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Avatar universal

throat again

I am going to the ENT again on the 24th but am really scared.  Like I have said, I have had this sore throat for almost a year. Just on the right side.  It will sometimes go for a week and then return.  I thought I saw some pus inside the right tonsil, but I can't be totally sure.  If this were throat cancer would it be worse by now.  Would it go away for a week at a time.  Would i be having problems swallowing, a lump maybe?  I don't have those symptoms.  The ent will probably do the scope again, through the nose to the cords. He has done this 3 times in the past, but i'm afraid maybe it has changed in the months that have passed since the last one.  I did have pain then, probably more than now, and he didn't see anything.  I had a neck ct(normal), neck ultrasound (2 small cysts 3mm), xray (nothing) and 3 scopes (nothing).  These tests were all 5 months or more ago.  I did have alot of pain then.  Shouldn't something have shown then?
Thanks and sorry to bother you yet again, you seem so helpful.
Missy
10 Responses
251132 tn?1198082422
MEDICAL PROFESSIONAL
As mentioned in the past, since the sore throat will sometimes go for a week and then return, it is more likely that something other than throat cancer is the cause.  Postnasal drip is one possible cause.  I hope that you checked with your ENT yesterday about the daily use of nasal washes, possibly followed by a nasal steroid spray.  If your sore throat is due to postnasal drip it should go away and stay away with this ongoing treatment.

Postnasal drip is drainage from the nose and sinuses dripping down the back of the throat.  There could be several reasons for this drainage.  One is an allergic reaction to inhaling something.  A second reason is a non-allergic, non-infectious inflammation in the sinuses that could be lingering after a cold or infection.  A third reason is chronic sinusitis.  Postnasal drip can cause irritation of the throat.  You may experience the postnasal drip as a feeling of something in your throat all of the time.  When your nose is stuffy it is possible for your ear on that side to also be stuffy and hurt.  If the stuffiness creates enough pressure it is possible that your jaw could hurt also.  A decongestant like Sudafed
Avatar universal
I wonder if the constant sore throat might be caused by GERD
[gastro reflux]. GERD often occurs with heartburn, but not always. A gastroenterologist could diagnose.

See:
http://www.aboutgerd.org/gerdother.html
What Else can we Attribute to GERD?

"Sore Throat, Cough
Awakening with a sore throat and cough is not always a harbinger of the common cold. Nocturnal reflux, especially after late-night food or alcohol intake, may reach the throat without awakening the individual. The refluxed gastric contents irritate sensitive tissues causing a sore throat, a need to "clear the throat," and cough. There are other causes of course, such as dry environments, or allergies. However, if due to reflux, the sore throat and cough is easily prevented by avoiding late
night eating and drinking, and employing other anti-reflux measures."
Avatar universal
Missy4, below is a web link that says persistent one-sided sore throat can be a symptom of GERD; also a link on Self-Help for GERD. Another link I saw said less than 50% of patients with GERD have heartburn.

http://www.webgerd.com/Patients.htm  Excerpt:
"Gastroesophageal Reflux Disease occurs when the lower esophgeal sphincter (a valve) between the stomach and esophagus weakens. Most probably, affected people are born with this condition. This
will lead to leakage of stomach contents (acid, bile, and semi-digested food) into the esophagus, causing heartburn, chest pain and esophagitis. The acid may reach the throat, leading to reflux laryngitis and hoarseness, chronic mostly one-sided sore throat and chronic dry cough. The refluxed acid may enter the windpipe specially when sleeping at night and lead to asthma, recurrent pneumonitis, or chronic lung disease and fibrosis as a result of inflammation of the lungs from aspiration.  Burning tongue and dental caries may also be caused by the acid-reflux.  In children, the acid may cause otitis media, earache and chronic sore throat."
-------------------
http://www.webgerd.com/SelfHelp.htm Excerpts:
"DIETARY MODIFICATIONS

The main offending foods to avoid in typical American diet are outlined below. We have also provided a detailed food list for patients who remain symptomatic in spite of following this outline.
......................
LIFESTYLE MODIFICATIONS

Elevate the head of your bed at least six inches by putting a couple of bricks or old books under the top legs of your mattress frame. You can also purchase special foam wedge pillow made for this purpose from your local pharmacy supply store, or try a more  advanced pillow by contacting www.propuppillow.com.
This will reduce the return of stomach acidity and semi-digested food into your esophagus, throat, mouth and potentially your lungs when you are sleep.
Avoid exercising at least for one to two hours after each meal. Do not bend from the waist down for 1-2 hours after each meal.
Avoid eating or drinking except water and medications for 2-3 hours before going to bed (go to bed with an empty stomach to reduce the chance of reflux).
Avoid wearing tight belts, pants or corsets.
Stop drinking alcoholic beverages.
Stop smoking.
Avoid large meals. If necessary eat smaller amounts more frequently.
Reduce your weight to diminish reflux.
..............
OVER-THE-COUNTER SELF MEDICATIONS"
=======================================

Avatar universal
thanks for the comments.  the ent says it is not gerd.  he says i have a cryptic tonsil.  i asked for a biopsy but he said no and he doesn't want to take my tonsils out.  would debris in the tonsil cause a sore throat for a year now?  the tonsil that is sore is a little smaller than the other one.  he said if it were cancer it would be larger.
any ideas?
Thanks,
Michelle
Avatar universal
I am with an ent at a teaching hospital.  Do you have a constant sore throat?  Would throat cancer not be more severe by now, or could it be slow growing, tongue-based or something?
Sorry, can you tell I"m terrified.  My ent doesn't feel any need to biopsy as he says he can't see any abnormality to biopsy.
Does your neck hurt as well?
Thanks so much for your time.
Michelle
Avatar universal
Missy, To rule out GERD I think you would need a 24 hr pH monitoring test. An ENT is not the best doctor to tell you whether you have GERD; the specialist is a gastroenterologist.
You could try posting your message for comments at:
http://www.medhelp.org/forums/Gastro/wwwboard.html

Regarding the cryptic tonsil; just means it has crypts that can collect white junk called tonsiloliths. If you shine a flashlite at your tonsils you may see this sometimes. One way to deal with it is a Water Pik attachment [Grossan I think] that washes them out.

