Orris

I have adenoids grade 2, cobblestone appearance in throat and i get feelibg of sick when i am in room with aircondition or cold area

Reading File
Finding Sources
Finding Sources
Finding Sources
Reading File
Reading File
Finding Sources
Finding Sources
Reading File
Reading File
Finding Sources
Reading File
Finding Sources
I now have solid information to give you a thorough, well-sourced answer.

Your Symptoms - What They Mean and What to Do

Your three findings - adenoid grade 2 hypertrophy, cobblestone appearance in the throat, and symptoms triggered by air conditioning / cold air - are all connected and point to the same underlying condition: chronic allergic rhinitis (or non-allergic rhinitis) with upper airway hyperreactivity.

1. Cobblestone Throat = Posterior Pharyngeal Lymphoid Hyperplasia

The "cobblestone" appearance on the back of your throat is not an infection - it is lymphoid hyperplasia of the posterior pharyngeal wall, a classic sign of allergic rhinitis. The lymphoid tissue becomes chronically enlarged due to continuous exposure to allergens or irritants, post-nasal drip irritating the back wall, and ongoing low-grade inflammation.
Classic signs of allergic rhinitis that cluster together (from Swanson's Family Medicine Review):
  • Pale, boggy nasal turbinates
  • Post-nasal drainage
  • Cobblestoning (lymphoid hyperplasia) of posterior pharyngeal wall -- this is your throat finding
  • Allergic shiners (dark under-eyes)
  • Allergic gape (mouth breathing)

2. Adenoid Grade 2 Hypertrophy

Adenoid hypertrophy (grade 2 = moderate, blocking roughly 25-50% of the nasopharynx) in adults is commonly driven by:
  • Persistent allergic rhinitis / chronic rhinosinusitis - the most likely cause in your case
  • Chronic adenoiditis (bacterial biofilm on adenoid surface)
  • Less commonly: HIV or lymphoproliferative disorders (worth excluding if you have risk factors)
The adenoid acts as a reservoir for bacteria and maintains the inflammatory cycle. (Scott-Brown's Otorhinolaryngology, Bailey and Love's Surgery)
Associated disorders you are at risk for (from Swanson's Family Medicine Review):
  • Chronic sinusitis
  • Otitis media / Eustachian tube dysfunction (ear blockage/pressure)
  • Obstructive sleep apnea
  • Asthma

3. Feeling Sick in Air-Conditioned / Cold Rooms

This is a textbook symptom of non-allergic rhinitis with nasal hyperreactivity - specifically, cold dry air (CDA) provokes your nasal mucosa.
From Scott-Brown's Otorhinolaryngology Head & Neck Surgery:
"Cold, dry air has been shown to lead to a condition known as skier's nose, in which rhinorrhoea features prominently... Cold dry air (CDA) challenge has been suggested to differentiate best between controls and idiopathic rhinitis patients."
The mechanism: Your nasal mucous membranes are sensitized and hyperreactive. Cold, dry air from A/C units strips moisture from the mucosa, triggers parasympathetic over-activity (runny nose, congestion, sneezing), and may also provoke a systemic "sick" feeling (fatigue, headache, throat irritation) through post-nasal drip and mucosal inflammation.

What You Should Do

Step 1: See an ENT (Otolaryngologist) or Allergist
  • Allergy skin testing or RAST (specific IgE blood test) to identify your triggers (dust mites, mold, animal dander, pollens are most common for perennial symptoms)
  • Nasal endoscopy to assess adenoid size and sinus drainage
Step 2: First-line Medical Treatment
TreatmentWhat It Does
Intranasal corticosteroid spray (e.g. fluticasone, mometasone, budesonide)First-line, most effective - reduces mucosal inflammation, shrinks turbinates and adenoids over time
Non-sedating antihistamine (e.g. cetirizine, loratadine, fexofenadine)Helps rhinorrhoea, sneezing, itching
Nasal saline irrigation (e.g. neti pot, saline sprays)Washes out allergens, thins mucus, soothes mucosa - very helpful for cold/A.C. sensitivity
Leukotriene antagonist (e.g. montelukast)Can be added to antihistamine for better effect
Intranasal corticosteroids are by far the most efficacious agents for allergic rhinitis - Swanson's Family Medicine Review
Step 3: Environmental Modifications
  • Use a humidifier in air-conditioned rooms - dry air is a major trigger; keeping humidity around 40-50% prevents cold dry air irritation
  • Use a HEPA air filter to reduce airborne allergens (dust, mold spores)
  • Cover your nose/mouth briefly when entering very cold air-conditioned spaces
  • Avoid known triggers (dust, mold, pet dander)
Step 4: If Medications Don't Help - Immunotherapy If pharmacological treatment gives inadequate relief, allergen immunotherapy (allergy shots or sublingual drops) is effective for long-term desensitization, especially for perennial allergens. It is the only treatment that modifies the underlying disease.
Step 5: Regarding the Adenoids Grade 2 is moderate and does not automatically require surgery. With proper treatment of the underlying allergic rhinitis, adenoid size often decreases. Surgery (adenoidectomy) is reserved for:
  • Grade 3-4 with significant nasal obstruction
  • Recurrent sinusitis/otitis media unresponsive to medical treatment
  • Obstructive sleep apnea

Key Takeaway

All three of your symptoms are part of the same picture: chronic upper airway inflammation (likely allergic in nature) causing reactive lymphoid tissue, adenoid enlargement, and a hyperreactive nasal mucosa that reacts strongly to cold/dry air. The condition is very treatable with the right combination of nasal steroid spray, antihistamines, saline irrigation, and allergen avoidance. Please see an ENT or allergist for testing and a personalized treatment plan.
Sources: Swanson's Family Medicine Review 9e; Scott-Brown's Otorhinolaryngology Head & Neck Surgery (Vol 1 & 2); Cummings Otolaryngology Head and Neck Surgery
This is a shared conversation. Sign in to Orris to start your own chat.