Answer:

Granular pharyngitis is a chronic inflammation of the pharyngeal mucosa, causing the lymphoid tissues at the back of the throat to swell and form red or pink granules. The condition can be acute or chronic, with symptoms such as dry, itchy throat, throat clearing, difficulty swallowing, painful swallowing, dry cough, cough with phlegm, fever, fatigue, loss of appetite, and sometimes swollen lymph nodes.

Viruses, bacteria, and fungi are common causes of the disease. Viruses typically attack first, followed by bacteria and fungi, leading to superinfection and continuous enlargement of lymphoid cells in the throat. Other risk factors for granular pharyngitis include chronic rhinosinusitis, recurrent acute pharyngitis, laryngopharyngeal reflux, regular exposure to tobacco and harmful substances, alcohol consumption, and poor oral hygiene.

When excessively cold water is consumed, the pharyngeal mucosa can experience sudden vasoconstriction, temporarily reducing local protective capabilities. The throat becomes more sensitive to irritants, especially in individuals already experiencing inflammation. While ice water acts as an irritant, there is no medical evidence directly linking it as a cause of granular pharyngitis. However, consuming ice made from unclean water does pose a risk of causing pharyngitis.

Doctor Hang performing a throat endoscopy for a patient. Illustration: Tam Anh General Hospital

If you are healthy, there is no need to completely avoid ice water. However, if you currently have pharyngitis, granular pharyngitis, or a sensitive constitution, it is advisable to limit cold drinks and ice. Ensure that any ice consumed is hygienic, and avoid drinking it when your throat is dry or irritated.

If granular pharyngitis is a complication of chronic rhinosinusitis, tonsillitis, or laryngopharyngeal reflux, treating these underlying conditions will lead to an improvement in the pharyngitis. Patients should also adopt home-based supportive measures such as gargling with physiological saline solution and drinking warm water to alleviate throat dryness and thin phlegm.

You should adhere to your doctor's treatment plan and attend follow-up appointments as scheduled. If symptoms persist, worsen, recur frequently, or if unusual signs appear, such as high fever, difficulty swallowing, or severe fatigue, you should seek medical attention promptly for examination and timely intervention.

Master of Science, Doctor of Medicine II Tran Thi Thuy Hang

Head of Ear, Nose, and Throat Department

Ear, Nose, and Throat Center

Tam Anh General Hospital Ho Chi Minh City