulting with an ENT specialist, considering allergy testing, making lifestyle modifications, and monitoring your symptoms, you can work towards finding relief. If your symptoms persist despite these efforts, further evaluation by an immunologist may provide additional insights into your health. Remember, it’s essential to advocate for your health and seek the care that best addresses your concerns.

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