Hi Dear, Welcome to HCM. Understanding your concern. Thanks for query . Granular pharyngitis is cause by infection which can be bacterial or viral. It can also be caused by acid reflux ,smoking and drinking. The silent reflux and allergy you mention in query are factor which exaggerating the condition further. I think wait and watch is not at all a good idea that too for such a long period of one year (as you mention) , because the infection can spread to other parts of the oral cavity or respiratory track and make things worse. I would suggest you to :- - Do warm saline gargles 3-4 times a day . - Avoid spicy and heavy meals . - Eat at least one hour before going to bed , eat small and frequent meals . - Take antacids (gelusil) to neutralize the acidity. - Take benadryl for allergy. Consult gastroenterologist for proper diagnosis of silent reflux. Doctor may prescribe H2 blocker like ranitidine and proton pump inhibitor like omeprazole . Also consult ENT specialist (ear,nose ,throat) for proper evaluation and treatment . Doctor may order throat swab test or blood test . Doctor may prescribe antibiotics or antiviral depending upon your condition. Hope your concern has been resolved. Best Wishes, Dr. Harry Maheshwari