I'm interested in your case because I also have the sore throat and cryptic tonsils, as well as asthma and pneumonitis. I've recently come to the conclusion I may have GERD exacerbating my lung problems. I'm starting by changing my life style for a while to see if it helps [no spicy food or alcohol, no food or drink within 3 hr of bedtime, just ice & water, etc] plus installing a MedSlant wedge on my bed to elevate the upper part of body. I also have rhinitis which I treat with Nasalcrom and Singulair;
the asthma with Pulmicort and Serevent.

Another thing for you to consider is trying another doctor, since the ENT you have been seeing hasn't figured it out; it would be best at a teaching hospital.
Avatar universal
I still think a consult with a gastroenterologist might be worthwhile, since chronic sore throat can be a symptom of GERD; maybe a problem in the esophagus?
Take a look at this link:
http://www.aafp.org/afp/990901ap/873.html Head and Neck Manifestations of Gastroesophageal Reflux Disease
Excerpts:
"Gastroesophageal reflux disease (GERD) is the most common esophageal disease. Besides the typical presentation of heartburn and acid regurgitation, either alone or in combination, GERD can cause atypical symptoms. An estimated 20 to 60 percent of patients with GERD have head and neck symptoms without any appreciable heartburn. While the most common head and neck symptom is a globus sensation (a lump in the throat), the head and neck manifestations can be diverse and may be misleading in the initial work-up. Thus, a high index of suspicion is required. Laryngoscopy can confirm the diagnosis of laryngopharyngeal reflux. Erythema of the posterior larynx may be seen, and the true vocal cords may be edematous. Treatment should be initiated with a histamine H2 receptor blocker or proton pump inhibitor. Lifestyle changes are also beneficial. Untreated, GERD can lead to chronic laryngitis, dysphonia, chronic sore throat, chronic cough, constant throat clearing, granuloma of the true vocal cords and other problems. (Am Fam Physician 1999;60:873-86.)
..............
Other symptoms include constant throat clearing (caused by increased secretions and irritation of the laryngeal mucosa); dysphonia (caused by edema or inflammatory lesions of the true vocal cords); chronic sore throat (often misdiagnosed as recurrent or chronic tonsillitis);..............
............
Indirect or direct laryngoscopy can be performed to confirm the diagnosis of GERD.
....................
If the history and physical examination fail to uncover serious pathology, patients with suspected GERD may begin empiric therapy, which consists mainly of lifestyle modifications and drug therapy (Tables 26 and 3). "



Avatar universal
I HAVE THIS EXACT PAIN YOU ARE TALIKING ABOUT. I HAVE BEEN TO DR. AFTER DR. I HAVE BEEN TOLD IT WAS POST NASAL DRIP BUT, I DONT SEEM TO HAVE ANY DISCHARGE FROM MY NOSE. I DO HAVE GERD. BUT, I HAVE BEEN ON NEXIUM FOR YEARS FOR THIS. I HAVE FINALLY MADE AN APPT. WITH A ENT DR. IT'S 3 WEEKS AWAY. AND I LIKE YOU AM WORRING MY SELF SICK.  MY PAIN COMES AND GOES ALSO. IT HAS BEEN DOING THIS SINCE OCT. 2002 I RECENTLY WENT ON TOPAMAX FOR MY HEADACHES AND THIS SEEMED TO MAKE IT A LOT WORSE. SO I HAVE GONE OFF OF IT. I WAS JUST WONDERING IF YOU HAD ANY MORE INFORMATION YOU COULD GIVE ME.
Avatar universal
Ragtop,

I don't have any answers for you. I wish I did.  My throat is still sore on that side.  If you find anything out please let me know.  How old are you?

One thing i have noticed is that i have some tonsil stones.  Little white balls of gross stuff in my right tonsil.  I keep thinking if it were something sinister hopefully my ent would have seen it.

It's been a year now and I am fed up.  He doesn't want to take my tonsils out but I don't know what to do anymore.

I'm 33 by the way.

Take care, Michelle
Avatar universal
I AM 38. ATLEST I KNOW I AM NOT ALONE. ANT THEY HAVEN'T FOUND ANYTHING SERIOUSLY WRONG. BUT, I KNOW IT IS FRUSTRATING. IT IS FOR ME. I DID TRY THE NASAL WASH LAST NIGHT AND I GUESS WE'LL SEE IF THAT HELPS ANY. I WILL KEEP IN TOUCH. AND LET YOU KNOW WHAT I FIND OUT AT THE ENT. MY APPT. ISN'T UNTIL AUG.6 BUT I PRAY IT WILL BE GOOD NEWS ALSO.. KEEP IN TOUCH.
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