Persistent Throat Pain: When to Seek ENT and Mental Health Help

Difficulties in initiating conversation?

Hello doctor, I engaged in oral sex with a sex worker at the end of August 2004 without protection, which led to persistent pain in my oral cavity, throat, and tongue.
Subsequently, I visited an otolaryngology clinic where the physician performed an endoscopic examination and a saliva test.
I also took medication for two months, including antibiotics and anti-inflammatory drugs, and I complied with the treatment, but there has been no improvement.
I wanted to see a urologist, but the nurse advised me to continue seeing an otolaryngologist based on my symptoms.
Eventually, the otolaryngologist referred me to psychosomatic medicine, which is psychiatry.
I am not opposed to seeing a psychiatrist; perhaps I am overthinking this, but after so many tests, the physician still could not determine the cause.
However, I am very curious as to why the doctor would refer me to psychiatry.
My understanding is that, as the doctor mentioned, my throat still shows signs of redness and inflammation, and my chest pain is becoming increasingly severe each day, which are concrete physiological symptoms.
Why does the doctor still believe that I am overreacting and that psychological factors are affecting my physiology? Please help me understand how I can seek appropriate assistance from a qualified physician for my ongoing symptoms, which include: small spots covering the roof of my mouth; persistent throat pain; continuous pain at the base of my tongue, under my tongue, and around my tongue, but no ulcers or open wounds; pain from the ear down to the neck; nausea with an inability to vomit; phlegm that I cannot clear; and chest pain and discomfort, especially sharp pain in my chest when my heart beats.

kk, 30~39 year old female. Ask Date: 2005/01/04

Dr. Cai Hongyan reply Otolaryngology

Hello, after a detailed medical history inquiry and physical examination, regarding the possible diagnoses of viral pharyngitis and bacterial pharyngitis, as well as chronic pharyngitis, anti-inflammatory medications and antibiotics were administered.
With unsatisfactory results from the medication treatment, bacterial infection has been ruled out.
Chronic pharyngitis or viral pharyngitis is correlated with human immunity to some extent.
Improving dietary habits and adjusting lifestyle routines are necessary treatment approaches.
It is recommended that you consult with a psychosomatic specialist to help manage life stress, which is expected to partially improve symptoms.

Reply Date: 2005/01/04

More Info

It sounds like you are experiencing a complex interplay of physical and psychological symptoms that can be quite distressing. Persistent throat pain, along with other symptoms such as chest pain, nausea, and discomfort in the oral cavity, can be challenging to diagnose and treat. Given your history and the ongoing nature of your symptoms, it’s understandable that you are seeking clarity and assistance.

Firstly, it’s important to recognize that the body and mind are intricately connected. This means that psychological stress or anxiety can manifest as physical symptoms, including pain and discomfort in various parts of the body. In your case, the referral from the ENT (Ear, Nose, and Throat) specialist to a mental health professional suggests that they suspect your symptoms may be exacerbated or influenced by psychological factors, even if there are also physical components to your condition.

Your symptoms, such as persistent throat pain, the presence of small bumps in the mouth, and chest discomfort, warrant thorough investigation. The fact that you have undergone various tests, including an endoscopy and saliva tests, indicates that your healthcare providers are trying to rule out serious underlying conditions. However, when these tests do not reveal a clear cause, it can lead to frustration and confusion.

Here are some steps you can take to address your situation:
1. Follow-Up with an ENT Specialist: Since you have ongoing throat pain and other symptoms, it may be beneficial to seek a second opinion from another ENT specialist. They may offer different insights or recommend additional tests to further investigate your symptoms.

2. Consult a Mental Health Professional: Given the recommendation to see a mental health professional, it may be worthwhile to explore this option. A psychologist or psychiatrist can help assess whether anxiety, stress, or other psychological factors are contributing to your physical symptoms. They can also provide coping strategies and therapeutic interventions that may alleviate your discomfort.

3. Keep a Symptom Diary: Documenting your symptoms, including their frequency, intensity, and any triggers you notice, can provide valuable information for both your ENT and mental health providers. This can help them understand the patterns of your symptoms and how they may relate to your emotional state.

4. Explore Stress Management Techniques: Engaging in stress-reduction practices such as mindfulness, meditation, or gentle physical activity can help manage anxiety and may also alleviate some of your physical symptoms. Techniques like deep breathing exercises can be particularly beneficial for managing acute discomfort.

5. Communicate Openly with Your Healthcare Providers: Be honest about your symptoms, concerns, and how they affect your daily life. If you feel that your physical symptoms are not being taken seriously, express this to your providers. Clear communication can help ensure that you receive the appropriate care.

6. Consider a Holistic Approach: Sometimes, a multidisciplinary approach that includes both medical and psychological support can be the most effective way to address complex symptoms. This might involve working with both an ENT specialist and a mental health professional simultaneously.

In conclusion, while it’s understandable to feel frustrated and concerned about your ongoing symptoms, it’s essential to approach this situation with an open mind. Both physical and psychological factors can play a significant role in your health, and addressing both aspects may lead to better outcomes. Seeking further evaluation and support from qualified professionals will be crucial in your journey toward understanding and managing your symptoms effectively.

Similar Q&A

Persistent Throat Discomfort and Chest Pain: When to Seek ENT Evaluation

I have been experiencing a sensation of something stuck in my throat for about a month. I have seen a doctor and taken medication, and my condition has improved somewhat, but the sensation is still present. I would like to ask the doctor if I need to undergo a throat endoscopy fo...

Dr. Ji Zhaoyun reply Otolaryngology
Hello, the situation you mentioned may be chronic pharyngitis. It is recommended to undergo laryngoscopy (to rule out the presence of any masses) or esophagogastroduodenoscopy, along with medication treatment. In addition to medication, please pay attention to the following daily...

Understanding Persistent Throat Discomfort: Is It Physical or Psychological?

Hello Doctor, I have a severe sensation of a foreign body and sharp pain in my oral cavity, throat, and pharyngeal wall, accompanied by unilateral tinnitus in my left ear for 24 hours. The base of my left tongue also experiences sharp pain. Whether I swallow or not, it feels like...

Dr. Lin Mianzhang reply Psychiatry
Hello Ms. Lin: It seems that you are raising your child alone without any supportive relatives, which must be quite stressful for you. Based on your description, you have seen many doctors and undergone various tests, but no significant issues have been found. I believe your symp...

Chronic Throat Pain: Exploring Possible Nerve Issues and Treatment Options

I have been experiencing a sore throat and hoarseness for six months. The pain is primarily a sharp sensation near the Adam's apple. Over the past six months, doctors have prescribed medications for allergic rhinitis and gastroesophageal reflux disease (GERD), and I have und...

Dr. Ji Zhaoyun reply Otolaryngology
Hello, if it is confirmed to be chronic pharyngitis without any special issues, it is recommended to take proton pump inhibitors (PPIs) and other related medications for three months while avoiding coffee, tea, cigarettes, alcohol, fried foods, and spicy foods. If symptoms persis...

Persistent Throat Pain: When to Seek Specialist Care?

I have been experiencing a sore throat for several years. Initially, it would only hurt when swallowing saliva, but recently the pain has become more frequent, and it still hurts even when swallowing saliva or drinking water. I am concerned that this issue will continue, and the ...

Dr. Zheng Jueyi reply Otolaryngology
Hello: Commonly, this is chronic pharyngitis. If there is no improvement, you may visit a hospital for further examination. Wishing you peace and health. Sincerely, Dr. Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.