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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34693
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have been suffering from a sore throat since December

Customer Question

I have been suffering from a sore throat since December 2015. A few days before Christmas, I awoke in the night with a severe sore throat. Advil did not improve it, so in the morning, I went to urgent care, where I was tested for strep (negative) and referred to an ENT the same day. The ENT looked up my nose/down my throat with a scope and said he saw a lot of inflammation and pus in my nasopharynx area. My right tonsil was also incredibly swollen. He prescribed augmentin (for two weeks) and prednisone (60 mg for two days).
I began to feel much better, but did not improve 100%. Throughout the month of January, I experienced a sore throat that would get worse throughout the day. In the morning I would feel fine, but by evening I would be in a lot of pain. It did not seem to matter what I ate. I had been eating extremely healthy (mostly leafy greens and vegetables with some whole grains and lean protein). I would have a few days here and there where I did not have a sore throat, but it occurred at least four days out of the week.
Since February, the sore throat has worsened and occurs every single day. I still feel almost completely fine when I wake up (around 6:30am), but by 9am, I am in a lot of pain, and nothing helps it.
At the beginning of February, I saw another ENT who took a throat culture and suggested acid reflux, and prescribed omeprazole 40 mg per day. This did not help at all. The throat culture was negative. In early March, I saw my primary care doctor who referred me to a GI specialist. The GI specialist changed my prescription to Nexium and scheduled me for an endoscopy with bravo pH monitoring in early April.
The Nexium has also provided nearly no relief. I have adjusted my diet several times. I have not had any alcohol since the beginning of January (and prior to January, I had only a glass of wine 2-3 times per week, so I am not a heavy drinker), and have had no coffee since February (used to have one cup in the morning with milk, no sugar). I have never smoked. I am a healthy weight (5’6” 120 lbs), which I have been my entire life.
I have not been terribly stressed (things have actually been going very well in my life, but I have not been able to enjoy it). I have not had any tomato based products, and have tried to eliminate all fatty foods. At this point, the only things I can eat without really aggravating my throat are watermelon and white rice.
I have never had traditional heartburn symptoms, and the GI doctor suggested this is “silent reflux.” If it is, the treatments are still not helping and I am losing my mind. I am miserable all the time, and I do not want to socialize or travel because this has become so debilitating. I cancelled a vacation I was supposed to take because of how negatively these symptoms are impacting my daily life.
I take Tylenol or Advil every single day to try and help with the pain, but it barely reduces it at all. I am on the verge of tears most of the day. The doctors have done very little to help me and say I need to give the medicine time to work, but it has been three months since these symptoms started and I am incredibly miserable. I don’t know what to do.
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.


I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

Your symptoms are suggestive of Hiatal hernia with acid reflux (GERD / gastroesophageal reflux disease) with resultant reflux laryngitis. Following investigations may be able to confirm it (suggested some by your GI specialist);

1) Barium esophagography

2) Ambulatory 24-hour pharyngoesophageal pH monitoring

3) Upper GI endoscopy

4) An inspection of the larynx by laryngoscopy which may show laryngitis.

Since you are not responding to the medications; Nissen fundoplication surgery may be needed. Following specialists are needed to work in tandem for treatment;

1) ENT specialist

2) Gastroenterologist,

Following measures are helpful meanwhile (you are doing majority of them):

1) Small 5-6 meals a day.

2) Last meal should be eaten 3 hours before lying down.

3) Avoid; fried or fatty foods, chocolate, peppermint, alcohol, coffee, carbonated beverages, citrus fruits or juices, tomato sauce, ketchup, mustard, vinegar.

4) Eat slowly so air is not swallowed.

5) Swallowing therapy by a speech-language pathologist.

6) Elevate the head of the bed by 6 inches.

7) Avoid tight clothing.

8) Apart from Acid blocker (Nexium) you may also take some antacid (Maalox) regularly.

Please see the resource;

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited and paid for my work.

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Thank you.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Best wishes,
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Expert:  Dr. Arun Phophalia replied 1 year ago.

Hope you are doing good. Let me know if I can help you further.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Let me know if you have any further questions. I would be glad to answer them.