Persistent Throat Pain and Swollen Tongue: Seeking Answers

Right-sided throat dryness and pain with inflammation and redness at the base of the tongue?

My husband has been experiencing a dry and painful throat for the past three months, with dark red streaks in his phlegm when he coughs.
He often feels nauseous and describes his saliva as salty.
The base of his tongue is red and swollen.
He drinks enough water daily to meet his hydration needs.
We have seen numerous doctors, including pulmonologists, who have found no abnormalities.
ENT specialists have also said there is nothing wrong, but their responses have varied.
One doctor suggested that gastroesophageal reflux might be causing the inflammation and swelling at the base of his tongue, while another doctor disagreed.
He has undergone an endoscopy, and the doctor confirmed there is no gastroesophageal reflux.
He has been taking the prescribed medications regularly, but there has been no improvement.
Each time we visit the doctor, we are told there is nothing wrong, yet he continues to feel very uncomfortable.

Chen, 20~29 year old female. Ask Date: 2015/10/10

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you have already undergone examinations and no abnormalities were found, the most common issue is still chronic inflammation, which may be related to gastroesophageal reflux, high stress leading to chronic fatigue, insufficient sleep, smoking, or other potential causes of chronic inflammation.
It is recommended to maintain a regular routine, drink plenty of water, and start with lifestyle adjustments.
If discomfort persists, you may seek medical attention for further evaluation.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/10/10

More Info

I'm sorry to hear about your husband's persistent throat pain and swollen tongue. It sounds like a frustrating and concerning situation, especially since he has seen multiple specialists without receiving a clear diagnosis or effective treatment. Let's break down the symptoms and possible underlying causes.

Symptoms Overview
1. Persistent Throat Pain: This can be caused by various factors, including infections, allergies, irritants, or even chronic conditions.

2. Dark Red Blood Streaks in Phlegm: This is concerning and could indicate bleeding somewhere in the respiratory tract. It’s essential to investigate this further.

3. Nausea and Salty Taste: These symptoms could be related to gastrointestinal issues, such as acid reflux, or could be a side effect of medications.

4. Swollen Tongue: This could be due to inflammation, allergic reactions, or systemic conditions.

Possible Causes
1. Gastroesophageal Reflux Disease (GERD): Even though the endoscopy did not show reflux, it’s possible to have symptoms of reflux without visible damage. GERD can cause throat irritation and a sensation of a lump in the throat.

2. Allergic Reactions: Allergies to food, medications, or environmental factors could lead to throat swelling and discomfort. An allergist could perform tests to identify potential allergens.

3. Infections: Chronic infections, such as viral or bacterial infections, could cause ongoing throat pain. Conditions like chronic sinusitis can also lead to post-nasal drip, irritating the throat.

4. Autoimmune Conditions: Conditions like Sjögren's syndrome or lupus can cause dryness and inflammation in the throat and mouth.

5. Oral Health Issues: Dental problems or infections in the mouth can lead to throat pain and swelling of the tongue.

Recommendations
1. Further Evaluation: Since multiple specialists have not provided a clear diagnosis, consider seeking a second opinion from a different ENT specialist or a gastroenterologist who specializes in functional GI disorders.

2. Allergy Testing: If allergies are suspected, an allergist can perform tests to determine if there are any allergens contributing to the symptoms.

3. Dietary Changes: Keeping a food diary may help identify any potential food triggers that could be causing the symptoms.

4. Hydration and Humidification: Ensure he stays well-hydrated and consider using a humidifier at home to alleviate throat dryness.

5. Medication Review: Review all medications with a healthcare provider to check for potential side effects that could be contributing to the symptoms.

Conclusion
Persistent throat pain and a swollen tongue can be challenging to diagnose and treat, especially when symptoms overlap with various conditions. It’s crucial to continue advocating for your husband’s health and seeking answers. If symptoms worsen or new symptoms arise, such as difficulty breathing or swallowing, seek immediate medical attention. Keeping a detailed record of symptoms, triggers, and responses to treatments can also be beneficial in discussions with healthcare providers.

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