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What is the remedy for severe throat pain?

Tuesday, 19 December 2006
Answered by: Dr. D. Balakrishnan
Professor of ENT
Government Medical College
Tamil nadu
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Q. I have throat pain for the past one month. The pain is worsening day by day and has spread to the ears, jaws, etc. But I don't have fever. I was administered with Erythrocin, but even after 2 days of the same there was no improvement. The medicine was changed to Amoxycillin with a pain killer (dolamide). The pain killer gave me a lot of relief and I took Amox for 5 days. But after 3 days of taking the pain killer, the throat pain reappeared. When the doctor asked me to continue Amox for 2 more days he told me that my tonsils are infected and are red with mucous. Since no improvement was there, he administered 5 days of Penicillin injections, which brought a little relief by the 4th day. But after 5 doses, the pain reappeared. The doc seemed doubtful if this was an allergy and put me on Airitis and Arinac AH for 10 days. I am not sure if I am on the right track of treatment. My symptoms are severe throat pain, which alternates from left to right and cough. What could be the real problem? What should be my food restrictions? I am drinking hot water and gargling with salt water. I have been taking Airitis & Arinac for 4 days but no improvement. When the pain increases, I take Dolamide, which gives me relief for 2 days. Is this harmful? It’s almost a month since this suffering started. Please advise.

A.  From your description, it appears that you have indeed got a throat infection. The medicines that you have received are rational. Inspite of that, you are not getting better. However, from the fact that you do not have fever or worsening of the original symptoms, it is clear that the medicines are indeed acting; but not good enough. Either the medicines are not completely appropriate or there is some other reason, which prevents complete resolution of the disease. From the vital data that you have provided, you appear to be a healthy adult with a reasonable nutritional status. A management plan could include the following: 1. A throat swab for culture of the organism (after stopping the antibiotic for at least 48 hours) and sensitivity testing for the most appropriate antibiotic. After taking the sample, a broad spectrum antibiotic could be started. While selecting the presumptive antibiotic, we will have to ascertain whether you are in the family way. This can be done easily by finding out the first day of your last menstruation. This presumptive antibiotic can be reviewed after the swab results arrive. 2. Also, a KOH preparation will have to be done to rule out candidiasis. 3. A blood smear examination, total leucocyte count, differential leucocyte count (DLC), ESR, ASO titre, blood sugar fasting and post prandial (one and a half hour or two hours after a meal), routine urine analysis will be the initial battery of tests. 4. Gastro oesophageal reflux disease also should be kept in mind. All the above must be done under the strict supervision and personal attention of a doctor. Kindly keep in mind that a personal examination and consultation is the best. My answer, at its best, can only serve as a method of brain-storming.

A.  From your description, it appears that you have indeed got a throat infection. The medicines that you have received are rational. Inspite of that, you are not getting better. However, from the fact that you do not have fever or worsening of the original symptoms, it is clear that the medicines are indeed acting; but not good enough. Either the medicines are not completely appropriate or there is some other reason, which prevents complete resolution of the disease. From the vital data that you have provided, you appear to be a healthy adult with a reasonable nutritional status. A management plan could include the following: 1. A throat swab for culture of the organism (after stopping the antibiotic for at least 48 hours) and sensitivity testing for the most appropriate antibiotic. After taking the sample, a broad spectrum antibiotic could be started. While selecting the presumptive antibiotic, we will have to ascertain whether you are in the family way. This can be done easily by finding out the first day of your last menstruation. This presumptive antibiotic can be reviewed after the swab results arrive. 2. Also, a KOH preparation will have to be done to rule out candidiasis. 3. A blood smear examination, total leucocyte count, differential leucocyte count (DLC), ESR, ASO titre, blood sugar fasting and post prandial (one and a half hour or two hours after a meal), routine urine analysis will be the initial battery of tests. 4. Gastro oesophageal reflux disease also should be kept in mind. All the above must be done under the strict supervision and personal attention of a doctor. Kindly keep in mind that a personal examination and consultation is the best. My answer, at its best, can only serve as a method of brain-storming.

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