Chronic granular pharyngitis: symptoms, treatment

Pharyngitis is an inflammation of the mucous membrane of the pharynx, usually of an infectious origin. At the same time, tissues of the soft palate and lymph nodes may also be involved in the pathological process. Often combined with tonsillitis - inflammation of the tonsils.

Granular pharyngitis is a form of chronic hypertrophic pharyngitis, which is characterized by the formation of small nodules (granules) on the back of the pharynx, consisting of lymphoid tissue, dead cells, leukocytes.

Causes and risk factors

Granular pharyngitis is a variant of the course of chronic pharyngitis, which develops in the absence of adequate treatment of the acute form. An important role in the occurrence of this disease is played by a genetic predisposition: granular pharyngitis is often diagnosed in members of one family. This disease belongs to polyetiologic - for its development a combination of several causal factors is necessary, one of which is genetic predisposition, and the other (other) endogenous (for example, diseases) or exogenous (for example, work in hazardous production) traumatic factors.

Risk factors for pharyngitis are:

  • chronic infectious processes in the upper respiratory tract, especially chronic rhinitis,
  • difficult nasal breathing (with polyps, adenoids, mouth breathing habit, etc.),
  • constant irritation of the mucous membrane of the pharynx (including antihypertensive drugs, food irritants, alcoholic beverages, tobacco smoke),
  • injuries of the nasal septum,
  • dental caries,
  • throwing the contents of the stomach into the pharynx through the esophagus (with gastroesophageal reflux disease, hernia of the esophageal opening of the diaphragm),
  • diseases of internal organs
  • metabolic disorders,
  • reduced immunity
  • susceptibility to allergic reactions
  • occupational hazards
  • exposure to negative environmental factors (too dry and / or polluted, dusty air).

Forms of the disease

Pharyngitis is divided into acute and chronic. In acute pharyngitis, the inflammatory process is usually noted in all parts of the pharynx. In the case of chronic pharyngitis, a clearer localization of lesions is noted - in the lower, middle or upper pharynx.

Depending on the etiological factor, acute pharyngitis is divided into infectious (bacterial, viral, mycotic), traumatic, allergic, and acute pharyngitis, caused by exposure to irritating factors.

Chronic pharyngitis can be catarrhal (simple), atrophic (when the affected tissues atrophy, i.e., decrease) and hypertrophic (when the affected tissue is hypertrophied, that is, increase). Granular pharyngitis is a variant of the hypertrophic inflammatory process in the pharynx.

Symptoms of granular pharyngitis

Symptoms of granular pharyngitis:

  • constant or frequent sensation of tickling, soreness, tickling, dry throat,
  • feeling of a foreign body or coma in the throat (does not interfere with food intake, but causes a desire to cough and / or make frequent swallowing movements),
  • slight pain when swallowing, especially solid foods,
  • dry cough, often in the form of an obsessive cough, the constant need to cough,
  • rapid voice fatigue.

When viewed from patients observed a thickening and swelling of the uvula and the soft palate. The back wall of the pharynx is edematous, the blood and lymphatic vessels are enlarged, create a specific branching pattern, the mucous membrane is hyperemic, and there are red lymphoid formations (granules) on it. In the throat accumulates a large amount of viscous mucous or mucopurulent secretions. Because of the need to constantly cough up or swallow accumulated mucus, patients become irritable, among other things, it disrupts sleep and can lead to persistent headache, a decrease in general well-being. Excessive mucous secretion coughing can cause nausea and sometimes vomiting.

Body temperature usually remains within the normal range. In some cases, patients complain of laying the ears, which is observed when swallowing and passes after several swallowing movements.

Granules that are formed during granular pharyngitis, if untreated, can grow significantly, causing constant accumulation of mucus, difficulty in eating, voice changes and other manifestations that reduce the quality of life.


For the diagnosis of granular pharyngitis, they collect complaints and anamnesis, objective examination of the patient, pharyngoscopic examination. To clarify the diagnosis, bacteriological or virological laboratory tests of the pharyngeal swab may be required.

Requires differential diagnosis with acute tonsillitis.

Treatment of granular pharyngitis

Treatment of granular pharyngitis is primarily aimed at eliminating the factors that caused the development of the disease, as well as at removing inflammation, getting rid of the granules and preventing further growth of tissues.

