pharyngitis tonsillitis

Chronic Pharyngitis: Causes,symptoms and treatment

Chronic pharyngitis can cause a significant problem in daily life, starting from  throat discomfort in the morning to alteration of voice .Chronic inflammatory condition of the pharynx characterized by hypertrophy of mucosa, seromucinous glands, subepithelial lymphoid follicles and even the muscular coat of the pharynx.

Two Types of Chr. Pharyngitis-

  • Chronic Catarrhal Pharyngitis
  • Chronic  Granular Pharyngitis ( Hypertrophic )

Causes ( Etiology ) Of Chronic Pharyngitis-

  • Persistent infection in the surrounding structures of pharynx like sinus, tonsils, nose etc including dental sepsis.
  • Mouth breathing exposes pharynx to air which has not been filtered ,humidified and adjusted. These are usually result of nasal polyp, rhinitis, turbinate hypertrophy,adenoids,tumors. It can also be due to protruded teeth or habitual mouth breathing.
  • Environmental Pollution
  • Faulty voice production as seen in certain professions like singers and over use of voice. Can also occur in case of pharyngeal neurosis

Symptoms-

  • Discomfort or pain in the throat- prominent in the morning
  • Foreign body sensation ( something stuck to throat ) sensation- patient has constant desire to clear his throat.
  • Tiredness of Voice-  voice may lose quality and even crack.
  • Cough-  irritable throat. Simply opening of mouth can cause retching and gagging

Signs-

 

pharyngitis tonsillitis
Throat in Chr. pharyngitis
  • Congestion of posterior wall of pharynx, engorgement of vessels, pillars may be thickened.
  • Increased mucus secretion.
  • Posterior pharyngeal wall may be studded with reddish nodules in case of Granular pharyngitis.
  • Lateral pharyngeal  bands may enlarge and uvula may be elongated and hypertrophied.

Treatment:-

  1. Etiological factor or causative agent must be eradicated for resolution of Pharyngitis. Eg. Stop smoking, abstain from alcohol and cold, irritant food.
  2. Voice rest is essential
  3. Speech therapy where faulty voice production is seen
  4. Warm Saline gargles may be soothing  and even relieves pain and irritation.
  5. Mandl’s paint can be applied to mucosa of pharynx

Surgical – Cautery of Lymphoid granules – Electrocautery  or Diathermy.

Actual case of Chronic pharyngitis-

pharyngitis

Source- Disease Of ENT, PL Dhingra and lecture notes

49 Replies to “Chronic Pharyngitis: Causes,symptoms and treatment”

  1. Respected Doctor,

    i have a similar condition i.e., chronic pharyngitis accompanied with pan sinusitis (large polyp on L.H.S and small polyp on R.H.S next to the nasal area). I have also been diagnosed with DNS on R.H.S.
    Have been running pillar to post for a resolution but doctors are recommending a surgery ‘balloon blasty’ for the polyps.
    Please suggest some remedial action.

    Reza Naheed

  2. I have chronic infammation on the upper pharynx since last few years. The infammation has been progressively increasing. The triggering factors are cold liquids intake, yogurt, cold fruits , weather changes etc. I have shown to few ENT specialist but they just prescribe anti allergens but for no improvement. One of them even tried oral steroids but didnt help. I did sinus X ray which looks clear. Not sure about rhinitis. Really not able to figure out wats the cause. But the constant inflammation is really very frustrating. I dont what to do next?

    1. Looks like you have inflammation of Nasopharynx.
      It is really disturbing and painful condition and usually makes you feel unwell in the mornings.
      The prevention is to avoid allergens, avoid fans and cold drinks before sleeping.
      And steam inhalation can be soothing.
      A course of antibiotic can be helpful if inflammation is severe.
      Avoidance of triggers are best way to get relief of the problem.

