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Suggest Treatment For Sore Throat
Question: My son has had a severe sore throat for well over a year. All blood test clear and ultra. Scan clear, but still has it. Throat pain keeping him awake at night. Have you any suggestions as to what it could be? Taking citalpram, but not helping
Brief Answer:
Likely repeated viral infection.
Detailed Answer:
Hello,
Welcome to HCM.
I have read your query and understand the concern about sore throat.
Your son is likely to be having chronic viral pharyngitis because of which he is having throat pain since 1 year.
As blood, ultrasound and throat endoscopy is clear, it is likely to be having repeated viral infection (like EB virus) but we should also rule out any acid peptic disease- acid reflux or regurgitation of partially digested stomach contents can damage the mucosa of pharynx leading to pharyngitis.
Also rule out any allergy and HIV for a safer side if they are not done earlier until then give him over the counter pain killers with antihistamines if there is cough.
He may need to see some local physician who will know about all these tests.
Warm salt water gargles will also be helpful to get relief from throat soreness and irritation.
Hope this helps and let me know if he is having any gastric refulx symptoms.
Regards,
Dr.Sandip Kabra
Likely repeated viral infection.
Detailed Answer:
Hello,
Welcome to HCM.
I have read your query and understand the concern about sore throat.
Your son is likely to be having chronic viral pharyngitis because of which he is having throat pain since 1 year.
As blood, ultrasound and throat endoscopy is clear, it is likely to be having repeated viral infection (like EB virus) but we should also rule out any acid peptic disease- acid reflux or regurgitation of partially digested stomach contents can damage the mucosa of pharynx leading to pharyngitis.
Also rule out any allergy and HIV for a safer side if they are not done earlier until then give him over the counter pain killers with antihistamines if there is cough.
He may need to see some local physician who will know about all these tests.
Warm salt water gargles will also be helpful to get relief from throat soreness and irritation.
Hope this helps and let me know if he is having any gastric refulx symptoms.
Regards,
Dr.Sandip Kabra
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Thank you
Further to above information, my son was put on a 20mg omreprasole for 3 months to tackle possible gastric reflux, however, he felt this had not made any difference at all and so the doctor at the Royal London hospital suggested stopping it.
Since that time, he briefly took , gelsemium and belladonna, homeopathic tablets..,which doctor said,may or may not help.
That was August 2015..didn't seem to help,and still experiencing painful, as if something is restricting , or in way of , blocking , across his Adam's apple ..or throat. Also extreme tiredness.
Since that time, XXXXXXX this year, he has again returned to local gp,he told Doctor, also seemed get tight, pain around chest,so now Doctor put him back onto another gastric reflux medication, this time 30mg, lansoprasole..and with that 10mg citalpram , as being unwell for so long has made him lose confidence and motivation.
Do you have anymore suggestions.. He was never unwell as a youngster, always had energy, so this is hard for him, demoralizing, so I,d appreciate any further help. If it is a result of a random viral infection from a long while ago, what can he do to relieve it. Although he seems to talk and eat ok, he says it hurts to talk. Do you think this is a gastric reflux condition as other doctors seem to think? He, s now a month into taking lansoprasole, so far no improvements..
Thank you
Further to above information, my son was put on a 20mg omreprasole for 3 months to tackle possible gastric reflux, however, he felt this had not made any difference at all and so the doctor at the Royal London hospital suggested stopping it.
Since that time, he briefly took , gelsemium and belladonna, homeopathic tablets..,which doctor said,may or may not help.
That was August 2015..didn't seem to help,and still experiencing painful, as if something is restricting , or in way of , blocking , across his Adam's apple ..or throat. Also extreme tiredness.
Since that time, XXXXXXX this year, he has again returned to local gp,he told Doctor, also seemed get tight, pain around chest,so now Doctor put him back onto another gastric reflux medication, this time 30mg, lansoprasole..and with that 10mg citalpram , as being unwell for so long has made him lose confidence and motivation.
Do you have anymore suggestions.. He was never unwell as a youngster, always had energy, so this is hard for him, demoralizing, so I,d appreciate any further help. If it is a result of a random viral infection from a long while ago, what can he do to relieve it. Although he seems to talk and eat ok, he says it hurts to talk. Do you think this is a gastric reflux condition as other doctors seem to think? He, s now a month into taking lansoprasole, so far no improvements..
Thank you
Brief Answer:
May be gastric reflux.
Detailed Answer:
Hello,
Thanks for providing more information.
As per the more facts you have shared here,there might be some gastric reflux because of which he is facing problem of throat infection but here I may NOT agree with your doctor's medication since only lansoprazole (a proton pump inhibitor) will not going to help from the relief of gastric reflux.
He will require proton pump inhibitors (lansoprazole) along with prokinetic drugs (like levosulpride or itopride) which actually increases stomach emptying time along with effect on gastro-esophageal sphincter and there by helps to reduce gastric reflux by tightening the sphincter.
He should continue with citalopram to relieve from anxiety or panic symptoms.
Apart from medication he need to follow some dietary precautions.
1) Avoid oily,spicy and high fiber diet.
2) Avoid eating with full stomach rather you eat small frequent meals.
3) Avoid taking rest for at least 2 hours after meal.
4) He can walk slowly up to first 2 hrs of meal but don't walk fast.
5) Should make regular eating pattern.
6) Have dinner before 8 pm so that at the time of sleeping stomach will be empty.
7) Do yoga regularly.
All this dietary measures along with prokinetic and lansoprazole medications would have cumulative effect which will be beneficial to him while treating for the GERD (refulx esophagitis).
Since the prokinetic drugs are prescription based,you will need to see some local physician or gastro-physician for the prescription.
If it is due to viral infection then there is no need to worry much since viral infection itself subsides with only symptomatic treatment within 4 to 5 days.I would not be personally worried about as a treating physician.
