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Family Medicine (Expert Forum)
I really need some help - Postnasal, Sore Throat , Hoarseness
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
I really need some help - Postnasal, Sore Throat , Hoarseness
by wheeler5000, May 09, 2006 12:00AM
I am 36 years old, male and a former cigarette smoker. I smoked for 19 years at approximately 5-9 cigs per day.I also quit at various times during those years.The longest lasting two months. For the last 13 years I
have a chronic thick mucus running down the back of my throat.
It coats the back of my tongue in yellow crud.It also causes
very bad breath, sore throats and hoarseness.My throat feels like its been scraped. Thats the best way I can describe it.
My hoarseness is not terrible, just more of a constant consistent raspiness.
Im not sure if Im just more aware of it lately but
things seems to have accelerated. I have quit smoking. This is week 3 of the cold turkey quit. I went to the family doctor. He gave me antibiotics, guafinex and flonase.They didnt work.I went to the ENT twice in the last 9 months. He did the scope twice.Up the nose and down the throat to the vocal cords.He tells me everything looks great. The first time everything looked perfect. The second time, my turbinates were slightly inflamed, which corresponds to the closed stuffy nose on one side when I wake each morning.As far as my nose goes, its always dry and doesnt run at all,but I do sneeze on accassion. He said take gaufenisen and sent me home. I went to the dentist. I think she did a cancer screen as she felt all over my neck. No problems to report.
Ive tried grossan nasal irrigator,saline and non saline nasal sprays,oral antihistamines, flonase, astelin, sudafed, guafensen and steroid nasal sprays.They have all failed to stop the drip.I have tried to increase my daily water intake.I am miserable and now reduced to taking homeopathic medicines.
Questions:
1.If the smoking caused this drip, how long will it take (smoke free) to subside? Could it take years? Will it ever subside or have I permanently ruined my body for the rest of my life with smoking?
2.What medications can I take to stop the drip?(other than what I mentioned)
3.Do I have throat cancer? Could two laryngoscopes done by an experienced ENT have missed something?
4.Please help me as Im at my wits end and tired of running from doctor to doctor.I even emailed Dr. Grossan. He tells me that
my problem is due to cilia that have slowed or stopped and I should use his nasal irrigator. I tried the irrigator, it didnt work and made me feel like I was underwater all the time.
have a chronic thick mucus running down the back of my throat.
It coats the back of my tongue in yellow crud.It also causes
very bad breath, sore throats and hoarseness.My throat feels like its been scraped. Thats the best way I can describe it.
My hoarseness is not terrible, just more of a constant consistent raspiness.
Im not sure if Im just more aware of it lately but
things seems to have accelerated. I have quit smoking. This is week 3 of the cold turkey quit. I went to the family doctor. He gave me antibiotics, guafinex and flonase.They didnt work.I went to the ENT twice in the last 9 months. He did the scope twice.Up the nose and down the throat to the vocal cords.He tells me everything looks great. The first time everything looked perfect. The second time, my turbinates were slightly inflamed, which corresponds to the closed stuffy nose on one side when I wake each morning.As far as my nose goes, its always dry and doesnt run at all,but I do sneeze on accassion. He said take gaufenisen and sent me home. I went to the dentist. I think she did a cancer screen as she felt all over my neck. No problems to report.
Ive tried grossan nasal irrigator,saline and non saline nasal sprays,oral antihistamines, flonase, astelin, sudafed, guafensen and steroid nasal sprays.They have all failed to stop the drip.I have tried to increase my daily water intake.I am miserable and now reduced to taking homeopathic medicines.
Questions:
1.If the smoking caused this drip, how long will it take (smoke free) to subside? Could it take years? Will it ever subside or have I permanently ruined my body for the rest of my life with smoking?
2.What medications can I take to stop the drip?(other than what I mentioned)
3.Do I have throat cancer? Could two laryngoscopes done by an experienced ENT have missed something?
4.Please help me as Im at my wits end and tired of running from doctor to doctor.I even emailed Dr. Grossan. He tells me that
my problem is due to cilia that have slowed or stopped and I should use his nasal irrigator. I tried the irrigator, it didnt work and made me feel like I was underwater all the time.
Doctor's Answer
by Kevin Pho, MD, May 10, 2006 12:00AM
, May 10, 2006 12:00AM
To answer your questions:
1) It would depend on the cause. Most cases of post-nasal drip can be treated. One option would be to perform a sinus CT scan to evaluate for chronic sinusitis or be referred to an allergy specialist.
2) You have pretty much taken every class of medication to help with the drip. Another option would be a short course of oral steroids, which can be discussed with your ENT.
3) A negative laryngoscope would make throat cancer unlikely. A neck CT scan can be considered for further evaluation.
4) I would suggest an allergist referral or another ENT evaluation (preferably at a major academic medical center).
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.
kevinmd_
1) It would depend on the cause. Most cases of post-nasal drip can be treated. One option would be to perform a sinus CT scan to evaluate for chronic sinusitis or be referred to an allergy specialist.
2) You have pretty much taken every class of medication to help with the drip. Another option would be a short course of oral steroids, which can be discussed with your ENT.
3) A negative laryngoscope would make throat cancer unlikely. A neck CT scan can be considered for further evaluation.
4) I would suggest an allergist referral or another ENT evaluation (preferably at a major academic medical center).
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.
kevinmd_