In order to fight infection, local (more often) and / or systemic (the need for them arises much less often) anti-infective drugs are used, the choice of which depends on the type of infectious agent (antibacterial, antiviral, antimycotic drugs). Fortifying agents, immunomodulators, vitamin complexes (especially vitamins A, E, group B) are prescribed.

Granules are eliminated by cauterization. For this purpose, chemical solutions (iodine-containing preparations, trichloroacetic acid, silver nitrate) are used. In the presence of granules of large sizes, liquid nitrogen is used (cryocoagulation method), as well as a minimally invasive method of laser cobaltation and radio wave quenching of the posterior pharyngeal wall.

To remove the swelling prescribed topical binders (lubricate or irrigate the back of the throat). To alleviate the pain, moisturizing agents are applied to the affected areas of the mucous membrane.

They are prescribed gargling with warm solutions of sodium chloride, antiseptic preparations, which helps cleanse the mucosa from pathogenic microorganisms and secretions accumulated on the mucous membranes. The use of medicinal herbs (chamomile, sage, linden, calendula), essential oils (lavender oil, eucalyptus, thuja), honey, propolis is effective for this purpose. Recommended inhalations with mucolytic agents, softening the mucous membrane, as well as drugs with anti-inflammatory effect, mineral water, essential oils, infusions of medicinal herbs.

Effective physiotherapy - electrophoresis, laser therapy.

One of the conditions for the effectiveness of treatment is diet. You should avoid eating too hot or cold, fried, spicy, salty foods, carbonated and sour drinks, alcohol, foods that irritate the mucous membrane of the pharynx. Also requires quitting smoking. To liquefy and remove mucus from the pharynx, an abundant drinking regime is indicated.

An important role in the occurrence of granular pharyngitis is played by a genetic predisposition: granular pharyngitis is often diagnosed in members of the same family.

Possible complications and consequences

Granules that are formed during granular pharyngitis, if untreated, can grow significantly, causing constant accumulation of mucus, difficulty in eating, voice changes and other manifestations that reduce the quality of life.

With timely and adequate treatment, the prognosis is favorable.


To prevent the development of granular pharyngitis, it is recommended:

  • timely treatment of pathologies contributing to the occurrence of the disease,
  • hardening,
  • regular walks in the fresh air
  • regular exercise
  • correction of the microclimate in rooms where a lot of time is spent (in particular, the humidity indicator),
  • rejection of bad habits,
  • nutrition, and other measures to strengthen the body.

Causes of granular pharyngitis

Chronic pharyngitis usually occurs as a result of long-lasting inflammation of the mucous membrane of the pharynx and frequent colds with a decrease in immune defense and as a result of the addition of a secondary bacterial infection.

Predisposing factors for the development of granular pharyngitis are:

  • constitutional features of the structure of the pharyngeal mucosa,
  • prolonged exposure to aggressive exogenous factors (dust, hot dry or smoke-laden air, chemicals),
  • difficulty in nasal breathing (mouth breathing, abuse of decongestants),
  • smoking and alcohol abuse
  • allergy,
  • endocrine disorders (hypothyroidism, etc.) and menopause,
  • vitamin deficiency A,
  • diabetes, heart, pulmonary and renal failure.

In addition, some diseases, such as gastroesophageal reflux disease, can cause granular pharyngitis. It is characterized by the reflux of acidic gastric masses into the esophagus and up, up to the oral cavity, as a result of which prolonged irritation of the pharyngeal mucosa can occur and, as a result, a center of chronic inflammation can develop.

With proper treatment for 15–20 days, granular pharyngitis enters a remission stage.


In the absence of timely and adequate treatment, the following complications can develop:

  • chronic bronchitis, laryngitis, tracheitis. A complication is associated with the spread of infection to neighboring organs. In this case, antibiotic therapy may be required.
  • peritonsillar and pharyngeal abscess. Characterized by involvement in the inflammatory process of nearby tissues. When infection enters the bloodstream, sepsis can develop,
  • inflammation of the inner ear. Complications can develop in 1-2 weeks after the exacerbation of granular pharyngitis and proceed with severe dizziness,
  • pathologies of the cardiovascular system and acute articular rheumatism. Develop with streptococcal infection etiology,
  • cervical lymphadenitis and sialadenitis. They are among the rarest complications requiring surgical treatment,
  • poststreptokokkovy glomerulonephritis. Complications are dangerous in the likelihood of developing renal failure.