If still problem persists even after above treatment,then I will advise him to see gastro physician for thoroughly examination and upper GI endoscopy and the tests I have mentioned previously.
Let me know if you have more doubts.
Regards,
Dr.Sandip kabra
May be gastric reflux.
Detailed Answer:
Hello,
Thanks for providing more information.
As per the more facts you have shared here,there might be some gastric reflux because of which he is facing problem of throat infection but here I may NOT agree with your doctor's medication since only lansoprazole (a proton pump inhibitor) will not going to help from the relief of gastric reflux.
He will require proton pump inhibitors (lansoprazole) along with prokinetic drugs (like levosulpride or itopride) which actually increases stomach emptying time along with effect on gastro-esophageal sphincter and there by helps to reduce gastric reflux by tightening the sphincter.
He should continue with citalopram to relieve from anxiety or panic symptoms.
Apart from medication he need to follow some dietary precautions.
1) Avoid oily,spicy and high fiber diet.
2) Avoid eating with full stomach rather you eat small frequent meals.
3) Avoid taking rest for at least 2 hours after meal.
4) He can walk slowly up to first 2 hrs of meal but don't walk fast.
5) Should make regular eating pattern.
6) Have dinner before 8 pm so that at the time of sleeping stomach will be empty.
7) Do yoga regularly.
All this dietary measures along with prokinetic and lansoprazole medications would have cumulative effect which will be beneficial to him while treating for the GERD (refulx esophagitis).
Since the prokinetic drugs are prescription based,you will need to see some local physician or gastro-physician for the prescription.
If it is due to viral infection then there is no need to worry much since viral infection itself subsides with only symptomatic treatment within 4 to 5 days.I would not be personally worried about as a treating physician.
If still problem persists even after above treatment,then I will advise him to see gastro physician for thoroughly examination and upper GI endoscopy and the tests I have mentioned previously.
Let me know if you have more doubts.
Regards,
Dr.Sandip kabra
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you for all your help in trying to get to the bottom of my son's constant sore throat and extreme tiredness.
I was very interested in your comments regarding pro kinetic drugs and I have been trying to research more about these. There seem to be a lot of side effects, especially if taken long term,so what I've read has been confusing, would it be only short term that these would be needed?
I appreciate it still may be a gastric reflux causing the sore throat, but most of the symptoms I've found don't seem to place this as main problem.
My son is not overweight, he is about 10 and half stone, 6 foot 1 inch, doesn't eat spicy food, generally eats nutritional food, and we have regular meal times. The main meal is always at least 4 hours before bed, but he does have snacks, I.e. Buiscuits, cake,cereal bar, after our main meal, which may only be an hour before bed..
I will follow up your suggestion of pro kinetics, with local gp and see if they can be prescribed.
If this was the answer, gastric reflux, how long roughly would he need to take the pro kinetic with the lansoprasole to see an improvement in his throat soreness? Would he see improvement after two weeks?
Overall, how long would he need try.. to see complete answer.. Would it be three months?
Once again, thank you for looking into this, it has been very hard to understand why he's had sore throat and extreme tiredness for so long.
I was very interested in your comments regarding pro kinetic drugs and I have been trying to research more about these. There seem to be a lot of side effects, especially if taken long term,so what I've read has been confusing, would it be only short term that these would be needed?
I appreciate it still may be a gastric reflux causing the sore throat, but most of the symptoms I've found don't seem to place this as main problem.
My son is not overweight, he is about 10 and half stone, 6 foot 1 inch, doesn't eat spicy food, generally eats nutritional food, and we have regular meal times. The main meal is always at least 4 hours before bed, but he does have snacks, I.e. Buiscuits, cake,cereal bar, after our main meal, which may only be an hour before bed..
I will follow up your suggestion of pro kinetics, with local gp and see if they can be prescribed.
If this was the answer, gastric reflux, how long roughly would he need to take the pro kinetic with the lansoprasole to see an improvement in his throat soreness? Would he see improvement after two weeks?
Overall, how long would he need try.. to see complete answer.. Would it be three months?
Once again, thank you for looking into this, it has been very hard to understand why he's had sore throat and extreme tiredness for so long.
Brief Answer:
Give prokinetic drugs for 15 days initially.
Detailed Answer:
Hello,
Thanks for the reply.
From all above discussion, it could be repeated viral infection or may be a gastric reflux which is causing sore throat problem and tiredness in your son.
Also it is good that you keep researching to find out the underlying cause, but it will require complete clinical examination by local physician with some relevant investigations as we discussed.
Further, I would recommend to take prokinetic drugs along with lansoprazole initially for 15 days to see the response.
And if the effect is good then it can be extended further for 2 to 3 months or as per requirement.
If the underlying cause is gastric reflux then yes, we may see improvement within 15 days but the drug should be continued further with some dietary precautions.
Hope this helps and let me know if you want some more clarifications.
Regards,
Dr.Sandip Kabra
Give prokinetic drugs for 15 days initially.
Detailed Answer:
Hello,
Thanks for the reply.
From all above discussion, it could be repeated viral infection or may be a gastric reflux which is causing sore throat problem and tiredness in your son.
Also it is good that you keep researching to find out the underlying cause, but it will require complete clinical examination by local physician with some relevant investigations as we discussed.
Further, I would recommend to take prokinetic drugs along with lansoprazole initially for 15 days to see the response.
And if the effect is good then it can be extended further for 2 to 3 months or as per requirement.
If the underlying cause is gastric reflux then yes, we may see improvement within 15 days but the drug should be continued further with some dietary precautions.
Hope this helps and let me know if you want some more clarifications.
Regards,
Dr.Sandip Kabra
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. Naveen Kumar
Answered by
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