      1. I have been diagonsed with chronic pharyngitis.My doctor says the tonsil has to be removed surgically and there is a bone in my nose which needs to straightened surgically since it’s blocking the air flow into right the nasal cavity.I have been suffering from this condition for past couple of years, have been avoiding cold drinks,ice creams,spicy foods, i dont smoke but still my throat gets sore every now and then.My doc says staying inside AC during office hours and going out to hot humid weather outside are one of the reasons why the condition is getting deteriorated. Is there any solution other than surgery and what if surgery does not cure it completely? i have been taking ayurbedic medicine (himalaya’s SEPTILIN)for past 2 months but it does not help either.

        1. The curved bone in septum of nose is called DNS ( Deviated Nasal Septum) and it can be cause of Recurrent URTI including Sinusitis and pharyngitis.
          If tonsillitis occurs too frequently and is troubling you too much , you may need removal indeed.
          Avoiding cold drinks, alcohol, smoking can help. Steam inhalation and warm saline gargle can help during symptoms.
          But what is your age? How often do you get tonsillitis per year? If you can reply this we can be clearer on the problem.

          1. I am 28.i got the pharyngitis atleast 12-14 times last year.The frequency has increased in the past year as compared to the previous years though.I would get the infection 2-3 times max in a year before last year.tonsilitis,sinusitis and pharyngitis are all linked i guess but every time i see a doctor, he says that its chronic pharyngitis.i see my throat every once in a while and it never looks better and looks exactly like in the picture above.sometimes i get bubbles on the upper pallet and it feels wierd sort of itchy.I would defintely stay away from cold drinks,ice creams,smoke and alcohol but for how long.How long will it take to completely recover from this?

          2. Hi I am 12 and I feel like I have a lump on the top of my throat also my throat in the back looks smaller like those pictures above. I feel like I’m gagging and mucus is in my throat I think I have pharyngitis but im not sure. Also I don’t know if I should go to my doctors to have them check my throat or if I can have examples of medicine I could take for this

          3. Hello Jennifer,
            Chronic pharyngitis is a commom problem and lumps are generally due to chronic granular pharyngitis. However we cannot prescribe or suggest you medical advice as per internet law. I suggest you to visit an ENT specialist to get it addressed.

        2. hi I’m not a doctor. but I’m also suffering from granular pharyngitis. If you have that co2 laser therapy could treat it. And I know a doctor his name is Dr. paulose

      2. my problem is exactly the same .. i have had this pharyngitis for a couple of years now … i want to know if this condition is dangerous in the long run … as in could it lead to cancer or anything serious if it persists ??

      3. Surgical – Cautery of Lymphoid granules – Electrocautery or Diathermy.I don’t think it’s a good treatment of chronic pharyngitis. You know that lymphoid granules will relapse. As opposed to that conservative treatment with aerosol inhalation is a long-term way.

  3. i have pharyngitis… i have all d symptoms i see for the chronic type. i find it hard to swallow anything and i cry when i even try to drink. it is really painful and the sensation has spread up to my ears… what should i do.?

  4. hi,,im 26yrs,when i was younger i usually have serious cough which usually lasts up to 3-4weeks,i visit the hospitals only to be given cough tab or syrups which does nothing to abeit my condition,.precisely 4yrs ago i resorted to herbal solution which proved effective for 4 cough free yrs.just 2months ago,i had most of the signs and symptoms above,went to the hospital only for them to discharge me with malaria-typhiod drugs..now i have almost all the s/s with the ringing/vibration sensation in the ear,,what should i do?with the little medicle knowledge i have,i think its granular pharyngnitis cos of presence of nodules at the side of my neck..pls help

    1. hi .I have same condition which u mention. hoe did u treat ur self .I need really help . I also hav vibration sense in ears and lymph nodes enlarge in neck and granules of posterior pharyngeal wall.plz help

  5. I am suffering from pharyngitis since 3 years.. but my throat isn’t itchy or irritating as its seen in sore throat .. only inflammation is there .. I feel all the time that the air way is narrower than it used to be .. like I feel the pharynx is constricted and I can’t inhale adequately .. but when I sneeze immediately I feel normal .. not constricted anymore but later I feel the congestion of throat again and the inhaled air has a cold feeling .. no warmth is there and I have DNS and persistent sinusitis .. please tell what to do …

  6. I have this itchy throat which doesn’t seem to get cured, no matter what. When i see my throat in the mirror, i can see some red boils on the upper side of my throat with mucous collection. Its worse in the mornings and gets worst when spicy food is eaten. I have tried all medications ,Antibiotics, anti inflammatory, anatacids also.. No effect. Please help. Thank you.

