Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
The exact site indicated by you, is where the tonsils are located. So there can be two things, either the tonsils are enlarged, or there can be folliculitis in the pharynx ( acute pharyngitis ).
In absence of any smoking history, it is most likely due to an infection.
It does not look like anything serious. We just need to approach it step by step.
Did you have any recent sore throat? Or any throat infection in the recent past?
Without looking at the swellings, it is slightly difficult however from the site it mostly won't be anything apart from enlarged tonsils or pharyngitis.
The acid reflux as you mentioned seems to be there, since your thorat is getting sensitive when you eat unhealthy. Is there any particular cause of your anxiety?
In the absence of any pain or fever, the infection seems to be mild. However if it is bothering you, and causing difficulties in swallowing, it is better to take a prophylactic course of antibiotics to reduce the swellings.
When you went to the doctor, did he examine your thyroid? Or rather was a thyroid enlargement ruled out? Because at times even thyroid enlargement will present asymptomatically. And the swelling will move up and down on swallowing, or drinking water.
Kindly reply to the following questions :
1) Any history of sore throat in recent past? Or any fever?
2) Any difficulty in swallowing?
3) Do you always get a lumpy feeling in the throat?
4) Any particular cause of your anxiety. Anything i can help you with?
5) Was a thyroid swelling ruled out? Any history of thyroid disorder in the family?
I am asking about thyroid because it classically is present around the site that you pointed out. Even though the possibility of it being a thyroid selling is low.
Awaiting your reply,
Regards.
Patient replied :
1) Any history of sore throat in recent past? Or any fever?
I havent had a sore throat or a fever recently however I have had one probably 2 months ago. 2) Any difficulty in swallowing?
There is no difficulty in swallowing, breathing or chewing. 3) Do you always get a lumpy feeling in the throat?
I get a feeling like I need to clear my throat in which can make me gag sometimes and cough
4) Any particular cause of your anxiety. Anything i can help you with?
Since I dipped i haad bad anxiety about having cancer from the bumps in the throat also have 2 bumps on my cheeks symmetrical on both sides which the dentist says its from biting
5) Was a thyroid swelling ruled out? Any history of thyroid disorder in the family
The doctor did not check my thyroid. The actually bumps don't move just when I can move my adams apple I can feel them on the back part just moving up and down. No pain with them or anything just anxiety of it being cancer or something bad.
Also I am big into lifting so I am bulking and I gained like 15 pounds fast which might have something to do with maybe acid reflux? I don't know what else the gagging feeling could be from.
Hello,
Thank you for the detailed follow up.
Okay firstly to address your anxiety, you won't develop cancer. You have no smoking history, and you only have a short history of dipping, it is not going to cause any harm, provided you stop it completely. Anxiety can also cause a gagging sensation apart from hyperacidity and acid reflux. I can't say for sure that anxiety is the primary cause, but it does lead to hyperacidity, acid reflux, palpitations, a feeling of lump down the throat, fatigue, e.t.c
So once again i reassure you, you can stop worrying about cancer.
Now in absence of any history of recent infections, or any fever or sore throat, it does not seem to be anything to be worried about. However i will advise you to take prophylactic antibiotic for a week,and if the bumps are due to mildly enlarged tonsils, or follicular pharyngitis, they will settle down. In some cases, such bumps can be present due to previous infections, or even severe acid reflux can lead to an irritation, leading to such bumps.
So I will advise you a couple of medicines. Kindly take them for 5 days and update me on your symptoms.
In case it does not resolve, an ENT specialist can examine your throat, do an Indirect Laryngoscopy which will give a better picture.
1) Cap. Omeprazole 20 mg, once daily for 7 days before breakfast ( will reduce the acid reflux ).
2) Tab. Augmentin 650 mg twice daily for 5 days. ( for subclinical infections ).
Hope this was helpful,
Regards.
Patient replied :
Hello sorry it took a while to get back, I know the acid reflux is from stress because I always stress out about these bumps on my cheek (inside) I will attach a picture. The dentist has said it is most likely from trauma like biting once again i dipped for about 2 years old patientso I was worried about mouth cancer. The bumps are symmetrical one on each cheek. They do not hurt and they do not cause any discomfort or anything. I noticed them about 3 months ago I believe and when I first saw them I kept picking at them which may have made them permanent? Maybe you can ease my mind when you see the photo. The photo is from tonight in which i did actually pick at them again so it is a little more raised. let me know what you think! Thanks.
Hello,
Thank you for the follow up.
That definitely looks like secondary to trauma. And please don't pick on them anymore, because the more you do, the more chances of them staying permanently or getting infected. I understand you picked at them, so that you can send a clear picture, but please avoid in the future.
Also 2 years old patientof dipping won't lead to cancer. And this does not look anything like cancer.
You can also apply Xytee Gel ( Metronidazole Gel ), on those affected spots. They will be helpful in faster healing.
Regards.
Patient replied :
Do i need to get the Xytee gel prescribed to me or can it be over the counter? Also, if they are already permanent, is that bad? They haven't caused any discomfort at all I can just feel them with my tongue. Also just for a doctors opinon, I have read unbiased articles on dipping and getting mouth cancer, in which they have researched to be not very harmful and very unlikely to develop. I am just curious on your opinion. Also can my bumps turn into mouth cancer or would they just kind of be there?
Hello,
See any kind of mouth ulcer no matter how trivial they are, has slight chances of malignancy if they are not treated properly, and more for the ones which are secondary to smoking or chewing tobacco.
And absolutely, i never meant to imply that dipping causes mouth ulcer. See anything that causes irritation in the mouth, for a long time can lead to a mouth ulcer. And if the ulcer persists, it has a very very small percentage of chance of turning malignant.
In your case, i am really not worried about cancer, and i will advise you not to worry about it either.
You will need prescription for Xytee Gel and i strongly believe once you apply, and if there is no further trauma, it will be resolved.
Thank You.