Hello,
Thank you for posting your query at DoctorSpring.com
You are suffering from sore throat and ear pain for a month.
Common possible causes incudes recurrent throat infection, acid reflux, nerve related pain( styalgia).
To get correct diagnosis you need examination by an ENT specialist, who can examine ear and throat. Can do endoscopic examination of Throat and throat swab, this is advisable for infections lasting over a month.
Feel free to discuss further,
Hope this helps,
Best regards
Patient replied :
So about six months ago, I notice my throat was red in the back. I did think too of it but then in March my son had strep so I also went on Augmentin. I had no changes in the redness. By the end of May I noticed my throat was getting sorer. I used coconut oil and that seemed to help some by the next week I went to see a PA. Rapid strep was neg. she said it was viral. After another week, the pain just kept getting worse. I went into quick care again and then rapid strep was still negative. This time they sent a culture and it was negative. He gave me Toradol, azithromycin and prednisone 60mg for 5 days. Things started to get better after this for about a week. I then went to see an ENT doctor. He looked around and found nothing. Three days later I went to another ENT doctor and was having 10/10 pain in my throat; it felt raw like a burn. I was unable to open my ear on the left side too. The ENT and he did and endoscopy of my upper airway and found nothing. I also had a CT with contrast my neck which was also neg. I went back on steroids for about 3 weeks this time. The pain finally got better down to 2-3. I did a follow up with him a few weeks later and he said things looked fine. I started taking Lorazepam .5mg at night. That does seem to help. I also told Prevacid for a while thinking it may be silent GERD. The pain has moved around sometimes so I thought it might be allergies. The Cetirizine seems to help. Now I does really hurt in the morning, I drink coffee seems to make it a little worse. I was using Listerine, hydrogen peroxide, and chlorhexidine which also seemed to irritate it more. Eating makes it worse. (Could it be a gluten allergy?) Every time I swallow it feels like part of my throat is rubbing together. My throat looks red, I have openings on my tonsils (so I have been concerned about crypts, I did notice awhile back I was having bad breathe). It is definitely more red/ swollen on the left. My tonsils are not swollen. It almost feels like something is covering my Eustachian tube. They only way I can pop my left ear is to hold my nose. I also have pain that goes down my left neck. My lymph node is hard and hurts if I press really hard. I have not had any blood work done. Ice on my throat helps, and I have using a heat pad on my neck. I have looked so many times in the back of throat and do not see any sores, ulcers, nothing, just red and the veins are red too.
Currently, I am taking Lorazepam.5mg at noc, Cetirizine 10mg daily, fish oil, Vit B 12, Vit C, Benadryl, Norco 5/325 prn
HX: I have had high cholesterol, I have taken my BP after work and it has been 140/90’s which it is usually always low but never been diagnosed with HTN. I drink wine 1-2 nights per week. I quit smoking about 3 months ago. I only smoked 2-6 per day. But I am definitely done.
I do not have a G. P. so I have an appointment in 3 weeks
I would really appreciate any recommendations you may have
Karen
Thanks for providing detailed information.
most likely you are suffering from chronic pharyngitis(persistant inflammation of throat).
This is very unlikely due to any infection because you do not have any fever. so common
irritant will be acid reflux or some allergy. following medicine may help you.
Tab. Rabeprazole(Rablet) 20 mg once in morning for 1 to 3 months.
Tab. Levocetrizie 5 mg one in night for 2-3 weeks.(rather than cetrizine)
Rather than lorazepam you can start Tab. Amitryptiline (tryptomer) 25 mg once in night for a
month.(This is anti anxiety medicine rather than sleeping pill)and it helps in nerve related
pain also.
If warm saline garggle helps you can do twice daily.
Tonsillar crypts are normal so need not to worry about it.
Xray styoid precess can be done to rule out styalgia.
otherwise with all these invesitgation we are not missing some major disease, so need not to
worry about it, but as it is affecting your normal life activity i hope it will improve soon.
Best Regards
Patient replied :
Thank you for providing this feedback. Can you prescribe these medication or will I need my local G.P. to? Do you think I should look into allergy testing? I am wondering about a gluten allergy? I was thinking about going off gluten for awhile to just see if it helps. I noticed yesterday that after I had crust from a quiche my throat hurt more and it was hard to clear my throat. My throat is still all red in the back more so on the left side. I will also check and see about having a an x-ray.
What kinds of things should I be aware of in looking for major concerns? This has been an emotional roller coaster, first thinking it was cancer... then to just feeling like I will never figure out what it is. The weird thing is I actual feel really good. I work out 3-4 per times week. Just want to be aware of the signs and symptoms I should really be concerned about if things get worse?
I plan to start on these medications and then can we do a f/u in a month?
Thank you
Karen
Hello,
You can get prescription from GP. This is very unlikely gluten allergy because gluten allergy
will have abdominal symptoms rather than throat symptoms. allergy testing can be done to
determine other possible causative allergens.
Cancer in such young age with these symptoms is very unlikely. in cancer you see a abnormal
mass or ulcer on one position only and it doesnot heals. Most of cancer lesion are painless in
begining. So it is unlikely in your case
so first you start these medication and get one consultation with local ENT specialist.
Hope this helps
Patient replied :
So last Thursday the pain started to get worse 10/10. Everytime I would swallow it felt like my throat was rubbing together like sand paper. I called the local ENT I have been see and he was able to get me in. He looked in my mouth and does note that I do have crypts but did not see anything. He also did an upper endscope and evaluated my eustrachian tube, back of throat, etc. and did not really see anything. He started my on omeprezole 20 mg BID and order an MRI. I do feel like the omeprezole is helping. It does not hurt all the time to swallow now. But now the left side of my left never my tonsil is hurting and inflamed. When I look into my mouth I can see that the left side of throat is more swallon then the right and it is red around the tonsils. Yet my tonsils are not swallon. So I am not sure if this is a tonsil stone. I do not see anything white at this point. I am getting so frustrated with and would like to just have my tonsils out. I would like to get your opinion on this. Do you think the MRI will show anything if the CT was completely negative. When the pain started. I was using hydrogen peroxide on cotton Q-tips the back of my throat. I was wondering if this could have caused a sore which the steroids helped to clear up or I have reflex and the acid reducer is helping.
Where do I go from here?
Hello,
I am happy to know that omeprazole is working. Though you have left sided throat pain still it is unlikely due to infection ( as you donot have fever, ur cuture and swab negative, last episode of pain with 10/10 improved by antibiotic)
This is very unlikely tonsillolith. You need not to worry about size of tonsil, many time it is asymmetrical and as is lymphoid tissue size may change.
Tonsillectomy may not really help you as there is no definitive indication, so i wont advice for same.
Continuation of omez twice daily for 2-3 months will be best option for time being. If require you can do garggle or add antiallergy medicine
Mri will give some extra information but most likely it will be normal
Hope this helps
Best regards