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Chronic Pharyngitis (Sore Throat) - Please Help!!!!
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Chronic Pharyngitis (Sore Throat) - Please Help!!!!

I'm a 23 year old male and I've had a chronic sore throat for over 5 months now.  It's driving me out of my mind.. Please help me where my other Doctors have not..

I've been tested for allergies and I've had a few allergies to trees indiginous to my location.  But upon use of Clarinex, Allegra, Zyrtec, etc. I received no relief.

I had a Barium swallow which showed reflux.. I was treated with 40 mg Nexium, twice a day.  This did not help.

Went to ENT, and took 875 mg of Augmentin for 2 weeks, with no relief!  Actually, it become WORSE on the antibiotics.

I then underwent an endoscopy, pH probe, and subsequent Nissen Fundoplication.  The endoscopy showed a very small area of inflammation and the pH probe showed supine reflux.  But after the Fundoplication surgery - I have received no RELIEF in the throat area.  This was supposed to fix my problem.  But it has been 3 weeks now and there is NO SIGN OF HEALING in my throat.

I've also been tested for HIV, Lupus, Sinusitis, H. Pylori, and have had a thyroid ultrasound.  All of these came back negative or normal!!

The only unexplored avenue that I can see is that in my Sinus CT the radiologist noticed "Septum Deviates to left with Left-sided septal spur."

Is this a possible cause of the problem??

Also let me tell you what my throat looks like..

If i shine a penlight back there I can see red patches and very dilated blood vessels. Also there is a yellowish lump just posterior to my soft palate if I raise my uvula and observe.  The lump is about .5 cm in diameter and slightly raised, but it looks like some of the vessels are originating from it.

Could this be some kind of Oropharyngeal / Nasopharyngeal Cancer?  Or can this just be a case of bad Post Nasal Drip that needs to be corrected with surgery?

I've tried Nasal Washing, and regularly using Sudafed & Guafennesin without any help as well...

I Do notice that if I drink beer or sometimes even after eating, I get the feeling like I need to clear my throat, but can't get anything up.  My voice will also sometimes go hoarse after actively talking for only 20-30 minutes.

Is there anything else this could be???

Thank you for your help!! This really has put me into a major depression and I'm not the person I was 6 months ago.  I just need to fix this problem and move on with my life.

Look forward to your response,
Nick


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With all th GI tests and procedures you have had, it is unlikely that a GI source is responsible for the sore throat.  

Infections have been appropriately treated, but you may want to be tested for mononucleosis (with a blood test) to be sure.  

Chronic sinusitis can certainly be considered - if there is concern about possible cancer or a mass, you can consider a scope by your ENT physician for further evaluation.

Another possibility can be allergies leading to chronic post-nasal drip.  A referral to an allergy specialist can be considered for further evaluation.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com
21 Comments
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BTW, I had my tonsils out last year and it helped for about 4 months..

I started getting a sore throat more and more.. First it was every months, then every two weeks, then every week..

Then I had my tonsils out and it got better for 4 months..

Then every month, then every other week - now its constant!!

I took this as a sign that whatever caused my tonsils to become irritated and have to be removed is still there, only now is affecting my throat...

any thoughts?
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-- Can I ask you how long you took NEXIUM-40mg?

In practice, I've found that people with chronic sore throat benefit from this treatment, but it takes awhile (6-8 months) of BID dosing to see real benefits.
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I took nexium 40mg twice daily (80mg day) for about 2-3 months, with no improvement..

Also, I've already had mono so I don't think thats the culprit AND my sinus CT came back negative for Sinusitis as I explained earlier..

I was tested for allergies, as I stated, but can that really be causing these symptoms?

thanks,
Nick
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Do you think that I'd have to wait longer for the fundoplication to fix the sore throat then?

It's only been 2 weeks, but my throat looks just like it did before the procedure... can it really heal this slow??

Other than the sore throat, I've healed amazingly quick after my operation and I'm back to all normal activities in 14 days :)

Thanks for your help!!

Nick
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hey nick,

it seems like your doctors have tried a lot of therapies ... i'd think that with the course of Augmentin & Nexium that LPR and any bacterial infection should have cleared up.

i'd probably suggest an allergy specialist next ...

what were the results of being scoped by your ENT?
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Max out on "Cold Eze" and drink LOTS of water. Use allergy medicine too. It helps post nasal drip and it worked for me.

