From the Research
Granular pharyngitis should be treated with a focus on addressing underlying causes and providing symptomatic relief, with antibiotics only considered if a bacterial infection is confirmed, as most cases are self-limiting and caused by viral infections 1.
Diagnosis and Treatment
The diagnosis of granular pharyngitis involves identifying the underlying cause of the inflammation, which can be chronic irritation or infection.
- Treatment begins with addressing underlying causes, such as: + Smoking cessation + Reducing alcohol consumption + Treating postnasal drip if present
- For symptomatic relief, patients can use: + Salt water gargles (1/2 teaspoon salt in 8 ounces warm water) 3-4 times daily + Stay well-hydrated + Throat lozenges containing benzocaine or menthol as needed ### Antibiotic Use Antibiotics are only appropriate if a bacterial infection is confirmed, such as group A beta-hemolytic streptococcal (GAS) pharyngitis, and should be prescribed according to the most recent guidelines, with penicillin being the preferred antibiotic for treatment of acute GAS pharyngitis 2.
- The use of antibiotics should be limited to patients with confirmed bacterial infections, as overuse can lead to antibiotic resistance and other complications 3. ### Additional Considerations Persistent cases of granular pharyngitis may require evaluation for underlying conditions, such as acid reflux, which might necessitate treatment with proton pump inhibitors like omeprazole (20mg daily before breakfast) 1.
- The granular appearance of the pharynx develops due to lymphoid tissue becoming hyperplastic in response to chronic inflammation, forming visible nodules on the pharyngeal surface.
- Most cases of granular pharyngitis improve with conservative management and addressing the underlying irritants, though symptoms may recur if triggering factors return 1.