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

[NPetruzzi]

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

[ckg]

-- 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.

[NPetruzzi]

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?

[Kevin Pho, MD]

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