Diseases of Throat
The throat has various diseases:
Diphtheria:
At first, dryness and hoarseness occur in the throat. Then irritation develops, causing repeated coughing. It feels as though something is stuck in the throat, so the patient repeatedly tries to swallow. Swallowing saliva, food, and drinks becomes painful. A mild fever with chills develops, causing bad taste in the mouth and foul-smelling breath. The voice becomes hoarse, and the throat membrane becomes red and swollen.
Causes:
Dust and smoke
Cold and dry weather
Attack of Corynebacterium diphtheriae bacteria or germs
Sour foods
Excessive use of fermented gruel and vinegar
Tonsillitis (Inflammation of the Tonsils):
On both sides of the throat are two glands that act like vigilant guards, preventing germs from spreading further by trapping and destroying them. If they become swollen for any reason, pain develops in them. Swelling can be felt beneath the lower jaw. On opening the mouth, the tonsils on both sides of the root of the tongue appear red and swollen. Swallowing food and drinking water becomes painful. When the swelling becomes severe, water may come out through the nose while drinking. Mild fever, headache, body heaviness, and fatigue are also experienced.
If the inflammation persists continuously, complications may arise, leading to pus formation in the tonsils. Foul-smelling discharge may come from the mouth, and some of it may enter the stomach and cause further problems.
Causes:
Infection by beta-hemolytic streptococcal bacteria
Excessive use of hot and dry foods
Hoarseness of Voice (Loss of Voice):
Inflammation in the vocal apparatus causes the voice to become hoarse. A person tries to speak loudly, but no sound is produced.
The voice becomes affected when a defect develops in the larynx. Diseases affecting nerves on both sides may influence the vocal system. The ninth and tenth cranial nerves together affect the front part of the palate. During speech, both branches are involved. Cough reflex becomes suppressed, and both vocal cords may fail, causing difficulty in swallowing. Damage to even one vocal cord can cause hoarseness. If both vocal cords stop functioning, breathing also becomes difficult, and food cannot pass properly.
Causes:
A sudden loss of voice is usually caused by viral infection of the larynx. Inflammation develops, making the vocal cords red and swollen. If one vocal cord stops functioning, the voice becomes hoarse. Various viruses may affect the larynx, including influenza viruses, adenoviruses, and enteroviruses. The patient may also develop fever and body fatigue.
Tumors in the larynx can also stop the vocal cords from functioning. In some patients, gases or secretions from the lungs rise toward the mouth during the night, causing obstruction in the throat. Minor cancers of the esophagus or lungs may also affect the vocal cords, leading to swelling of the larynx and hoarseness.
If the nerve pathways in the brainstem become swollen, or chest infections affect the nerves supplying the vocal cords through the neck, the voice may become weak or depressed. Sometimes neck injuries damage the nerves and stop voice production altogether. Occasionally, eating cold and dry foods may also cause hoarseness, which may recover on its own.
Goiter:
An enlarged thyroid gland is called goiter. It may result from a thyroid tumor or from iodine deficiency in the diet. In iodine deficiency, the pituitary gland produces more thyroid-stimulating hormone (thyroxine stimulation), causing the thyroid gland to enlarge.
Goiter is more common in the mountainous regions of Pakistan where iodine deficiency exists. It is less common in Western countries. Women are more commonly affected than men, and about 9% of the population may suffer from it.
In this disease, the gland enlarges. Usually there is no pain, but goiters caused by abscesses may be painful. Large goiters can cause difficulty in breathing. Initially, they appear smooth but later become rough and irregular.
There are three types of goiter:
Simple Diffuse Goiter
Nodular Goiter
Fibrotic Goiter
1) Simple Diffuse Goiter:
There is no clear cause for its enlargement. It is generally smooth and soft. Autoimmune thyroiditis and thyrotoxicosis are associated with this type. Thyroiditis is a viral disease and may result from hyperthyroidism.
2) Nodular Goiter:
Nodular goiters may occur singly or in clusters. They are common in elderly people. They may put pressure on the windpipe and food pipe and may also cause nerve paralysis leading to neck pain.
One nodule may become enlarged and difficult to diagnose. It may be painful, and if untreated, may develop into thyroid cancer.
3) Fibrotic Goiter:
This type is very rare and produces a “woody gland”. It becomes hard and irregular in shape.
Sore Throat (Pain in the Throat):
Pain occurs in the throat, especially while eating or drinking. Pain is also felt during swallowing saliva or any substance.
Causes:
Excessive use of hot and dry foods
Hyperthyroidism:
When the thyroid gland becomes overactive, the level of thyroid hormones in the blood increases. As a result, the patient experiences anxiety, weakness, sweating, palpitations, and excessive sensitivity to heat. Diarrhea may occur, weight decreases, menstruation becomes irregular in women, and tremors develop in the hands.
The eyes may bulge outward and the eye muscles become stiff, affecting vision. Double vision may occur. This specific condition of the eyes is called exophthalmos. The thyroid gland enlarges outwardly in the neck.
Laboratory tests show elevated T3 and T4 levels, while TSH becomes low. Blood calcium levels may rise, leading to kidney stones. Sometimes hyperthyroidism results from a pituitary gland tumor that raises TSH levels, indicating secondary hyperthyroidism.
Some patients experience hair loss and increased appetite. White blood cells and platelet counts may decrease. Men may show signs of impotence. The most obvious sign is enlargement of the thyroid gland.
Causes:
Excessive use of cold and dry foods
Hypothyroidism:
For proper functioning of the thyroid gland, TRH and TSH hormones are necessary. Deficiency of these hormones causes hypothyroidism, and symptoms gradually begin to appear.
Children born with congenital thyroid deficiency experience stunted growth. Due to lack of thyroxine in the blood, physical and mental development becomes defective, especially affecting muscles, bones, and the nervous system. Their bodies remain small, and the nervous system remains underdeveloped.
Metabolism slows down, including intestinal movement, causing chronic constipation. Cardiac output into the arteries also decreases.
This developmental disorder may occur due to inactive thyroid function or iodine deficiency in food. If diagnosed early and treated with thyroxine, the disease can be controlled. However, if hormone deficiency continues during growth, irreversible damage occurs, particularly to the nervous system.
In adults, reduced thyroid function causes myxedema. Weight increases, cold becomes intolerable, fatigue persists, and fluid accumulates under the skin.
Symptoms include:
Fatigue and weakness
Slow work performance
Soft or hoarse voice
Swelling around the eyes
Feeling cold
Rough skin and hair loss
Weak memory and abnormal behavior
Thick tongue and slow pulse
Enlarged heart and fluid in the chest cavity
Heavy menstrual bleeding in women
Laboratory tests show:
T4 below 5 micrograms per deciliter
Increased cholesterol, CPK enzyme, liver enzymes, and serum prolactin
Decreased blood sugar and sodium
Increased TSH in primary hypothyroidism
Patients may develop peripheral neuropathy causing tingling in hands and feet. Weight increases, sensitivity to cold worsens, and they avoid work. Walking becomes unsteady, and some women may become infertile.
Causes:
Radiotherapy
Side effects of radioactive iodine
Surgery
Reduced production of thyroid hormone
Failure of the pituitary gland
Dysfunction of the hypothalamus