How to manage my throat tightness and tongue swelling?

Hello,

Welcome to icliniq.com.

I understand your concern.

Having reviewed your symptoms, I think that if any of the doctors could not find a particular cause, it might be what we call burning mouth syndrome with globus sensation. It may be due to certain local conditions, like ill-fitting dentures, jagged, sharp, or carious teeth. It may occur due to acid reflux or in diseases like diabetes. Even post-nasal drip due to sinusitis can cause burning in the mouth. Prolonged intake of any medicine can cause this.

However, send details of these:

• Do you smoke?
• Can you attach a picture of your throat and tongue lesions?

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern.

It will be really helpful if you could attach a picture of your tongue and throat. Other things I would like to ask:

1. Is there any swollen lymph node in the neck?
2. What about the difficulty in swallowing?
3. Is it progressive or intermittent?
4. Is it for solids, liquids, or both?
5. How is your voice?
6. Did your doctor do an indirect laryngoscopy, i.e., examination of the throat with a mirror or a fiberoptic laryngoscopy?

If everything is normal, then it is most likely due to reflux. Pantoprazole 20 mg is inadequate; you need Pantoprazole 40 mg, Domperidone 30 mg combination. You will also need to avoid taking heavy meals at night. Avoid hot and spicy, oily, and fried foods. Also, try elevating the head end of the bed by using extra pillows if it does not cause discomfort. Do you snore?

Revert with answers.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern.

To be honest, your tongue seems fine to me (attachment removed to protect patient identity). It is not swollen. You might have a feeling, but it is not. You most likely are suffering from globus pharyngeus since a dry swallow is more problematic than swallowing actual fluids and solids, and at times it can be severe.

I would suggest the following:

1. Stop taking pain medications, as they can worsen your reflux and globus sensation.
2. If at all, the feeling of tingling and pain is severe, use topical medicines for the tongue, like a topical ointment containing Choline salicylate plus Lidocaine, to be applied to the tongue.
3. Take Pantoprazole and Domperidone twice a day, half an hour before meals.
4. Use Chlorhexidine mouthwashes after each meal twice or thrice a day.
5. Also, you can try lozenges containing amylmetacresol and 2,4-dichlorobenzyl alcohol, or whatever you get.

To me, it does not seem to be sinister unless you actually develop shortness of breath, effortful breathing, or any difficulty or pain swallowing. Further, you also have to control your anxiety. It is important to understand that our brain reinforces our feelings. If you have any urge to cough, you try to avoid it because it often causes more coughing. Take plenty of water, and do not let your mouth and throat dry.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern.

It will, please have patience. Trying too many GPs will not help, as they will run a battery of tests, which may not even be required. Bring changes in your diet and lifestyle, and maintain an overall active lifestyle, and you will see this go.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.