Posted by: Madelaine | 2011/10/25

Lump in throat

Dear Dr,

I had my tonsils removed on Tuesday the 2nd of August 2011, 10 days later I was rushed back to theatre with a post-op bleed, and since then I felt this knob in my throat. I went back to my ENT and he told me that it was scabs and will take 6 weeks to heal properly.

8 Weeks later I was back, and he then told me that I have “ globes pharynges” , caused by the tube that was put down the airway to prevent the blood from going into my lungs during the procedure, and this damaged the airway, but will eventually go away.

He prescribed a cortisone inhaler and nexiam to keep any reflux down cause that could make it worse.

3 Days later my mouth was full of thrush, I could not get hold of my ENT, and saw someone else, he then treated me for the thrush, and said I must stop the cortisone immediately, and also told me that the knob will eventually go away, If I stress less, and stop clearing my throat all the time. He prescribed nystacid oral rinse, which cleared the thrush.

I went back to my ENT on the 30th of September and insisted on an X-Ray (Barium Swallow). He again told me that everything seems normal, and I suffer from reflux went I lie down at night, and this aggravate the “ knob” , he prescribed a 3 month repeat for nexiam.

This is now a month later, and I do not feel any better, some days is worse that others. I went to see my GP yesterday and asked him to please help me, because this problem is affecting my whole life, my marriage, my personality everything!!!!

He referred me to a different ENT this time for an ultra sound or CT scan and I have an appointment to see him on Friday 28 October @ 11h00am, and I hope and pray that this will be the end of it.

I am 36 years old, and currently taking Serlife (Anti-depressants) after post natal depression was diagnosed 18 months ago.

Please any advice will be greatly appreciated.

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Our expert says:
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Dear Madelaine

I agree that you need to see an ENT. A tonsillectomy at a later stage of life is considered one of the most painful operations that one can have, and the healing time varies greatly from patient to patient. Your post-operative course was also stressfull, but bleeding after a tonsillectomy is a reality, and can occur in any patient after the op. It may be that you will just take longer to get back to normal. Having to deal with the added stress of a baby, and the post natal depression is making thing more difficult for you. It is important that you have the examinations to make sure there is no problem, as a negative CT scan is also a very important answer. The globus sensation (lump in the throat) is caused by involuntary contraction of the constrictor muscles in the throat, and this can cause severe pain. The fact that you had the operation has caused irritation to the muscles in that area, as the tonsils are situated on the constrictor muscles. Removing them causes an inflammatory reaction to these muscles, it is possible that the muscle- bed is just taking longer to heal. In your case I would most likely have suggested the same, as any problems can be addressed, and if you know all is well, you will realise that things should settle in time. Not every patient reacts the same way, so do not worry to much if all the tests are negative, it only means that you are taking a bit longer to settle after your operation.


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