Accurate diagnosis, correct treatment, protection from external factors that can provoke the occurrence of the disease, provide a favorable prognosis.

Preventive measures

Prevention of granular pharyngitis includes the following measures:

  • Rejection of bad habits.
  • Air humidification in residential premises.
  • Dieting. The decrease in the daily diet of salty, spicy dishes and an increase in food rich in nutrients.
  • Regular check-ups. Timely treatment of sinusitis, tonsillitis.
  • Strengthening immunity. Hardening, physical education, walking and jogging in the fresh air.

What is granular pharyngitis, the causes of development

Pharyngitis - sore throat, which is accompanied by a pronounced lesion of the mucous membrane of the pharynx and lymph nodes. The granular form is characterized by the appearance of certain granules on the back of the pharynx, consisting of elements of overgrown lymphoid tissue, leukocytes, dead cells, and bacteria. Sizes of small nodules are 1-2 mm. Larger granules can provoke irritation of the nerve endings, which leads to an aggravation of the disease.

There are two forms of granular pharyngitis: acute and chronic. The latter, as a rule, develops as a result of untimely or incorrect treatment of the first.

Causes of chronic granular pharyngitis

The main causes of hypertrophic pharyngitis are genetic predisposition and negative environmental impact. Therefore, if you have relatives with a history of this disease, it is necessary to take a closer look at your health, especially pharynx diseases.

In addition, the pathology may be caused by the following factors:

  • susceptibility to allergic reactions
  • penetration into the throat of acidic gastric contents through the esophagus (this phenomenon is observed during the gastroesophageal reflex),
  • regular irritation of the pharyngeal mucosa with aggressive substances (sour, salty, spicy foods, tobacco smoke, alcohol),
  • sluggish pathologies of the sinuses,
  • the defeat of the nasopharynx with various fungi, viruses and bacteria that provoke the development of inflammatory processes,
  • frequent and long stay in rooms with low humidity,
  • damage to the nasal septum or abnormal nasal cavity structure,
  • complicated sinusitis, caries, rhinitis, tonsillitis,
  • regular contact of the mucous membrane of the respiratory organs with toxic dust and gases.

Often, acute pharyngitis takes the form of granular. This happens when the treatment does not give the desired effect. The presence of previous diseases of the nasopharynx increases the likelihood of transition to the granular form.

Chronic and hypertrophic granular pharyngitis: photos, symptoms

Symptoms of granular pharyngitis are quite specific and are characterized by the following features:

  • paroxysmal cough
  • almost constantly feeling of sore throat,
  • the presence of a viscous sputum in the throat in the morning, when trying to cough, which appears nausea and vomiting,
  • slight pain when swallowing.

In the diagnosis of the disease, symptoms such as swelling and reddening of the laryngeal tissues, their apparent thickening, as well as the appearance of granules and follicles on the pharyngeal surface are observed. If the course of hypertrophic granular pharyngitis is accompanied by the addition of an infection, the symptoms may resemble purulent tonsillitis in an acute form with aching joints and high fever.

Sometimes the symptoms of the disease are mild, so they go unnoticed. Meanwhile, the development of pathology continues, and in the absence of treatment, the disease passes into a complicated stage.

When the first signs of the disease appear, you should as soon as possible seek qualified help to carry out competent diagnosis and prescription of therapy. This can only be done by an otolaryngologist.

Granular pharyngitis: treatment

Before starting treatment of granular pharyngitis, it is necessary to eliminate the factors that provoke the development of inflammation:

  • To exclude from the diet foods that cause allergies or irritate the laryngeal mucosa,
  • stop drinking alcohol and smoking
  • change the place of work (if the development of the inflammatory process is caused by harmful gases in production).

It is also being developed. special diet, excluding salinity and hot spices. The food consumed by the patient should be of a soft consistency, not too hot or, conversely, cold. It is necessary to include various cereals, ground meat, stewed vegetables, yogurt, kefir and other dairy products in the diet.The amount of fluid consumed increases to 2.5 l / day. And, of course, the basis of the treatment of granular pharyngitis is medication.

