Cobblestone throat refers to "lumpy" or rough surface at the back of the throat (see image as example). Cobble stone throat is a potential finding on clinical examination when a doctor examines the back of the throat. This is associated with Pharyngitis, that is inflammation of this area. It can lead to swelling of the lymphatic tissue (a component of the immune system) deep in this area that leads to the rough appearance on the surface. Possible causes for cobblestone throat include Infections, Allergies, Irritants, Acid reflux, and others. Read on to find out more about each of these.
These are a common cause of cobblestone throat, out of which viral infections are the commonest type as opposed to others such as bacterial and/or fungal infections. Often a period of rest and actively hydrating with lots of water will provide great relief for most viral infections and antibiotics are not useful. However, if the symptom persists for more than 2-3 days of rest and hydration, it would be pertinent to get an examination with your doctor for a check-up to ensure there are no features of certain severe viruses (such as Ebstein Barr) and/or others such as bacteria, and treatment would be tailored accordingly (may include antibiotics, depending on examination findings)
2. AllergyOften wake up in the morning with a runny or blocked nose, with sensations of mucus trickling backwards down your throat (post-nasal drip)? Or perhaps you develop these symptoms on exposure to certain triggers like dust or cold air? This may mean you have allergic rhinitis, another cause of "cobblestoning" of the throat. Here, the underlying cause being the allergy for the inflammation and swelling of tissue at the back of your throat. This may need specific treatment such as anti-histamine tablets and/or nasal sprays which your doctor can prescribe.
Prolonged/excessive exposure to airborne irritants can also lead to inflammation and cobblestone throat, such as smoking, vaping and/or air pollution.
Ever feel like there may be sourish fluid from your tummy that finds its way back into your mouth, or a burning sensation in your throat/tummy? These are possible symptoms of gastro-esophageal reflux disease (GERD) which can also be a cause for inflammation and irritation in the throat. You can read more about GERD at the link above!
5. Thicker mucous
This would be diagnosis of exclusion, and you would need to have a review with your doctor to ascertain none of the other possible causes are leading to the irritation. With thicker mucous, there are reports that irritation in the throat can develop. This may arise as a result of inadequate hydration and/or certain medications. Once again, a period of rest and hydration may provide relief, but if symptoms persists for more than 2-3 days, do visit your doctor for an examination.
Finally, as with most medical issues, occasionally there can be more insidious causes of a given finding which your doctor would look out for. In the case of cobblestone throat, these include certain growths and or blood cell disorders that can be and early sign of potentially serious diseases.
Ultimately, as you probably gathered above, a period of rest and increased water intake will provide significant relief of cobblestone throat arising from most common causes.
However, if you find your symptoms are persisting more than 2-3 days, or developing with other concomitant problems such as painful lumps in the neck, ear discomfort, or blood in your phlegm, do have an early review with your family doctor. Depending on his findings, he would be able to offer tailored therapy or, if required, a referral to a specialist colleague for further assessment. The latter may be a specialist from Otolaryngology (or "Ear, Nose, Throat (ENT)") for further evaluation and consideration if a scope may be required.
For greater convenience, you may consider having an initial consultation online via video call with a doctor to assess whether you really need to make that trip down. Several of these applications also provide specialist referrals and/or medication delivery to your home as well.