What is chronic pharyngitis, types and causes of chronic pharyngitis

Chronic pharyngitis is a disease that confuses patients. It is not easy to cure it completely because repeated attacks will bring various discomforts to patients. The long-term treatment process can easily cause patients to develop psychological intolerance and impatience. Among upper respiratory tract infections, the incidence of chronic pharyngitis is extremely high, and there are different clinical symptoms.

Chronic pharyngitis is a chronic inflammation of the pharyngeal mucosa, submucosal and lymphoid tissue. Diffuse pharyngitis is often part of chronic inflammation of the upper respiratory tract; localized pharyngitis is mostly inflammation of the pharyngeal lymphoid tissue. This disease is common in clinical practice, has a long course, and symptoms are prone to recurrence.

Pathological classification of chronic pharyngitis

1. Chronic simple pharyngitis

This type is more common and manifests as chronic congestion of the pharyngeal mucosa. The lesions are mainly concentrated in the pharyngeal mucosa, with a lot of lymphoid tissue infiltration around the blood vessels, and infiltration of white blood cells and plasma cells can also be seen. Hyperplasia of mucosal and submucosal connective tissue may be accompanied by hypertrophy of mucous glands, hypersecretion of glands, increased mucus secretion and greater viscosity.

2. Chronic hypertrophic pharyngitis

Also known as chronic granular pharyngitis and pharyngitis, chronic simple pharyngitis that does not heal may develop into chronic hypertrophic pharyngitis, which is also very common in clinical practice. The pharyngeal mucosa is congested and thickened, with extensive connective tissue and lymphoid tissue hyperplasia in the mucosa and submucosa. The lymphoid tissue around the mucous glands proliferates and there are multiple granular lymph follicles on the posterior pharyngeal wall. They may be chronically congested, or multiple lymphoid follicles may fuse into one. The inflammatory exudate in the mucous glands may be sealed therein, forming cystic white spots on the top of the protrusions of the lymphoid granules. When they rupture, yellow-white exudate can be seen. This type of chronic pharyngitis often involves the lateral pharyngeal cord lymphoid tissue, causing it to proliferate and thicken in a cord-like manner.

3. Atrophic and dry pharyngitis

It is less common in clinical practice. In the early stage of the disease, the secretion of mucous glands decreases and the secretions become thick and dry. Due to chronic inflammation of the submucosa, it gradually becomes organized and contracted, compressing the glands and blood vessels, reducing glandular secretion and causing nutritional disorders, causing the mucosa and submucosa to gradually atrophy and become thinner. Dry crusts or pus crusts may be attached to the posterior pharyngeal wall, usually accompanied by a foul odor.

4. Chronic allergic pharyngitis

Also known as chronic allergic pharyngitis. It is an IgE-mediated type I allergic reaction that occurs in the pharyngeal mucosa. Allergens stimulate the pharyngeal mucosa, causing plasma cells that synthesize IgM to transform into plasma cells that synthesize IgE. IgE then attaches to the surface of mast cells and alkaliphils, putting the pharyngeal mucosa in a sensitized state. When the same allergen contacts the body again, the allergen binds to the IgE on the surface of the mediator cells, causing the mediator cells to degranulate and release a variety of inflammatory mediators including histamine and synthetic prostaglandins, which can cause capillary dilation, increased vascular permeability, and increased glandular secretion, causing allergic reactions. Food allergens mainly cause allergic reactions through the complement C3 and C4 pathways. Chronic allergic pharyngitis is often accompanied by systemic allergic diseases or allergic rhinitis, but it can also occur alone. Seasonal chronic allergic pharyngitis, its symptoms may vary seasonally. If you are allergic to food, you may experience symptoms related to chronic pharyngitis after eating allergenic foods.

Analysis of the causes of chronic pharyngitis

Repeated attacks of acute pharyngitis are the main cause of chronic pharyngitis. In addition, upper respiratory tract lesions adjacent to the pharynx, changes in climate and geographical environment, occupational factors, systemic factors, allergic factors, etc. are all possible causes of chronic pharyngitis. During treatment, it is important to pay attention to analysis, as it may be caused by a single factor or a combination of factors.