Granular pharyngitis: drug therapy

After the diagnosis, the specialist may prescribe the following types of medical procedures using medications:

  • Knitting preparations will help to remove puffiness in the throat. Solutions of nitrate of silver or tannin in glycerin showed high efficiency. They need to lubricate the throat. For the same purpose, medications such as Protargol and Collargol.
  • For gargling is used saline or sea ​​saltdivorced in water. Rinse the throat preferably as often as possible in order to quickly get rid of the mucus accumulated there.
  • Cauterization of pellets is carried out using lapis or trichloroacetic acid. Large clusters are removed. liquid nitrogen or by laser.
  • In order to reduce dryness, the throat must be lubricated with solutions. vitamins A and E oil based.
  • To soften the inner surface of the pharynx by using corticosteroids or mucolyticswith anti-inflammatory effect.

Procedures for granular pharyngitis

In the clinic specialist can appoint the following procedures:

  • phonophoresis with propolis,
  • mud applications
  • electrophoresis on the submandibular region,
  • darsonvalization,
  • UHF heating.

All of the above physiotherapy promotes relief of inflammation and activation of the regenerative processes in the throat.

At home, compresses are made on the basis of camphor alcohol, which are superimposed on the back of the neck. In addition, hot foot baths can be used.

Treatment of granular pharyngitis by folk methods

Folk remedies are used in the treatment of granular pharyngitis only as an additional means to the main therapy. There are many recipes of alternative medicine, the use of which will help speed up the healing process.

  • Propolis. This product of the life of bees is one of the most effective means in the treatment of pharyngitis of any etiology. For the preparation of medicinal tinctures, it is necessary to crush the propolis and pour it into a small container with water. At the same time, all unnecessary impurities will float to the surface and a pure product will remain, which we will use to prepare the medicine. Now you need to take the purified propolis (30 g), pour it with alcohol (100 ml) and insist for at least a week. During all this time, the liquid must be periodically shaken. Then the tincture should be well filtered and mixed with glycerin or peach oil in a 1: 2 ratio. the resulting mixture to process the mucous. The procedure is carried out 1 time / day, the course of treatment is 10-15 days.
  • Sage. To rinse the pharynx, sage decoction is prepared with the addition of calendula, plantain, thyme or chamomile. One Art. l mix the mixture with boiling water (0.5 l.), boil for 15 minutes (no more), cool slightly. In the cooled broth add citric acid (at the tip of the knife) and honey (1 tbsp. L.). Cooked means necessary as often as possible to carry out rinsing the throat.
  • Milk. To get rid of cough with granular pharyngitis will help mukaltin with milk. To do this, dissolve 3 tablets of the drug in warm milk (100 ml), add iodine (2 drops). Take before bedtime, the course of treatment is 10 days.
  • Aloe. The juice of a homemade plant aloe or kalanchoe is useful to drip into the nasopharynx. To prepare the drug, wrap the leaves of the plant in a plastic bag and place in the refrigerator for 48-72 hours. After that, squeeze the juice and drip it into the nose so that it falls into the throat.
  • In order to liquefy the sputum accumulated in the throat, inhalations are used, using Lasolvan, Berotec or magnesium sulfate. Inhalation of sage broth with calendula, pine cones or pine needles will help to disinfect the throat and alleviate the pain.

Causes of disease

Granular pharyngitis begins to develop if there are two main components: a hereditary predisposition to such a disease and the harmful influence of the environment. Therefore, if among relatives, someone suffers from a pathology, it is necessary to take seriously any diseases of the throat.

In addition, granular pharyngitis, the treatment of which we consider below, can trigger the following factors:

  • sluggish diseases of the nasal sinuses,
  • smoking,
  • constant interaction of the respiratory mucosa with dust and gases,
  • caries, sinusitis, complicated rhinitis, tonsillitis,
  • alcohol consumption,
  • infection of the nasopharynx with various viruses, bacteria and fungi that cause the development of the inflammatory process,
  • damage to the nasal septum or abnormal development of the nasal cavity,
  • constant presence in rooms with low humidity.

In case of granular pharyngitis, an urgent need to consult a doctor. If this disease is ignored, fibrous films begin to form on the walls of the pharynx. They arise as a result of the death of cells of leukocytes, which is why the inflammatory process is difficult to treat. After that, granules begin to form, affecting the trigeminal nerve. The patient is plagued by a painful cough that contributes to the occurrence of severe pain in the throat. In addition, pharyngitis of any form is very contagious. A sick person should be isolated from the team.

This disease occurs most often in a chronic form. Its symptoms manifest as follows:

  • tickling arises in the throat, it does not pass for a long time,
  • sore throat when swallowing,
  • pestering, agonizing cough,
  • viscous mucus is formed in the throat, which is very difficult to cough up.