  7. hi. i am a new medical graduate. i have throat infection since last several months. used azithromycin,augmentin(co-amoxiclave), clarithromycin, cefixime, erythromycin but no improvement. now i am. thinking about a full work up. endoscopy, culture and sensitivity and other Baseline investigations. i will go to a professor soon.

  8. my voice is becoming husky, i have to clear my throat all the time. and have pussy white spots at back of throat not on tonsils. so many times have antibiotic treatment but it is recurrent.

      1. done CT scan on Nov 2012, nothing found, but, does’nt heal , infection, seen on right side, white patches and some granular, what can I do ? im afraid of cancer

        1. If the membranes are over tonsils , it can be membranous tonsillitis.
          There are many causes of white patch over tonsils and pharynx.
          Diphtheria is almost unlikely in this vaccination era. Infectious mononucleosis causes acute symptoms.
          Other causes could be Agranulocytosis – Get a Complete blood count and differential done
          Rare causes include Injury over tonsils and leukemia.
          In all cases, you need to see a Doctor, preferably ENT surgeon

  9. I have some kind of discomfort or burning sensation in the back of my throat constantly for several months already .It look like granular pharyngitis I went to the Ent for 4 times but they don’t find anything bad with my throat;Just a sacs by my tonsils and also the soft tissue by the gland bother me . I have done blood test and Ct scan. I already tried different Antibiotics but nothing relive my discomfort and cant believe how they do not know anything and does not help at all…I am so afraid and I don’t know what to do or who can help me.

  10. My son who is 12 yrs old was suffering from acute dry coughing. I have visited the ENT doctor, he diagnosed with granular pharyngitis and given antibiotics and and advised gargling with Betadyne…after 3-4 days recovery was not satisfactory so we consulted with another ENT, he says apart from the above there are minor holes therefore after eating/drinking if any thing gets in in these holes coughing starts..he suggested for surgery the only solution..and added that complications like growth problems..rheumatide etc.. .we again consulted with the 1st ENT and asked for suggestion..he says these minor holes are already there but surgery requires in extreme cases..kindly suggest appropriate solution..

    1. If tonsillitis is a significant problem or develops complications or is cause of chronic ill health, surgery may be needed. The holes you are talking about may be tonsillar crypts. You can consult ENT doctor at TU TEACHING HOSPITAL, if opinions made you confused.

      1. Hello I am 17 having pharyngitis from two year till noe I guess it is bacterial ,symptoms are swollen and painful throat and lump nodes ,whitish spots over the tonsils pharynx and many other area of the throat , slight fever headache ache in neck and near the ears , gets worse while taking antibiotics , have visited few docs but no positive result my recent do suggested surgical treatment ,the thing I worry about is none of my previous doc suggested surgery ,don’t know we her to do it or not I am afraid that what if it gets worse after surgery , I kindly ask you if it will be beneficial for my troth or not to get surgical treatment , yours sincerely

        1. Roya,
          We cannot provide any medical suggestion based on online queries. But as per general understanding, your symptoms seems like that of chronic pharyngitis and doctor seem to suggest, removal of tonsils ( Tonsillectomy). If tonsils are trouble some, with frequent cause of ill health, removal is suggested. If you are in a doubt, you can get a second opinion from another ENT surgeon as per my opinion.
          Thank you.