Bob
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Ruzzi: I share your pain. Have sr-throt, dripping, off/on voice
loss for over a yr. Know how to work the system w/Dr's. Did back
ofc for yrs. We have a problem I called `I Dunno'! I made it up!
I'm well knowledged w/ anatomy/nervous system. After 13 ENT's,
2 clinics, your tests + others & procedures, I dunno sounds like
a dx. Make sure U get copies of ALL tests/procedures. You are
allowed to have these for `Your Home Health File'. You'll be
amazed @ what they didn't share w/U, unless you're lucky. They
also have dictations (colleagues share opinions) & don't step on ea. others opinions. Sometimes U get 1 by error & read what
they suspect but didn't fol/up. U also can get hospital files
too. All info will form a pattern that tells U abt care. Don't
share `He said'. I've ruled out things after I reviewed myself.
Doses of antibiotics of many, didn't help. Throat culture, (they
scrape blisters on back/tonsils were questionable. No Doc agrees
w/ me, but they seem to lack neuro-info abt how things work. The
drainage comes from the maxillary sinus every 30 min. If backs-
up due to inflamm. or swelling, it gets old & infection/allergen
starts. Finally pops & burns throat. Stress causes nerves/glands
to tremor & over-drip. I use 1mg alprazolam 3x day & drainage
lessons. Cepacol spray temp-numbs. Zithromax is helping more to
heal than other anti's. Do U have any other symptoms like spine,
head-prssr, ear sounds/fullness, neck pain? Is your BP good?
BP can effect inflammation. @ 150/90, I was put on med+HCT & got
better. HCT is a diurectic that pulled excess fluid out of cells
& sinuses drained better. I had a side effect & stopped HCT.
Now I have no voice. It's our drainage that appears to be doing
cautering to tissue. Speak & U tremor the throat & get worse.
Mornings feel like vinegar on open wound until I get hot tea.
Hot `beef broth' from store opens voice for awhile too. Let us
know if any other symtoms (symptoms) we might compare. Hope I helped U get
more bang for your buck! I think it's viral & it's hard to dx.
It's frustrating to know U can't function, talk or scream from
the raw-feeling. What state in US R-U? Barometric prssr can also
cause a seasonal response like an allergy but they can't detect.











