Atrophic pharyngitis
Atrophic pharyngitis is a long-term ongoing inflammatory process in the mucous membrane of the throat, accompanied by pathological cell transformations, thinning of tissues and the loss of their natural physiological functions. Atrophic pharyngitis is a dangerous disease, which is regarded as a condition that predisposes to the further development of oncological processes. Treatment of this type of chronic pharyngitis should be long-term and complex. There is a chance that if you start it on time, you can achieve a complete restoration of the structure of the mucous membrane of the throat.
Atrophic pharyngitis is the terminal stage of chronic pharyngitis, which is preceded by a catarrhal and hypertrophic form of the disease.
Content:
- Causes of atrophic pharyngitis
- Symptoms of atrophic pharyngitis
- Diagnosis of atrophic pharyngitis
- Treatment of atrophic pharyngitis
Causes of atrophic pharyngitis
The causes of atrophic pharyngitis can be of both endogenous and exogenous origin.
It is important to establish the etiological factor that led to the development of the disease, since the success of treatment depends on this in the future:
- High level of air pollution in the area of residence.
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Diseases of the nose that interfere with normal nasal breathing. As a result, a person breathes through his mouth and untreated and unmoistened air enters the throat mucosa.
- Occupational hazards. Chronic pharyngitis is a frequent companion of metallurgists, workers in the chemical industry, cement plants, flour-grinding industry, etc.
- Smoking. Moreover, tobacco smoke is dangerous not only for the smoker himself, but also for those people who breathe this air.
- Reception of strong alcoholic drinks.
- The presence of a focus of chronic infection in the mouth, nose, paranasal sinuses, throat.
- Violations in the work of cellular and humoral immunity.
- The habit of drinking too hot drinks, which has a permanent traumatic effect on the mucous membrane of the throat.
- Frequent use of vasoconstrictor nasal drops that run down the back of the throat and irritate it.
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Diseases of the digestive system: reflux esophagitis, hernia of the alimentary opening of the diaphragm, peptic ulcer, gastritis. Throwing acidic stomach contents into the throat occurs most often during a night's rest. It will not be possible to get rid of pharyngitis if the pathology of the gastrointestinal tract is not eliminated.
- Constitutional features of the structure of the throat and gastrointestinal tract as a whole.
- Allergy.
- Endocrine pathologies (menopause, hyperthyroiditis, etc.).
- Lack of vitamin A.
- Diabetes mellitus, disorders of the cardiovascular system.
- Pharyngitis as a postoperative complication that arose after a tonsillectomy.
- Throat injuries - chemical, thermal, mechanical.
- Some experts are of the opinion that there is a connection between chronic atrophic pharyngitis and a hereditary predisposition to it.
Symptoms of atrophic pharyngitis
Symptoms of atrophic pharyngitis, as a rule, are pronounced and force the patient to seek medical help. Lack of treatment leads to progressive sclerosis of the mucous membrane of the throat, as well as the lymphoid, glandular apparatus and the submucosa of the throat.
The symptoms of this pathological process are as follows:
- Severe discomfort in the throat, which is explained by the presence of a viscous thick secret in it. Mucus is very difficult to separate, often dries up completely and forms crusts.
- Violent cough, with which the patient tries to get rid of the crusts. Sometimes, with considerable effort, it succeeds. The crusts look like large fragments or are completely casts of the inner surface of the throat. The cough is persistent and dry, it is not difficult to distinguish it from a broncho-pulmonary cough.
- Constant discomfort in the throat makes a person irritable, interferes with daily activities, and disrupts his sleep.
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The general condition of the patient is not greatly disturbed, the body temperature will rise only during an exacerbation of the pathological process.
- The mucous membrane of the throat becomes pale, dry, has a pathological varnish sheen. A convoluted network of blood vessels is clearly visible through it.
- Atrophy of autonomic and sensory nerve endings leads to the extinction of pharyngeal reflexes.
- Patients have difficulty swallowing food. This process can be painful.
- If the disease is provoked by problems in the work of the digestive tract, then the patient will experience belching and heartburn. When gastritis, peptic ulcer disease subsides, symptoms of atrophic pharyngitis will become less pronounced.
- An unpleasant odor comes from the patient's mouth.
- Small vessels of the pharynx are prone to bleeding.
- The patient is constantly tormented by thirst, which forces him to drink more.
Diagnosis of atrophic pharyngitis
Atrophic pharyngitis is diagnosed by an otolaryngologist. The diagnosis is made on the basis of the patient's complaints and after the pharyngoscopy.
Atrophic pharyngitis should be the reason for a comprehensive examination of the gastrointestinal tract, since a clear relationship has been established between these diseases. Therefore, the patient is referred for a consultation with a gastroenterologist.
A bacteriological and virological examination of a throat smear is mandatory. This allows you to assess the state of the microflora of the mucous throat, identify possible pathogenic pathogens and determine their sensitivity to a particular drug.
