Throat Discomfort: Possible Causes and Next Steps

There is a foreign body sensation in the throat that feels like peeling skin?

Hello, doctor.
Due to occupational factors, I have been speaking for long periods, and it seems that I have developed calluses in my throat over the years.
Speaking too much, staying up late, and eating spicy food easily irritate my voice.
However, I haven't sought medical attention for this.

The main issue is that in the past month, I experienced a rare occurrence of tonsil stones (as shared by other users on various websites).
A few days later, I felt something stuck in the left side of my throat, which caused pain when swallowing, yawning, or lecturing.
I visited a clinic where the doctor performed a simple examination and prescribed me a three-day course of anti-inflammatory medication, but there was no significant improvement.
After two weeks, the pain gradually subsided.

Now, a week later, I feel a small, flaky, loose foreign body sensation on the right side of my throat (near the thyroid cartilage) when swallowing, which is painful.
Even when I just wake up and try to swallow saliva, I experience a nauseous feeling in my throat.
These recent occurrences are experiences I have never had before.

1.
I wonder if this condition is related to the calluses in my throat?
2.
Should I return to the same clinic for further evaluation, or should I go to a larger hospital for specific tests?
3.
Should I see an ENT specialist, a thyroid specialist, or do you have any recommendations on which department might help identify my issue?

Lucy, 20~29 year old female. Ask Date: 2015/12/18

Dr. Zheng Jueyi reply Otolaryngology

Hello, the presence of nodules on the vocal cords typically manifests as hoarseness.
If the symptoms do not improve or if there is persistent pain, it is advisable to visit an otolaryngology clinic or the otolaryngology department of a hospital for an endoscopic examination.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Otolaryngology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/12/18

More Info

Understanding throat discomfort can be complex, especially when it involves symptoms that have developed over time. Based on your description, it seems that you have been experiencing a series of throat-related issues, including the presence of tonsil stones, pain during swallowing, and a sensation of something stuck in your throat. These symptoms can be quite distressing and may be related to your long-standing vocal demands due to your profession.

1. Connection to Vocal Strain: The discomfort you are experiencing may indeed be related to the vocal strain from prolonged speaking, especially if you have developed vocal nodules or "calluses" on your vocal cords. These nodules can cause hoarseness, throat pain, and a sensation of something being stuck in your throat. Additionally, factors such as late-night speaking, spicy foods, and dehydration can exacerbate throat discomfort and contribute to inflammation.

2. Next Steps for Evaluation: Given that your symptoms have persisted and evolved, it would be prudent to seek further evaluation. While the initial treatment with anti-inflammatory medication provided some relief, the recurrence of symptoms suggests that a more comprehensive assessment is warranted. You should consider returning to your primary care physician, but it may be more beneficial to see an Ear, Nose, and Throat (ENT) specialist. An ENT can perform a thorough examination, which may include a laryngoscopy to visualize your throat and vocal cords directly. This examination can help identify any structural issues, such as nodules, inflammation, or other abnormalities.

3. Choosing the Right Specialist: In this case, an ENT specialist would be the most appropriate choice for your symptoms. They are specifically trained to diagnose and treat conditions related to the throat, voice, and swallowing. If the ENT finds any abnormalities that require further investigation, they may refer you to other specialists, such as a speech-language pathologist for voice therapy or a gastroenterologist if there are concerns about acid reflux, which can also contribute to throat discomfort.

4. Self-Care and Management: In the meantime, consider implementing some self-care strategies to help manage your symptoms. Staying well-hydrated, avoiding irritants such as spicy foods and smoking, and practicing good vocal hygiene (such as resting your voice when possible) can be beneficial. Additionally, if you suspect that your symptoms may be exacerbated by stress or anxiety related to your work, exploring relaxation techniques or speaking with a mental health professional may also be helpful.

In summary, while your throat discomfort may be connected to your vocal demands and potential vocal cord issues, it is essential to seek a thorough evaluation from an ENT specialist. They can provide you with a definitive diagnosis and appropriate treatment options tailored to your specific needs. Remember, early intervention can often lead to better outcomes, so don't hesitate to seek help.

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