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What could be the cause of lumps on my throat and tonsils? (photo)

Ear, Nose & Throat
What could be the cause of lumps on my throat and tonsils? (photo)
DOCTOR’S ANSWER (1)

Thank you for your question. From the clinical history and the picture provided, you may have a cobblestone throat.

However, it is best to see an ENT Specialist to have a full examination of your throat and head & neck region to rule out any worrisome lumps. A picture alone (especially in the throat region which is more difficult to visualize) may not be enough to clinch a diagnosis.

Cobblestone throat are bumps at the back of your throat that formed after chronic irritation from postnasal drip. They are a result of enlarged lymphoid tissues in the throat. Postnasal drip refers to a sensation of mucous stuck behind your nose and throat region.  

The common causes of postnasal drip include:

1. Rhinitis (Sensitive nose) - This refers to inflammation of the nasal cavity and can be allergic or non allergic (which can be determined from clinical history and allergy tests). Common symptoms include runny nose (clear mucous), blocked nose, sneezing, postnasal drip as well as itchy eyes and nose. Treatment consists of allergen or trigger avoidance, nasal steroid sprays, antihistamines and decongestants.

2. Sinusitis (or rhinosinusitis) - This refers to infection of the sinuses (air-filled cavities in the face that produce mucous that drains into the nasal cavity). Typical symptoms include coloured mucous (usually yellow, brown or green), blocked nose, postnasal drip, facial pain and sometimes loss or reduced sense of smell. Treatment includes a course of oral antibiotics, nose wash (with salt solutions) and antibiotics.

3. Laryngopharyngeal reflux (LPR) - This refers to backflow of acid from the stomach up to the foodpipe and throat. As the voicebox is a very sensitive organ, a small amount of acid reflux can cause inflammation (swelling) of the voicebox, resulting in sensation of mucous stuck in the throat and globus sensation (feeling of a lump in the throat). Other common symptoms of LPR include sore throat, itchy throat, frequent throat clearing and hoarse voice. Treatment includes lifestyle changes and acid suppressant medications.

4. Dehydration - Many people are unaware that our nose and sinuses produce about 1-2 litres of mucous each day! However, majority of the mucous flows down seamlessly down our throat without us noticing its presence. However if our mucous becomes thicker due to dehydration, it can irritate the throat. 

5. Medications - Certain medications such as blood pressure and birth control medications can result in a thicker mucous.

It is important to treat the underlying cause of cobblestone throat although the appearance may persist for a while. Cobblestone throat is a benign condition. It is not a sign of cancer. It is still best to have your throat checked by a doctor (General Practitioner or ENT Specialist) to ensure that your throat lumps are indeed benign.

An ENT Specialist will also likely perform a nasoendoscopy (a scope passed throught the nose and down to the level of the voicebox) which is done under local anaesthesia in the clinic for a complete assessment. 

Hope this helps and all the best!


Dr Gan Eng Cern
MBBS, MRCS, MMed, FAMS

38 Irrawaddy Road #08-45
Mount Elizabeth Novena Specialist Centre
Singapore 329563


24477 views 18 Mar 2018
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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