Treatment of atrophic pharyngitis
Treatment of atrophic pharyngitis should be based on the pathogenetic mechanisms of the disease. First of all, those pathological conditions that have caused chronic inflammation should be eliminated. It is important to qualitatively sanitize the nose and paranasal sinuses, to achieve normalization of nasal breathing, and to treat (conservatively or promptly) tonsillitis. The elimination of adverse industrial and household influences is important.
No less important is a diet that involves the complete elimination of any irritating food. This applies to hot, cold, spicy, sour and salty foods.
In the local therapy of atrophic pharyngitis, a variety of techniques are applicable, including:
- Gargling;
- Throat lubrication;
- Inhalation with various medications;
- Novocaine blockade;
- Moxibustion;
- Physiotherapy treatment.
There are a large number of topical drugs that can cope with the disease, which makes it possible to make the best choice in each specific case. When using antibacterial agents, it must be borne in mind that after the destruction of all microbes on the mucous throat, mycotic microorganisms will most likely take their place. Therefore, antifungal antiseptic treatment is important. But it is important to observe the measure, because the thinned mucous membrane is practically devoid of superficial epithelium, and increased treatment can lead to its complete death. This will cause severe discomfort in the patient and cause the progression of the pathology.
When choosing a topical drug for the treatment of atrophic pharyngitis, the following requirements must be considered:
- The product must fight bacteria, viruses and fungi.
- The drug must be absorbed slowly from the mucous membrane.
- The drug should not cause allergic reactions.
- The product should not irritate and dry out the mucous membrane of the throat.
You should not use soda solutions and sulfonamide-based products (Ingalipt) to rinse your throat, since they have a drying effect, which is contraindicated in atrophic pharyngitis. Of the local antibiotics, it is best to give preference to the drug Fyuzafunzhin. You can also use the following antiseptic agents: Hexetidine, Biclotymol, Yoks, Antiangin, Rotokan, Sebidin, Terasil, Octenisept. In case of fungal infection, it is advisable to include Clotrimazole and Candide in the treatment regimen. It is worthwhile to be wary of the use of preparations based on iodine and propolis, as they have an irritating effect on the mucous membrane of the throat.
Herbal preparations (Tonsilgon, Faringomed, Traumeel S, etc.) are considered harmless, but you should remember about the possibility of an allergic reaction to them.
Immunocorrectors can increase the local protection of the mucous membrane of the throat, for which the following drugs can be included in the treatment regimen: Bronchomunal, Imudon, IRS 19, Gepon, Lizobakt, Polyoxidonium, Hexaliz, Likopid.
To eliminate pain and reduce inflammation, you can use Strepfen or Tetracaine.
To liquefy viscous thick mucus, to remove crusts from the throat, it is recommended to inhale with saline and alkaline mineral waters using a nebulizer. Well moisturizes the mucous membrane of the throat by gargling with saline. The regular implementation of this procedure allows you to eliminate the symptoms of the disease, to normalize the functioning of the mucous membrane. Inhalation with Bronchobos, Fluditek drugs can get rid of multiple crusts in the throat.
Oil solutions of vitamin A, vitamin E help to alleviate the symptoms of the disease. The drugs are instilled deep into the nasal cavity, or they lubricate the back of the throat with them.
Novocaine blockade with aloe can quickly and effectively relieve the symptoms of the disease. This treatment promotes the formation of mucus, which relieves dryness and soreness. The full course of treatment includes 10 procedures, the interval between them should be at least 7 days.
Effective in the treatment of atrophic pharyngitis, irrigation of the nasopharynx with the Aqua Maris spray containing sea water. The use of this agent promotes the death of pathogenic microorganisms, has an antiseptic effect, moisturizes the mucous membrane of the throat.
No less important is the treatment of diseases of the digestive tract. If it is the pathologies of the digestive system that led to the development of pharyngitis, then their elimination can lead to complete recovery and normalization of the throat. The gastroenterologist is engaged in the treatment of gastrointestinal diseases.
With regard to taking systemic antibiotics, the most commonly used drugs are the penicillin group, namely Phenoxymethylpenicillin, which allows you to get rid of streptococcal pharyngitis. An antibiotic is prescribed inside only after the bacterial nature of atrophic pharyngitis has been clarified. For allergies to penicillins, cephalosporins (Cefixime, Cefuroxime axetil, Ceftibuten) or macrolides (Azithromycin, Erythromycin, Clarithromycin, etc.) can be used.
With regard to physiotherapy, such techniques as UV irradiation, drug electrophoresis of the throat, ultrasound therapy, phonophoresis of the throat, diathermy of the neurovascular bundles of the neck, diadynamic current, darsonvalization of the back of the neck have found wide application in the treatment of atrophic pharyngitis.
The author of the article: Lazarev Oleg Vladimirovich | ENT
Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)
