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Had a sore throat for months. Tried amoxicillin, penicillin. Hurts after talking loud. Cure?

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I've had a sore throat for months. Tried amoxicillin, penecillin. Did not help. Sometimes my ears flutter, as if they have water in them. Thin mucous drip down my throat. Mostly on the left side. Throat feels prickly, stings. Hurts after talking loud after long loud conversations. Sometimes Malox gives some relief. But not long enough. Clearing my throat often. Sometimes when I bend over my nose drips. I've tried the Nedi Pot. Helps for about an hour. Then sometimes makes it eve worse. It's the worst in the morning, and late afternoon, I have had heartburn on occasion. So I take Prilosec. But not regulary.
Posted Sun, 19 May 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 39 minutes later
Hi,

Thank you for your query.

1. This seems to be a Post Nasal Drip (PND). The source of this thin mucus is the nose and sinuses.

2. Worsening of the symptoms in the morning is usually related to the frontal and sphenoid sinuses. Worsening of the symptoms in the afternoon is usually related to the maxillary sinuses.

3. Initially you may try out a two week trial with an anti-histamine (such as loratidine, rupatidine, levocetrizine or fexofenadine), an anti-leukotriene (such as montelukast), a steroid nasal spray (such as mometasone, fluticasone or ciclesonide) and regular steam inhalation. This must be prescribed by your physician.

4. If the response is good then this treatment may be continued for a couple of months and then tapered off.

5. If the response is poor, get a plain CT PNS (Para Nasal Sinuses) done.

6. An important but rare condition to rule out is CSF rhinorrhea, since the Tea Pot or Reservoir Sign is positive in your case (Nose drips when you bend over). Get this nasal fluid that drips for CSF (Cerebro-Spinal Fluid) and beta 2 transferrin. In the Handkerchief Test, normal nasal secretions will dry and stiffen the cloth handkerchief (because normal nasal secretions contain mucus), while CSF will not.

7. Get an Impedance Audiogram (Tympanometry) done. If this test is normal, there is no fluid in the ears.

8. A PND worsens acidity. Acidity worsens the PND. Hence this vicious cycle has to be broken with medication.

9. You may follow up with the reports and response to the above medication directly at bit.ly/Dr-Sumit-Bhatti

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had a sore throat for months. Tried amoxicillin, penicillin. Hurts after talking loud. Cure? 1 hour later
forgot to mention that there is a bad taste in my mouth. Reminds me of a tonsil infection taste. ( which I had a few times as a teenager)
 
 
Answered by Dr. Sumit Bhatti 6 minutes later
Hi,

Thank you for writing back

1. The bad taste in the mouth may be due to PND, acid reflux, dehydration, fungal infections and so on.

2. Get a throat swab sent for bacterial culture and antibiotic sensitivity if you suspect the tonsil to be a source and get your throat examined.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had a sore throat for months. Tried amoxicillin, penicillin. Hurts after talking loud. Cure? 15 days later
feels like something's stuck in my throat. Or like a DRY spot. Foul taste. Stuck my finger down there as far as I could. My finger smell stinks like a Yeast Infection. Gross. Throat feels stingy
 
 
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for writing back

1. The dry spot is most probably an inflamed island of lymphoid tissue. These small collections of lymphoid (tonsil-like) tissue are spread randomly all over the throat. When enlarged, this is known as Granular Pharyngitis and this enlarged lymphoid tissue may give the feeling that something is stuck in the throat.

2. Some of these areas may retain food debris, bacteria, fungi and saliva. When compressed, a foul smelling discharge may be released. Severe granular Pharyngitis may also make the throat more sensitive.

3. Get a a throat examination and a Videolaryngoscopy done. This will help settle the cause of the fouls smelling discharge and the stinging in the throat.

4. Use a medicated mouthwash regularly for a couple of weeks.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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