  
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I too have a very similar problem.  A chronic, mild sore throat, that is mostly aggravated by talking, that has lasted for almost 3 years.  I have also been through a series of doctors including ENT and Infectious Diseases, but noone has been able to help.  I have had a tonsilectomy and have been treated for acid reflux, alergies (allergies), and yeast.  Nothing has solved the problem.
  I have been swiching and swallowing Nystatin for a few months and this seems to have lessened the pain, but has not made it completely go away.  I have been pain free for a few days at a time, but it does seem to return.
   It feels like a dry throat often centered around the area where my right tonsil used to be.  Sometimes it is more of an itchy pallate. Sometimes it feels like the glands on the right side of my throat are swollen.  I also notice symptoms that sound like post nasal drip quite often.
   The initial sore throat, 3 years ago, started out feeling like a normal sore throat from a cold, the only difference is that I had a swollen gland directly under my chin in the bottom of my jaw that I have never had before.
    I have had no other health issues, I am very active, and have noticed no decrease in performance.  If anything, in the past three years I have had fewer colds than normal and no serious sore throats.
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I have had the some of the symptons everyone has discussed, but mine seem to be more of allergy symptons I think. My throat has the blood vessels, and I wake up with a hoarse throat everyday. I have been to 3 different ENT'S, and it seems like my next stop will be an allergist, again. I used to be on allergy shots, and it helped me, but then I had to quit taking them because my arm, where the shots were given, started to swell up like a balloon! There is one sad thing about this, I can't sing like I used to because my throat is constantly sore. I know what the people that have this problem is going through, because it seems like every chance you get, you try to feel better and you think it will help, but then it's the same again. I've also had my tonsils removed, and that didn't help! I just wish I knew what is making my throat so sore, it's even like this when I speak for more than like 30 minutes.
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I I have suffered from indigestion and heartburn for quite a few years, nothing serious, but I have had Zoton now and agin from my doctor, they are excellent and completely stop the problems, about 6/8 months ago however I developed a hoarse throat, which wasnt really sore, I could eaat and drink with no problems, my doctor gave me some more zoton and I was sent for the camera down the nose trick, they said it was acid burn on the throat, I was told to carry on taking the Zoton, for two months, which I did, but it has got worse, I have no indigestion now but the the throat is not healing, in fact it is getting worse , it is now hoarse and sore, I have difficulty swallowing now and again, I went back to my Gp and she said carry on taking Zoton, and it could take a long time to heal?? It is a real nuisance and gets me down, it is a strain to talk, and I am worried about it developing in to something more serious. Anyone else had this problem, how long did it take to go, and what has helped you.
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Avatar_n_tn
Benjo: Sounds like acid-reflux. Zoton is used for severe cases.
It's like U hick-up enzymes that you don't digest well or even
stress causes problem. If stomache/indigestion problems have
been in your history, Dr. might be correct. I use Cepacol spray
at night for a temp-fix at bed. Hot beef broth from a can helps.
Won't make U popular, but 1/2 a raw onion boiled in lg-cup twice
& then sip off/on is a old folk remedy. Juice has a healing
property & works for me + wards off colds/flu. There are some
chewing gums that numb also. Might check pharmacy. Sometimes
an allergy to a food or additive will trigger problem. Ask if U
have Oesophagitis. Sounds better than `why the raw throat?' You
may need to change your diet.
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To JK06238:  I can relate to your symptoms more than any others that I have read.  I have had smae symptoms since 1 yr ago.  It started with a core throat, sore under tongue area; redness on right side of throat and my tongue tingles; my ears ring constantly.  I went to my PCP andhe said I have chronic alergies (allergies) and treated me with sincus medications including augmentin.  I did get much better adn the symptoms went away and then a few mobths ago they cameback andit was much worse; I actually thought I was about to expire; I was sleepy, sluggish, tired from the am to the pm.  I medicated myself with penicillin and motrin 800 for weeks until I ran out and decided to go back to my PCP.  Again, it chronic alergies (allergies) and he put me on Claritin and flonase which Ihave already used int he past expet for Claratin, I was on Zyrtec and flonase; I got betteragin; symptoms went away but not 100% this time; then justin the lsat fewweeks, they are back and I feel sick in the mornings and night.  I have very little appetite; I went back to my PCPp and requested a referral to see a ENT; waiting on authorization but other symptoms include, my throat is somewhat swollen on right side; I have neck stiffness and tenderness around ear,down my through and under tongue and under chin area.  I have some mucuc but not alot but it seems to be very thick and is hard to cough up.  I smoked for years and quite in early 2004 and that's when I started having these problems.  I thought it was just my body trying to recovery from smoking for so long and I am very concerned.  I am not the happy,lively woman I use to be because all I think about is cancer dayu and night, at work and when I am with my family and it's starting to be notices by my boyfriend and all I do is think about what it could possible be.  So I can relate to your problem very much. I am looking forward to going to the ENT within a week or so and finding o ut what is REALLY going on in my body.  Please reply and let me know if you have had any success with disgnosis of your problem.  Tks, and God's speed....Floridian59
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I have had my second visit to ENT, and once again they put a camera down my nose, my voice has become worse over the months and my throat has become more sore, this time the Doc said he would send me for a biopsy under aneasthetic, which of course made thankful, but made me worry about cancer, I am waiting for my appointment at this stage, I am surprised none of you have been sent for a biopsy, they cant really tell what the trouble is they look a little deeper, some of you seem to have worse symptoms than I have, and for longer times. keep on posting here with updates, it helps to know others have the same problem, and how they are dealing with it.
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i have had my tonsils out and have been in constant pain ever since then i think that surgery should be outlawed for anyone cause they do not cause the problem they help you with the problem i need help with my problem i have had my tonsils taken out and am now going to sue the dr. for this cause i have severe allergies and so bad taht my ears ring. and he did not check that like he should have and now all i do is cry.
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Floridian again:  Since I posted my first comment on 3 Nov; I have been very concerned.  I am tracking my days to see what makes a difference in my energy level and the pain in my neck and I found that the less I move around the better I feel during the course of my day.  Over the weekend, I did as little as possible and I did get as sick feeling and nausiated as I normally get but it's like someone said previously, once I think I'm better; there it comes again; sick at my stomach, sever pain near my right ear and tonsil and down my larnyx and just plain tired and food is the last thing on my mind.  I finally received my referral to see an ENT on 14 Nov and I am so ready to find out what is wrong regardless of what it is.  I am so tired of assuming based on what I read from others and getting my hopes up that it's nothing serious and then I think that I'm dying.  So I am so grateful to have others people who can understand my mental and physical delimma with whatever this illness is.  I can relate to the fact that I had tonsil problems as a child but not since I am been an adult but I have to remember that I am much older and my immune system isn't like it use to be.  I also did some research and I have found a Cancer Site that gives great info on natural supplements to take to ward off those cancer causing floaters in our bodies and I am starting to try a natural approach until I get to see the ENT.  I will pray for everyone's full recovery from this mysterious illness.  Please reply......
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It's so nice to hear from others that are just as frustrated as I am. I'm sick of not getting any answers. I miss singing and talking and I feel like I am not myself in public because I have to judge whether someone is worth talking to at a party if I know I'll lose my voice after speaking with them.
I have had stroboscopy in addition to seeing the ENT quite a lot. No answers from anyone. The allergist found I was allergic to dust mites and put me on Allerex. I've been on other allergy medicine before but I do find that this one helps to recover my voice so I can at least be heard/understood faster than nothing at all; especially if I've been in an environment where I have to compete with other noise to be heard (bars, sports games, etc).
I once found a website of a professional singer that had similar problems and a naturalist/holistic doctor said something about parasites causing the problem. I tried looking up more about this but I couldn't find much so who knows how valid/possible it is. I hope some smart doctor out there find something that can help us! My next step is to meet with the speech pathologist to see if I'm speaking or breathing incorrectly. Who knows if it'll make a difference but I can't just give up.
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Calc Phos in triturated doses will help with overall "throat health"   also, check for systemic fungus.  Often overlooked especially if antibiotics have been taken.  Check out book called "the fungus link" by doug a. kaufmann.  Also try essential oils such as oregano, clove, etc.  that are anti-fungal/anti-viral.  young living has extremely pure unadulterated essential oils of this quality.  for my family, I use a combination called Thieves applied topically near tonsils, a drop between two altoids then place in both sides of mouth so thieves can slowly disperse and a drop on the soles of each feet (best absorbsion for systemic issues).

