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Pin prick sensation in throat when swallowing hot drinks and certain foods. Any idea?

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ENT Specialist
Practicing since : 2001
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I keep getting an intermittent 'pin prick' sensation on the left hand side of my throat. I am only aware of it when I swallow hot drinks, and certain foods. It doesnt seem to happen with soft goods like Pasta, or cold drinks. I have seen my GP about it a couple of times. He has felt around my neck, and looked at my throat by me saying 'arr'. He says he cannot feel or see anything wrong. He has advised me to gargle with salt water.

In your experience, can you give me any idea on what this could be. It has been happening for 3 weeks now, but my GP doesn't seem concerned. I am very worried about it, and need some idea of what you think it could. be, and what I can do to treat it.

I do not have a sore throat - just this intermittent sensation. I am an allergy prone person - allergic to pollen, cats, dogs, dust. I have post nasal drip and a stuffy nose. I take an antihistamine for this.
I have no other symptoms.
Posted Tue, 8 May 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Naveen Kumar 2 hours later

Hi

Thanks for the query

There are various reasons to get a lancinating type of pain in the throat, and the commonest of them are ulcer in the throat and granular pharyngitis.

According to the description given by you, the probable causes of the sharp pain could be:
1. The post nasal drip secondary to allergic nasal condition causing granular pharyngitis

2. The antihistaminic you are taking to get rid of the nasal allergy - which has the propensity to cause dryness of the throat and thus irritation

3. An ulcer in the throat

Only after examining the throat thoroughly, the exact cause of this problem can be found out. And it would be a bit difficult task for a GP to diagnose the most probable cause of your problem. Hence, it is better to consult an ENT specialist for the same. Till then, drink plenty of warm water; avoid those food stuffs which can cause pain, avoid salt gargles as this can further worsen your throat problem. I would also suggest you to use antihistaminic only when required.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Pin prick sensation in throat when swallowing hot drinks and certain foods. Any idea? 6 hours later
Thank you for your advice. I also didn't mention the fact that I snore a lot, and often wake during the night with a dry mouth and throat, because I tend to breathe through my mouth due to the stuffy nose. I think this might be the root of my problem.

Can you offer any advice on what I could do to help alleviate this problem, as I fear that the non use of antihistamine might make my contributing symptoms worse.
 
 
Answered by Dr. Naveen Kumar 3 hours later
Hi,

Thanks for writing back.

Yes, you are right; Mouth breathing can cause dryness of the mucosa of the throat causing pain. Snoring is due to blockage of the nose secondary to nasal allergy and once the nasal stuffiness is relieved, eventually the throat problem will get resolved.

You can try using steroid nasal spray to decongest the nose and relieve the nasal allergy. This will also minimize the use of antihistaminic. Also, do steam inhalation 3-4 times a day, with this the nasal block will be relieved and mouth breathing can be avoided.

Wish you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Pin prick sensation in throat when swallowing hot drinks and certain foods. Any idea? 2 hours later
Would a lubricating throat spray be of any use at bedtime? I have noticed some that are intended for people who snore?
 
 
Answered by Dr. Naveen Kumar 3 hours later
Hi,

Welcome back.

To be XXXXXXX doctors do not recommend the use of lubricating throat spray as the treatment for snoring. The aim is the treatment of the cause. There are various other factors which need to be followed that can help in reducing the snoring.

1.     Breathing problems can raise the risk of snoring; stuffy nose caused by a cold or allergies has to be treated
2.     Avoid using alcohol and medicines like sleeping pills or tranquilizers
3.     Quit smoking if any.
4.     Eat sensibly and exercise
5.     Sleep on one side of the body rather than on your back
6.     Regular sleep patterns help you sleep better and more restful sleep may reduce snoring
7.     Do steam inhalation every night before going to bed.
8.     Drink plenty of warm water

If all the above methods fail, then consult an ENT specialist for expert management.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Pin prick sensation in throat when swallowing hot drinks and certain foods. Any idea? 2 hours later
I have purchased a nasal spray with the ingredient oxymetazoline. It says not to use for more than 7 days. I intend to use this instead of antihistamine as you suggested. What would you recommend I use once the 7 days are up. Also, how long should I wait before using it again to avoid any damage (rebound).
 
