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Long standing throat problem, LPR, tonsils. Suggest treatment and remedy - Online Doctor Chats

Date : 31-May-2013
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1773 Questions
Doctor:How can I help you?
User:i have this long standing throat problem
User:the last time i went to an ENT.. they told me its LPR
Doctor:Yes, - can you elaborate about this problem?
User:there is a raw feeling in the left side of my throat coupled with only my left ear being blocked
User:anything i swallow i actually get the feeling in my ear as well..
User:its ok in the mornings but by evening time it becomes more
User:plus i also have tonsils problem.. anything cold and within the same day i have throat pain
User:could you please help me out
Doctor:May I know your age?
User:and this left side throat problem has been there for the last 5-6 months
User:im 34 yrs old doctor
Doctor:Let me brief you.
Doctor:LPR - laryngo pharyngeal reflux is a chronic condition and as you may have read about it - here the contents of stomach and acid reflux back to the upper air way and digestive tract
Doctor:leading to chronic inflammation.
Doctor:This results in myriad of upper respiratory symptoms such as yours.
Doctor:As an ENT surgeon has examined you and diagnosed to have LPR, I agree that these symptoms could be related to this reflux problem.
User:it is not cancer or anything right?
Doctor:Reflux of stomach contents can sometime lead to a premalignant condition called barrets oesophagus.
Doctor:Your symptoms doesn't suggest you have one such premalignant condition.
Doctor:However the confirmation is only by an endoscopy.
User:ok.. also the thing is that my tonsils have become more sensitive only after this LPR thing..
User:earlier i used to be able to have cold stuff without a problem. i only had to watch out in winter.. now its become an all season affair
Doctor:Tonsil inflammation can lead to chronic inflammation and such conditions are best managed by surgery - removal of tonsils.
Doctor:I understand your tonsils are getting affected both by cold and LPR.
User:so what is your suggestion doctor?
Doctor:If you been suffering from this tonsil problem for too long
Doctor:and if the symptoms are very frequent,
Doctor:surgical removal of tonsils will definitely benefit you.
Doctor:* this will relieve your tonsil related complaints such as pain in the throat, pain while swallowing and to some extent the ear fullness.
Doctor:LPR needs to be managed by a course of proton pump inhibitors and prokinetic drugs.
User:could you please prescribe me some?
Doctor:Your physician would know about these medications and the right dose for you.
Doctor:* I suggest my patients drugs like pantoprazole with or without domperidone for a period of 2-4 weeks
User:ok.. and when should i be taking them?
Doctor:In addition to these it is important that some life style changes be carried out.
User:what changes doctor?
Doctor:Since the medical drugs are prescription only medications, you need to review with your doctor and take a prescription for him/her.
Doctor:As far as life style changes are concerned, the following would be useful.
Doctor:1. Be regular with your food timings.
Doctor:2. Do not eat till the brink. Rather small frequent meals would do.
Doctor:3. Drink plenty of water
Doctor:4. Avoid any thing that is spicy and hot.
Doctor:5. Restrict caffeine intake to not more than 1-2 cut.
Doctor:Absolute restriction will be more better.
Doctor:6. If you smoke or consume alcohol, restrict that.
Doctor:7. After your diner, it is compulsory that you get to bed only after 2 hours.
User:restrict to? probably once a week and 2-3 smokes per day?
Doctor:Sleeping immediately after a full meal increases LPR.
Doctor:Smoking worsens LPR.
Doctor:It would be better to quit smoking.
Doctor:8. Sleep with your head end elevated.
Doctor:Some of my patients sleep with their headend of the cot elevated on a block of wood.
Doctor:you may try putting 2-3 pillows under the neck to elevate it above the stomach.
Doctor:9. Regular sleep improves LPR.
Doctor:10. Physical exercise, yoga and other alternative form of treatment such as accupunture /accupressure have been helpful.
Doctor:If these measures and medications do not provide proper relief
Doctor:and if the condition is not responding to any other treatment, surgery is sought as last resort of treatment.
Doctor:I suggest you to try these lifestyle changes and medications for a few weeks and see how it goest.
Doctor:if there is no improvement, the next step would be to for endoscopy.
Doctor:Have you followed?
User:yes sir
User:thank you so much for your time
Doctor:Thanks for consulting me.
Doctor:Bye for now.
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