Recurring ENT Symptoms: When to Seek Further Medical Attention?

Symptoms have recurred after six months, and there are additional symptoms?

At the beginning of the year, I experienced recurrent nasal congestion, followed by a foul-smelling nasal discharge and itchy ears, which prompted me to visit a clinic.
I forgot which side of the sinus the doctor mentioned was slightly inflamed (it was also noted that this was caused by post-nasal drip).
I was prescribed medication, a nasal spray, and an ointment for my nose and ears.
Although my symptoms improved significantly, about six months later, around mid-June, I started feeling a sensation of something stuck in my throat, sometimes accompanied by a feeling of pressure and heat.
I mistakenly thought I had contracted COVID-19, but home rapid tests returned negative.
However, due to being busy with moving, I didn't pay much attention to my health.
A few days after moving, the symptoms returned: a sensation of something stuck in my throat, recurrent nasal congestion, itchy and painful ears, and additional symptoms (twitching of the right eyelid and a tight feeling in the right side of my face).
I then visited a large hospital's ENT department.
During my first consultation, the doctor diagnosed my symptoms as esophagitis caused by gastroesophageal reflux disease (GERD) and prescribed medication (including Cetirizine 2 mg, Omeprazole chewable tablets, Acetylcysteine 600 mg effervescent tablets, and a long-acting cough expectorant 75 mg, as well as a 24-hour sustained-release nasal spray).
I was advised to undergo an endoscopy during my next visit.

During the follow-up, the endoscopy results indicated the presence of mucus, which explained the sensation of something stuck in my throat, and there was inflammation in certain areas that appeared white.
The doctor assured me there were no tumors or other abnormalities and prescribed the same medication for another 28 days, advising me to continue taking it.
After taking the medication for two to three days, I noticed swelling on the left side of my neck near the shoulder, some body weakness and soreness, blurriness in my right eye with a dry and sticky sensation (I do not have myopia), and occasional pain on the right side of my nose.
These symptoms have begun to affect my daily life, and I am unsure if these new symptoms are related to the esophagitis caused by GERD or chronic pharyngitis.
Should I return to the doctor immediately to change my medication, or should I finish the prescribed medication before returning for a follow-up?

Chen, 20~29 year old female. Ask Date: 2022/07/20

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the situation you described may be chronic pharyngitis.
It is recommended to undergo laryngoscopy to rule out any masses, as well as to consider medication treatment.
In addition to medication, please pay attention to the following daily living 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.
If symptoms persist or worsen, it is advisable to consult an otolaryngologist.
Wishing you peace and good health.

Reply Date: 2022/07/20

More Info

When dealing with recurring ENT (ear, nose, and throat) symptoms, it is crucial to understand when to seek further medical attention. Based on your description, it seems you have been experiencing a range of symptoms, including nasal congestion, throat discomfort, ear itching and pain, and additional symptoms such as facial tightness and eye issues. These symptoms have persisted despite initial treatment, which raises some concerns.

Firstly, it is essential to recognize that ENT symptoms can often be interconnected. For instance, nasal congestion can lead to post-nasal drip, which may irritate the throat and contribute to a sensation of something being stuck in the throat. This can also lead to ear discomfort due to the Eustachian tube's connection between the throat and the ear. The presence of a white coating in the throat, as noted during your endoscopy, could indicate inflammation or infection, which may require further evaluation.

The medications prescribed to you, including antihistamines and medications for gastroesophageal reflux disease (GERD), suggest that your healthcare provider is considering multiple potential causes for your symptoms. GERD can indeed cause throat irritation and may lead to a sensation of tightness or discomfort in the throat. However, the additional symptoms you are experiencing, such as swelling in the neck, body aches, and visual disturbances, warrant further investigation.

Here are some considerations regarding your situation:
1. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare provider in determining the next steps.

2. Follow-up Appointment: Given the new symptoms you are experiencing, particularly the swelling in your neck and changes in your vision, it is advisable to seek medical attention sooner rather than later. These symptoms could indicate a more serious underlying issue that needs to be addressed.

3. Medication Review: While it is generally a good idea to complete a course of prescribed medication, if you are experiencing significant side effects or if your symptoms worsen, you should contact your healthcare provider. They may need to adjust your treatment plan based on your current condition.

4. Consider Other Causes: The symptoms you describe could be related to several conditions, including allergies, infections, or even autoimmune issues. A thorough evaluation by an ENT specialist may be necessary to rule out other potential causes.

5. Urgent Care: If you experience severe symptoms, such as difficulty breathing, swallowing, or significant swelling, seek immediate medical attention. These could be signs of a more serious condition that requires urgent care.

In conclusion, while it is essential to follow your healthcare provider's recommendations, your current symptoms suggest that a follow-up appointment may be necessary sooner than planned. Do not hesitate to reach out to your doctor to discuss your concerns and the new symptoms you are experiencing. It is always better to err on the side of caution when it comes to your health, especially with symptoms that are affecting your daily life.

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