These are the symptoms of chronic granular pharyngitis. Treatment should be carried out as quickly as possible. It is also necessary to constantly implement preventive measures, especially during the period of seasonal colds, then the risk of recurrence will be minimized.

Conservative treatment of the disease

Treatment of granular pharyngitis in adults should take place under the supervision of a otolaryngologist, and this should be done comprehensively. Most often, the chronic form is treated by conservative methods, including the use of drugs and physiotherapy, which quickly leads to a positive result. Gargling is the most effective treatment for pharyngitis. For this purpose, decoctions of herbs are used, as well as alcohol tinctures diluted with water.

To eliminate the granules that are coated with the mucous membrane of the larynx, apply the cautery method using preparations containing water-based iodine, trichloroacetate acid and protargol. In order to liquefy the thick mucus that has accumulated on the walls, inhalations are used based on such medicinal herbs as chamomile, eucalyptus and sage, containing oil-alkaline substances. Through this method of treatment is not only the elimination of mucus, but also ensures the destruction of pathogenic bacteria.

If granular pharyngitis was diagnosed, treatment is carried out with the help of supporting vitamin therapy. The most suitable option should be selected only by a doctor who is familiar with the history of the disease. To get rid of pathogenic microflora and improve immunity, use antibacterial and antiviral drugs in conjunction with anti-inflammatory and homeopathic remedies.


With a disease such as granular pharyngitis, the symptoms, the treatment of which we are now considering, can be very damaged mucous. In this case, the operation is shown to remove overgrown tissue. Do it with a laser. This allows you to quickly get rid of the formations and growths.

Laser surgery is absolutely safe and painless. The peculiarity of such treatment lies in the fact that the granules and overgrown areas of the mucous tissue carry out a point effect without damaging the healthy surface. Almost immediately begin to noticeably decrease plaques and decreases the intensity of the inflammatory process.

Treatment of granular pharyngitis folk remedies

This disease will pass much faster if you additionally use the help of traditional medicine. We present the most popular and effective recipes. For example, very well relieves pharyngitis propolis. To make the tincture, it is crushed and poured into a small container with water. Thus, it is cleared of impurities that must be drained. Then 30 g of pure propolis is mixed with 100 g of alcohol and infused for a week. During this time it is necessary to shake it well several times. After that, the tincture is filtered and combined with glycerin or peach oil in a ratio of 1: 2. The resulting mixture lubricates the inflamed mucosa once a day. Therapy lasts about 10 days.

“Mukaltin” with milk also helps well. Three tablets of this natural medicine are dissolved in 100 g of warm milk and two drops of iodine are added there. The mixture is drunk at bedtime for 10 days. In addition, it is useful to bury in the nose aloe juice or kalanchoe. In this case, the torn sheets must be wrapped in a bag and put in a refrigerator for 72 hours. After that, they squeeze the juice out of them and bury it in the nose so that it flows directly into the throat. You can make useful inhalations from decoctions of cones or pine needles, as well as calendula with sage. This procedure well reduces pain and disinfects the throat.

Granular pharyngitis in a child

Children are especially hard to bear this disease, because the viscous secret in the larynx does not allow the baby to breathe normally, but he still cannot cough up. Because of the painful cough, the child cannot eat and sleep normally.

If the diagnosis was “granular pharyngitis,” the baby must undergo a full comprehensive examination to identify other hidden ailments. It is advisable to visit doctors of other specialties, and not just one otolaryngologist. With the diagnosis of "granular pharyngitis" in a child, treatment should be as follows:

  • taking vitamins to support the body
  • lubrication of the larynx or gargling with herbal tinctures or antibacterial drugs,
  • carrying out inhalations using herbal infusions and decoctions,
  • exclusion from the diet of the baby foods that can cause allergies, for example, citrus, chocolate and others,
  • cauterization of pellets in the larynx.

Although surgery is considered to be quite an effective method of treatment, it cannot guarantee the prevention of recurrence of pharyngitis.

Thus, we found out what is granulose pharyngitis. The treatment of this disease is carried out in different ways, and it must be done in a timely and correct manner. Otherwise, the inflammatory process can cause various complications.

Watch the video: Severe Chronic Granular Pharyngitis- Testimony- Dr Paulose FRCS ENT (January 2020).