hope this helps

Regards,

Rich
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Benjo could you please tell us what the biopsy revealed? I have identical symptoms to you guys and am currently at the 'pre-see someone in ENT' stage. What I don't understand is why this seems to affect one side of the throat much more than the other. The most depressing symptom for me is the interruption to my speech, I constantly have to cut myself short in conversation. After speaking for about 20mins in a day my throat becomes raw and my voice becomes hoarse.
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I'm so glad you guys are posting.  My boyfriend is so frustrated with his symptoms and the doctors just seem so either lazy or not willing to say "I don't know".  So the common response (and seemingly the only confident response they've all agreed upon) is reflux.  He's had the same reaction to meds... antibiotic: got better, then worse, reflux meds: seemed to help and then worse than before...
I'm wondering about Benjo for sure, but I'm also curious, have any of you had irritated gums? -Like something sharp is poking your whole gumline? -like how a cleaning feels.  There are not specific areas, and no "spots".  
Also, probably not related, but just to see if there might be more common threads, Is anyone having painful lymph nodes under arms? (His comes and goes.)
I'm almost convinced that it's yeast.  When I can convince him of that -and to go on the strict diet to get rid of it, I'll let you know how it works out...
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Thank you for posting.  This is the first time I have found something on the internet that seems to describe similar symptoms that which I have for the last year or so.  At first, it started with a sore throat, redness, irritation.  This didn't worry me.  Then one night, while sipping diet pepsi I felt a swelling at the back / base of my tongue (I believed).  It was a minor swelling, but was noticably different from anything I have ever felt before.  Once approximately every two weeks I got the same symptom, and otherwise my throat was just mildly sore.  Went to PCP a few times, and was treated for post-nasal, sinusitus (had CAT scan of sinuses), allergies, quick-check for strep... no help with each treatment, all checks negative.  I used to sing often, but since this has progressed, I cannot sing more than 10 minutes max, and my throat gets fatigued, and voice lowers some.  My normal range is still there whenever I start to sing though.  Always can talk, but talkin on the phone makes my thoat fatigue also.

I went to a ENT starting at the end of August, and he did the camera up the nose, down the throat, and saw lots of redness.  Put me on Nexium, once a day.  It has helped take away the soreness mostly, but once a month or so I get swelling again, in the throat, lump in throat.  I have seen the ENT in October also, and he wanted me to stay on the Nexium, as the redness wasn't entirely healed, and I was still experiencing some symptoms.  Tomorrow is my next ENT appt.  I will post back after it.

In the last 4 weeks I have noticed my right throat gland swollen, consistently, and in the last 3 days my right tonsil tingling and swollen too.  In my throat, when I swallow food, it goes more to the left side now, as I belive my whole right side feels swollen.  Left side feels great / normal.  Just the last 2 days, my right ear has a consistent / intermittent ring (very mild) but it concerns me if it is connected.  

I can very much relate to the worries all of this brings, and how each one of you posted about your worries.  Yes, cancer and the like all come to mind.  Just know you all are not alone in dealing with these types of mysterious symptoms.  

Thanks for your time reading.... and your advice from other's posts!

Kevin
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I too have had similar symptoms for almost 2 years, had laryngoscopy, showed redness, tried antibiotics, which seemed to help some, then the problem came back.

Had tonsils removed, problem seemed to go away for awhile.

I am a smoker, but use nicotine gum most of the time, I feel its something to do with the gum. Also feel problem could be allergy related or sinus. I sleep on my side and throat side having problem is the one facing down

Next step is to get Barium swallow.

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