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What Causes Red Patches At The Back Of The Throat?

Posted on Mon, 7 Sep 2015

Question: I used to clear my throat more and more often for the past couple of years and now I have noticed worsening symptoms when I look with a flashlight in my throat. First, tonsils looked inflamed, then 2 raised bumps appeared, then the far back of throat looks red and patchy. I have to swallow constantly because my throat feels strange and it is starting to ache. No other symptoms except fatigue. Also I seem to have some thick phlegm I'm trying to swallow constantly. The bad news is that it's been slowly getting worse for almost 2 years and now harder to manage. Can phlegm cause this severe of irritation? Why are there raised red bumps that never go away? I'm worried about some serious cause, because it's getting harder to swallow comfortably.

Answered by Dr. Sumit Bhatti (25 minutes later)

Brief Answer:
Granular Pharyngitis, Post Nasal Drip.

Detailed Answer:
Hi,

Thank you for your query.

1. The red patches at the back of the throat are known as Granular Pharyngitis. This is common with a Post Nasal Drip (PND) due to CRS (Chronic Rhinosinusitis).

2. The source of this PND must be established. AN ENT Specialist will be able to check and investigate. Granular Pharyngitis, when severe, gives a cobblestone appearance.

3. Acid reflux, allergy and snoring/mouth breathing may also be involved. Rule out Chronic Tonsillitis.

4. Upload the test and examination results for further treatment advice.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumit Bhatti (34 hours later)

Thank you for your initial thoughts - it will be awhile until I can meet with an ENT specialist and you are giving me some ideas to consider. My dad had a deviated septum to the extent that he had surgery to repair it. I think it's genetic because I breath completely out of one nostril at night and about 1 1/2 during the day. I don't feel congested at all but I just know that I don't smell as well and that there is blockage when I test it. From your opinion, how much of a factor could this play in my symptoms that I told you about?
Thank you!

Answered by Dr. Sumit Bhatti (1 hour later)

Brief Answer:
Options are discussed in detail.

Detailed Answer:
Hi,

Thank you for writing back.

1. Septoplasty is one of the options.

2. Get a plain CT PNS (Para Nasal Sinuses) pre and post de-congestion. Try to get the first scan done when you feel obstructed. Then immediately instil 5-8 drops of 0.1% Xylometazoline nasal drops (such as Otrivin) and wait for 15 minutes by the clock. Rescan and compare the images and note if the obstruction is relieved.

3. If the obstruction is relieved, get Radio-frequency nasal turbinate reduction done. This will be a day-care procedure under local anaesthesia and a septoplasty can be avoided.

4. If there is no relief, a septoplasty is advised along with turbinate reduction.

5. This should reduce your PND or nasal obstruction and decrease your symptoms.

6. Remember to attempt maximum medical therapy for 6-8 weeks before any surgical intervention. This would include an anti-histamine, an anti-leukotriene, a steroid nasal spray, hypertonic saline nasal washes and regular steam inhalation.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumit Bhatti (16 hours later)

Thanks again for your advice. My throat was feeling a bit better this morning but then I used a flashlight and saw a small flat red patch on the roof of my mouth and several "specks" around it that looked like the color of fresh blood. It doesn't hurt and I can't rub it off so it is not actually bleeding on the outside. Should this be a concern and what could be causing that?

Answered by Dr. Sumit Bhatti (9 hours later)

Brief Answer:
Normal, inflamed lymphoid tissue.

Detailed Answer:
Hi,

Thank you for writing back.

1. These red patches are also small islands of the same lymphoid tissue spread throughout the throat that is visible as Granular Phartyngitis on the Posterior Pharyngeal Wall (PPW). This tissue is not visible till it is inflamed.

2. Treatment will remain the same and these patches and specks will subside.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

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. Chakravarthy Mazumdar