“Cobblestone throat” describes bumps on the back of the throat alongside soreness and irritation. Causes include allergies, postnasal drip and viral infections, such as flu.

Cobblestone throat is a term to describe bumps on the back of the throat that resemble the texture of a cobblestone street. It can cause the throat to feel swollen, irritated, or itchy.

It is sometimes possible to treat cobblestone throat with home remedies. However, it is best to consult a doctor for advice and treatment if symptoms persist.

This article discusses the symptoms, causes, treatment, and prevention of cobblestone throat and how doctors diagnose it.

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For some people, cobblestone throat does not cause symptoms. However, people may develop cobblestone throat when they have symptoms of other conditions, such as heartburn or allergic rhinitis, commonly known as hay fever.

The characteristic symptoms of cobblestone throat are bumps and swelling at the back of the throat, glands, or mouth. The bumps are due to inflamed tissue.

Other symptoms of cobblestone throat may include:

In cobblestone throat, polygonal cells bulge out from the soft tissue lining the pharynx or behind the tonsils. The cells swell in reaction to an irritant, such as allergens or infection.

Postnasal drip (PND), which is excess nose and throat mucus, often causes cobblestone throat. Postnasal drip occurs when the nose produces too much mucus, or the mucus becomes too thick. It then runs through the nose or down the back of the throat, known as the nasopharynx, which can cause irritation.

Another common cause of cobblestone throat is pharyngitis, most often due to a viral infection, such as the common cold or flu. Pharyngitis is the medical term for a sore throat. Some other viruses that can cause pharyngitis and cobblestone throat include:

Less commonly, the cause of pharyngitis and cobblestone throat is a bacterial infection, such as group A streptococcus, also known as strep throat.

Other causes of cobblestone throat include:

  • Allergies: Breathing in allergens such as pet dander, pollen, and mold spores can irritate the throat.
  • Silent reflux: Stomach acid flows back into the esophagus, causing throat irritation and damage.

It is important to consult a doctor if additional symptoms accompany a sore throat.

Cobblestone throat is not typically a symptom of cancer.

A doctor will usually be able to diagnose cobblestone throat, and its cause, by performing a physical examination.

They will check the throat for signs of infection or swelling. If a doctor concludes that cobblestone throat is not due to a viral infection, they may order other tests, such as a blood test and a throat culture, which involves using a swab to test for bacteria and less common viruses.

A doctor may also ask questions about how long the throat has been sore and whether the patient has allergies or a history of conditions such as acid reflux.

Learn how to tell whether a sore throat is due to an allergy or a cold.

Treatment for cobblestone throat depends on the underlying cause. For bacterial infections, a doctor may prescribe antibiotics, which kill bacteria and prevent them from reproducing.

Viral infections, such as flu, do not respond to antibiotics and usually get better without treatment. Pharyngitis usually resolves within 7–10 days.

Home remedies

The following home remedies may help relieve pain and discomfort:

  • drinking plenty of water
  • resting
  • consuming manuka honey to reduce inflammation
  • drinking warm beverages, such as tea
  • gargling salt water
  • sucking on a throat lozenge
  • using nasal sprays for postnasal drip

Read about 15 natural remedies for a sore throat.

The following tips may help reduce the risk of cobblestone throat due to allergies and bacterial or viral infections:

  • avoid allergy triggers
  • take allergy medications as a doctor or health professional recommends
  • practice regular and thorough handwashing
  • avoid contact with people who have contagious viral or bacterial infections
  • cover the mouth and nose when coughing or sneezing, using the inside of the elbow
  • avoid sharing towels, toiletries, and eating utensils
  • clean surfaces regularly

Cobblestone throat typically disappears within a few weeks if caused by an allergy or a viral infection, such as a cold or flu. However, bacterial infections may require antibiotics.

If cobblestone throat persists, it may be due to postnasal drip or a condition such as acid reflux. If symptoms worsen or last longer than a few weeks, a person should consult a doctor.

The characteristics of cobblestone throat are bumps in the back of the mouth or throat that resemble a cobblestone texture. A doctor can usually diagnose cobblestone throat with a physical examination.

Viral or bacterial infections, allergic rhinitis, and acid reflux typically cause cobblestone throat, which usually resolves without treatment. Some home remedies may help reduce pain and swelling. Doctors may prescribe antibiotics if the cause is a bacterial infection.