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Suggest Treatment For Persistent Pharyngitis

Posted on Thu, 28 May 2015

Question: I have persistent dry cough since last one year. Doctor said it's pharyngitis which is persistent. 5 months back I had sinus infection and headache. Ent specialist said I have mild dns and congested terbunator. This is the reason for all trouble. Now I am taking nasal inhaler memoflo. But no improvement. I have dry nose. Not much breathing problem. Only right nostril has got breathing obstruction. What to do? I m tired with the dry cough.

Answered by Dr. Krunal Karade (48 minutes later)

Brief Answer:
Do investigation like CT Scan Nose with paranasal sinuses

Detailed Answer:
Hi,
Thanks for the query.

I have read your query , reviewed your medications and understand your concern.

Your clinical history is suggestive of having allergic rhinosinusitis with DNS leading to Post nasal discharge (PND) . PND causes dry cough .

If I were your treating doctor , I would advice
do investigation like CT Scan Nose with paranasal sinuses to know extend of disease inside nose with sinuses ,
for dry cough use Saline nasal spray or rinse thrice daily like solspre & salt water gargle twice daily ,
Tab Rantac twice daily &
Continue memoflo nasal spray 2 puff each nostril twice daily .

Gargle with water 20 mins after nasal spray use to remove any spray coming to throat .

Use complete treatment plan to get early relief .

Hope it is helpful to you . If you have any further questions I will be happy to help.
Regards.

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Krunal Karade (1 hour later)

I had ct scan of paranasal sinus. It shows mild DNS. Congested turbulence. One polyp at left nose. After medicines sinus pain reduced. It is almost 5 months. But the dry cough still there.
I have grannule sort of things at back of the throat. Little tonsillitis. Dry cough. Dry nose with after sleep crust. I can breath freely with one nosetril but interrupted breath from another nostril.

This cough not reducing. I m taking water from nose.
Can cough started all of a sudden while having dns from long? Is it granular pharyngitis.
In general I m not beating through mouth. Can dns causes pharyngitis? What to do to reduce it?

Answered by Dr. Krunal Karade (4 hours later)

Brief Answer:
Dry cough can start if DNS is associated with allergy.

Detailed Answer:
Thanks for the follow up query.

Dry cough can start if DNS is associated with allergy. It lead to Post nasal discharge .

Your dry cough is because of combination of both Post nasal discharge (due to DNS & allergy ) + granular pharyngitis .

Infected Post nasal discharge (due to DNS & allergy ) can cause granular pharyngitis .

To reduce it ,
Use Saline nasal spray or rinse thrice daily like solspre ,
Salt water & Antiseptic chlorhexidine Mouth Wash gargle twice daily for granular pharyngitis ,
Tab Rantac twice daily &
Continue memoflo nasal spray 2 puff each nostril twice daily .

You will get relief .

Regards.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Krunal Karade (9 hours later)

Hi Doctor,
I tested allergy 2 months back and nothing significant found which can cause allergy.
Can post nasal drip generates due to DNS?
I deffinitely had DNS for long, but the cough started from last year only. Is it not surprising?

Answered by Dr. Krunal Karade (5 hours later)

Brief Answer:
Yes DNS & turbinate hypertrophy can generates post nasal drip .

Detailed Answer:
Hi ,
If absolute eosinophil count (AEC) is within normal limit , then allergy is not significant .

Yes DNS & turbinate hypertrophy can generates post nasal drip .

DNS & turbinate hypertrophy increases progressively over the period of time .
This lead to dysfunction ventilation in nose & sinuses which result into excess secretion post nasal drip.

If PND is more , you can add Antihistaminic Fexofenadine Tab Allegra at night to decrease secretion .

Regards.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Krunal Karade (2 hours later)

Thanks a lot for your answer. Just the last questions:
1. I can breath properly through my left nostril, but from right nostril is congested. Breath in is not very free, breath out is ok. Can it be considered as poor ventilated?
2. I never had this kind of throat infection before, it just started from 2015 January onwards. Can PND started all of a sudden?
3. I had sinus infection 4 months back, but after antibiotic It did not come back Atleast I am not feeling any pain). I am taking memoflow continuously. Can still PND be generated?

I will take the drug you prescribed. What else can be done to reduce it? Shall I need to go for Septoplasty?

Answered by Dr. Krunal Karade (2 hours later)

Brief Answer:
Use complete treatment plan to get relief as advised .

Detailed Answer:
Thanks for the follow up query.

1) If your breathing is not free on one side then it can be consider compromise ventilation .
2) Yes , PND can start all of a sudden . Since DNS & turbinate hypertrophy increases progressively over the period of time . Now the frequency of getting excess PND will be more .
3) Even on momeflo nasal spray continually , still PND can generated if sub-clinical infection present inside sinuses .

Use complete treatment plan to get relief as advised .

You will need Septoplasty & turbinate reduction in future to avoid complication if
frequency of attack increases .

Regards.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vaishalee Punj