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Severe sore throat, coughing up blood, ear ache & headache. Have hiatus hernia & acid reflux. Taken pencilin. Suggestion?

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Hello,

I am 38yrs year old and self employed. I have been feeling unwell for about 10 days. I do have a hiatus hernia and acid reflux and I have seen a throat specialist previously. I was advised to double up on Lanzoprozole but am already on 30mg per day.However a severe sore throat started about 5 days ago which has not improved. I cannot talk and even swallowing water is like swallowing razor blades.The GP was reluctant to refer me privately to see the specialist at this point, without trying medication, despite my pleas. I was initially prescribed Amoxiccilin. As this was not helping, they changed the medication to Penicillin. On top of this I have double up Lanzoprozole and am having to take about 6 paracetamols for aches and pains. I have started coughing up blood with what looks like pieces of meat in it - not pleasant. I now have severe ear ache and a constant headache and progress is very slow. The GP did not seem to concerned about the blood - but I am considering my history. I dont smoke but due to a stressful job I have approxmately 2 large glasses of wine per night.They have talked about allowing the infection to clear and then POSSIBLY being referred onto a specialist?? I am concerned that they will not do this. What do you suggest? I do query cancer and I have had to clear my throat for about 15years and things seem to be getting worse.
Posted Mon, 21 May 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 5 hours later
Hi,

Thank you for your query.

1. Get a videolaryngoscopy done. A common cause of coughing up blood with clots (pieces of meat) is severe throat infection. A throat swab for culture and antibiotic sensitivity will be better than changing antibiotics ad hoc. Did you had fever or cough?

2. Acid reflux may also be involved as you also have haitus hernia. It may be a contributing cause of the severe dryness in the throat (intense pain like swallowing razor blades) along with allergy or infection.

3. A stronger painkiller such a Ibuprofen or Tramadol will be better than plain Paracetamol. Ask your GP to prescribe these in combination with Paracetamol in stead. Add an anti-allergic and a medicated gargle which soothes the raw throat.

4. If you feel that Lansoprazole is not very effective there are other similar drugs such as omeprazole, esomeprazole, pantoprazxole, rabeprazole and dexrabeprazole which may be tried.

5. Your earache is probably referred pain and headache denotes the severity of the infection. You should discuss with your GP that such severe infection, with added symptoms (such as coughing up blood and clots, earache, headaches and feeling unwell besides treatment), lasting more than ten days should be referred immediately to a specialist.

I must emphasize that Cancer is not a worry at present. Kindly let me know the results of your investigations, with images and video of the videolaryngoscopy, if possible. This will help decide medication and further treatment.

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

Regards.
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Follow-up: Severe sore throat, coughing up blood, ear ache & headache. Have hiatus hernia & acid reflux. Taken pencilin. Suggestion? 35 minutes later
Thank you very much for your reply. I found it very useful. Im feeling upset about it at the moment as despite the pain and discomfort that I am in and 3 visits, the GP states that the infection needs to be cleared up as much as possible through the course of antibiotics before they MAY refer me. Does this need to be the case? I have not had a cough or fever with this but feel very tired. Do I need a referral letter from the GP or can I approach a specialist privately, without one - particulary the one I have seen previously?

What would be the timescale roughly to be seen on the NHS? I will probably need to go privately. Thank you for your time

XXXXXXX
 
 
Answered by Dr. Sumit Bhatti 27 minutes later
Hi,

Thank you for writing back.

1. You should discuss with your GP that such severe infection, with added symptoms (such as coughing up blood and clots, earache, headaches and feeling unwell besides treatment), lasting more than ten days should be referred immediately to a specialist.

2. The rough timescale for referral on the NHS will be unpredictable. You may approach the specialist you have seen previously for a private consultation. The cost however will be much more.

3. You may get in touch with Dr. Anirvan Banerjee, ENT Consultant at XXXXXXX Cook University Hospital, +0000, YYYY@YYYY for guidance on NHS matters.

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: Severe sore throat, coughing up blood, ear ache & headache. Have hiatus hernia & acid reflux. Taken pencilin. Suggestion? 19 hours later
Attended A & E last night due to the severity of ear and headache. I was seen very quickly. My throat was examined and the Dr could not see any sign of infection near the tonsils. Saw an ENT specialist today and had the camera up my nose and down throat. My right ear was shown to have what looked like a balloon inside it, looking very sore. He stated that the throat was red but nothing more than that. This, he felt could have been aggravated by the reflux. He stated that I had a chronic upper respiratory viral infection and has prescribed differing antibiotics, co-codamol and nasal spray.

We will see how things go. Thank you very much for your response and I will recommend you to others in the future.

Many thanks

XXXXXXX
 
 
Answered by Dr. Sumit Bhatti 8 hours later
Hi,

Thank you for following up.

Kindly let me know about your progress, if possible.

Wishing you good health.

Regards.
Above answer was peer-reviewed by
 
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