Unexplained Pain and Foreign Sensation in Right Throat During Swallowing

There is an area in the middle to lower right side of my throat that experiences an unexplained pain and a sensation of a foreign body when swallowing?

I have been experiencing pain in the right side of my throat (the area between the Adam's apple and the right collarbone) for over a year.
It feels like there is a foreign body present, and sometimes it hurts while other times it is tolerable.
The sensation at the pain point varies depending on the movement of my neck during swallowing.
There is no swelling in the appearance or palpation of my neck; it feels like an issue within the throat.
I can feel it when swallowing water or food, but the sensation of a foreign body and pain is most pronounced when swallowing saliva.

I have a history of bilateral otitis media, with the right ear being more severely affected, and there is a small swollen lymph node on the right side due to the ear infection.
My right ear occasionally hurts as well.
Additionally, I have been dealing with gastroesophageal reflux disease (GERD) for nearly two years.
I underwent an endoscopy in July of last year, and the doctor noted that my esophagus had some abrasions, which have not healed since.
I frequently experience chest tightness and stomach pain (I am currently receiving treatment for GERD at a traditional Chinese medicine clinic).

I am unsure if these conditions are related, as my throat pain has persisted despite having undergone an endoscopic examination by an ENT specialist, which showed no issues.
I hope the doctor can provide some answers.
Thank you for your patience in reading this.

huàn xióng, 20~29 year old female. Ask Date: 2023/04/06

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the issues you mentioned may have a low correlation with each other and could involve multiple different diagnoses.
It is advisable to consult an otolaryngologist for an examination.

Reply Date: 2023/04/06

More Info

The symptoms you are experiencing, particularly the unexplained pain and foreign sensation in your right throat during swallowing, can be quite distressing and may stem from several interconnected issues. Given your history of ear infections, gastroesophageal reflux disease (GERD), and the recent findings from your ENT examination, it is essential to consider how these conditions might be contributing to your throat discomfort.

Firstly, the sensation of a foreign body in the throat, especially when swallowing, can often be linked to inflammation or irritation in the throat or esophagus. In your case, the chronic gastroesophageal reflux could be a significant factor. GERD can lead to the backflow of stomach acids into the esophagus, causing irritation and inflammation. This irritation can extend to the throat, leading to sensations of pain or discomfort, particularly when swallowing. The fact that you have experienced esophageal erosion, as noted during your endoscopy, further supports the idea that your reflux is affecting your throat.

Additionally, your history of middle ear infections, particularly the more severe right ear infection, could also play a role. The ear, nose, and throat are interconnected, and issues in one area can often affect the others. The presence of a swollen lymph node in your neck could indicate an ongoing infection or inflammation, which might also contribute to your throat pain. Even if the ENT examination did not reveal any significant issues, the lingering effects of your ear infection could still be causing discomfort in the throat area.

It's also worth considering the possibility of referred pain. Sometimes, pain originating from the ear or even the neck can manifest as throat pain. This is particularly true if you are experiencing any neck stiffness or discomfort, which could alter the way you swallow and exacerbate the sensation of pain or foreign body sensation in your throat.

Given the complexity of your symptoms, it would be advisable to follow up with a healthcare provider who can perform a thorough evaluation. This may include imaging studies, such as a CT scan, to assess for any underlying structural issues or further evaluation of your lymph nodes. Additionally, a gastroenterologist may provide further insights into managing your GERD more effectively, potentially alleviating some of your throat symptoms.

In the meantime, there are several strategies you can employ to help manage your symptoms. These include:
1. Dietary Modifications: Avoiding spicy, acidic, or fatty foods that can exacerbate GERD symptoms. Eating smaller, more frequent meals may also help.

2. Hydration: Staying well-hydrated can help soothe the throat and reduce the sensation of a foreign body.

3. Posture: Maintaining an upright posture during and after meals can help minimize reflux.

4. Medications: If you are not already on a proton pump inhibitor (PPI) or H2 blocker for your GERD, discussing this with your doctor may be beneficial.

5. Throat Care: Gargling with warm salt water or using throat lozenges may provide temporary relief from throat discomfort.

6. Stress Management: Since stress can exacerbate GERD symptoms, incorporating relaxation techniques such as deep breathing, meditation, or yoga may be helpful.

In conclusion, while your throat pain and foreign sensation during swallowing may be multifactorial, addressing your GERD and monitoring any potential connections to your ear issues will be crucial in managing your symptoms. A collaborative approach involving your primary care physician, an ENT specialist, and a gastroenterologist will likely yield the best outcomes for your health.

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