          1. I’m so thankful for your online advice that you gave for d/t people with d/t complaints, even patients(people) can understand how health professionals evaluate and manage d/t cases accordingly

  11. Hello administrator
    I was suffered from streptococci species which was sensitive with gentamicin only .
    I gone through injections & after 10 days of swab culture it was negitive.
    Now I have scratchy and mild pain on my throat walls from 3 months ,Doctor told me its granular pharyngitis.I want to send pic also If I can get e-mail address

  12. Also I would like to share that some times I feels pukish also with severe pain in my throat with no swallowing difficulty.
    Neck ultrasound also done with normal result
    Thanks

  13. I have had chronic pharyngitis for the past 18 mos with swollen lymph nodes and traumatic weight loss, tonsils were removed (said to have been the cause) December 2015 with no change. Continue to lose voice every other month, constant antibiotics, steroid and pain meds, swollen lymph nodes that NEVER went down in severe constant pain while under the car of several ENT’s who seem NOT to know what to do at this point and have refereed me to a Neurologist. I’m in desperate need of help, education, referral, etc

    1. Hi, Rhonda Mccrimon! Do you still have pharingitis? I’m having the same problem for 2 months now. Any advise?

  14. Hello I’m 37 years old male around 1 year back I just got sore throat suddenly wirh no cold or cough . I went to ENT he said I have granular pharyngitis . .since then Have taken several antibiotics, steroids, allergy medicines , steroid nasal spray. Although never had cold or post nasal drip. Also done endoscopy for acid reflux but no signs of reflux. CT Scan shows DNS but I have no breathing issues or PND. No improvement my Thorat is always red and hurts while eating. Tonsils are red and covered with white spots. What it could be?

  15. Hi Admin …. i caught a cold last year and after that my throat infection persists .. i never had such issue before … i did MRI scan, CT Scan did septoplasty Surgery as well but no improvements at all my tonsils looks congested but are not enlarged neither red…. the area which is inflamed and swell is posterior wall of pharynx it have some nodules kind of infection on both sides… had every possible antibiotic with no improvement. did had laser therapy once but infection strike back again . I dont have much problem while eating or drinking but once my mouth gets dry or weather gets dry my pharynx area swells alot this thing is continously going on for 1.5 year now … taken every possible medication with no improve ment only thing which temperory gives relief is gargle with AVC ….. Kindly please give any suggestion… my blood tests everything are normal.

  16. I had an acid reflux about an year ago. Than Dr. finds out i have pharyngities on my troat. it takes 1 month to recover. Than after a month when i was in cold it was come again. than i suffered a month. than I had my tonsil surgery & it goes away. but it comes again when i take very cold water. & it’s 1.5 months i have been suffering with this. i have a little bit swallowing problem. & on my back of the throat i had some little red lump & white macule. i have no head pain or ear pain, no fever at all. My throat swab culture test report is : Normal Flora Isolated. & Gram Stain Test result is Gram positive bacilli -2+; Gram Dipplococci 2+; Gram Negative Bacilli-2+. i had try many antibiotics. but it doesn’t work. i realized when i garggle with salt it will become more painful. now what should I do .??

  17. Hi, I have been diagnosed by a specialist with Pharyngitis, after 4 months of extreme throat discomfort. I am a 35 year old female. The specialist did not give me any indication of how long it will last, and I have been doing everything as advised to sooth it, but nothing works. I have read that it will most probably go away eventually by itself, but have you ever heard of Pharyngitis that lasts for years? Any advise greatly appreciated.

  18. I went to see an ENT specialist few years back and asked her to remove my tonsils cause that’s what everybody said can help with my problem. But she said I got chronic pharyngitis and I don’t need surgery , prescribed some medications but I still go back to my sufferings so I’ve tried erythromycin and works wonder for me just after taking one tablet I can feel great relieve after two days it’s gone also tried to avoid cold drinks and pollution cause that’s what triggering it. As much as possible also avoid stress , eat lots of fruits and get some rest.

  19. I went to see an ent specialist last year and diagnosed with chronic pharyngitis, recently I caught a cold and the throat problem became more serious. Went to see another ent specialist last week still said the same thing . But the problem is I realised I have persisted low graded fever for a week already(99.2 f ear) wonder it would possibly caused by the chronic pharyngitis .

  20. I seems to suffering from chronic pharyngitis..I have sores on throat .. always secretion of mucus is occurring..I have taken antibiotics but it could not work..l felt some sores near the internal nares also.. please help me..l am scared..

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