 
Answered by Dr. Naveen Kumar 3 hours later
Hi

Thanks for writing back

Please don’t use Oxymetazoline nasal spray, it is not recommended for your condition. You are suffering from Allergic rhinitis for which you would require a steroid nasal spray (such as Fluticasone/Momentasone) and an antihistaminic. In the initial days of treatment antihistaminic has to be taken continuously and after a week or ten days it can be used only when required. Oxymetazoline will worsen your nasal problem and can lead to a condition called Rhinitis Medicamentosa if used for more than 5 days.

My suggestion to you is to consult a good ENT specialist and request for the above nasal spray.

Take care

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Pin prick sensation in throat when swallowing hot drinks and certain foods. Any idea? 20 hours later
I have obtained a product called Pirinase (fluticasone propionate 0.05%) nasal spray, which says to use once per day in the mornings. You mentioned in your last reply about using an antihistamine alongside it for a week to ten days. Can you advise which type of antihistsmine is best to use with the spray, and how long for...
 
 
Answered by Dr. Naveen Kumar 4 hours later

Hi

Welcome back

Fluticasone is one of the potent steroidal nasal spray, you need to use it for at least 4-5months and alongside you can use an antihistaminic (such as Fexofenadine or Levocetrizine). Antihistaminic has to be used initially for a week or 10 days continuously and later on to be used only when you are having allergic symptoms like sneezing, running nose, nasal stuffiness, etc.

It is better to consult your doctor for the appropriate dosage (which depends upon the nasal findings) and tapering of the steroidal nasal spray. Remember! Steroid nasal spray should not be stopped suddenly; it has to be tapered before stopping it.

Wish you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Pin prick sensation in throat when swallowing hot drinks and certain foods. Any idea? 36 minutes later
Hi

What are the reasons for taking cetrizine (uk version I presume) alongside the nasal spray for 7 to 10 days continuously?

I have used the nasal spray for the first time today (about 6 hours ago) but my nose now feels heavily congestedad a result. Is this to be expected, as I understand it takes time to build up to work efficiently...
 
 
Answered by Dr. Naveen Kumar 8 hours later
Hi

Cetrizine is a fourth generation antihistaminic and even though it is claimed to be a non-sedating antihistaminic, some people do experience some amount of drowsiness. Also, the newer generation antihistaminic such as Fexofenadine or Levocetrizine is more potent than Cetrizine and causes almost no sedation.

It is very unusual to have nasal congestion following the use of steroid nasal spray (Fluticasone). It should be preferably used in the morning hours as soon as you get up from the bed and the oral antihistaminic needs to be taken in the night only before going to bed.

If you still continue to have nasal congestion following steroid nasal spray, then you would require a short course of oral steroids till the action of the nasal steroid takes over. Also, do steam inhalation 2-3 times a day, which gives excellent relief from the nasal congestion.

Hope this answers your query. Please accept my answer in case you have no follow up queries.

Wish you good health.

Regards.
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Pin prick sensation in throat when swallowing hot drinks and certain foods. Any idea? 3 hours later
Hi

Thanks for your reply. Could you explain why it is necessary to take an antihistamine tablet alongside the nasal spray for 7 to 10 days continuously?
 
 
Answered by Dr. Naveen Kumar 8 hours later
Hi

Thanks for writing back

Antihistaminic medicines block the production of histamine and reduce the allergic symptoms (sneezing, runny nose and watery and itchy eyes).

Histamine is a chemical released from the cells of the body (such as mast cells, basophils, etc.), in response to an allergen (such as dust, dander, pollen, smoke, etc.). When this histamine is released by the cells in the nose and eyes, it results in allergic symptoms like sneezing, runny nose, itchy eyes/nose and nasal congestion.

Antihistamine blocks the histamine receptors in the nose and halts the allergic symptoms. Antihistamines are the most commonly used medications to treat allergic rhinitis. Antihistamines begin to provide relief in 30 minutes to 2 hours. Antihistamines do dry up the runny nose caused by nasal allergy.

Topical corticosteroids are currently the most potent medications available for the treatment of allergic rhinitis. It helps in inhibition of allergen induced mediator release and reduces the allergic symptoms.

Hence, both the drugs act synergistically to reduce the prodromal symptoms, nasal allergy and inflammation of the nasal mucosa. Initially both are given together in order to control the acute symptoms, once this is controlled, steroid nasal spray alone will suffice in controlling the allergic related symptoms and should be used as prophylactic treatment. But sometimes when the symptoms are not controlled with steroids alone, you have to use either antihistaminic or mast cell stabilizers to suppress the allergic mediators.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
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