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Doc: why do I keep getting sore throats?

Chronic sore throat: potential causes & concerns

Dear Friends,


Welcome back to TGIF Dr Euan's Blogpost!


Today, we will look at a very common problem that affects millions of people worldwide: Chronic or Persistent Sore Throat.



Chronic pharyngitis is a recurrent or persistent sore throat that lingers for a few weeks or returns frequently. Chronic pharyngitis may be caused by infection, environmental pollutants, allergies, or acid reflux.


Correct and accurate Diagnosis will lead to appropriate treatment to address the underlying cause.


Q: What are the signs and symptoms of chronic pharyngitis?

Chronic pharyngitis symptoms are similar to acute pharyngitis symptoms. Generally, the condition is considered to be chronic if symptoms linger for longer than 10 days. Common warning signs include:

  • Pain or scratchiness in your throat.

  • Swollen lymph glands in your neck.

  • Hoarseness.

  • Difficulty swallowing.

  • A ticklish sensation in your throat.

  • A tired voice.

  • A sensation that something is stuck at the back of your throat.

If you have an infection as well as having a sore throat, you may also experience:

  • Fever.

  • Headaches.

  • Nausea and vomiting.

  • Coughing.

  • Sneezing.

Q: What’s the most common cause of a sore throat?

Infections are still the most common cause of both acute and chronic pharyngitis.


However, a number of other factors can result in chronic pharyngitis, including:

  • Persistent tonsillitis, a condition in which your tonsils become chronically inflamed and infected.

  • Environmental pollutants, such as cigarette smoke and chemicals.

  • Allergic reactions to pollen, mold, and pet dander.

  • Laryngo-pharyngeal reflux (LPR), where stomach acid goes back up into your throat and causes irritation.

Very rarely, throat cancer can cause chronic sore throat. This type of cancer starts in your pharynx or larynx (voice box). The resulting throat pain may be accompanied by shortness of breath, lumps in your neck, or bleeding from your nose or mouth.


Q: How is chronic pharyngitis diagnosed?

Your GP will begin with a physical examination. He / She may also recommend a throat culture or rapid antigen detection testing for strep throat — especially if they think your pharyngitis is due to something other than a virus.

If needed, your GP may refer you to see an ENT Specialist for a more detailed examination, including a flexible, fiber-optic Naso-endoscopy.

Photo showing nasoendoscopy in clinic


Q: How is chronic pharyngitis treated?

Treatment for chronic pharyngitis depends on the underlying cause. Once your healthcare provider determines what led to your sore throat, they’ll recommend an appropriate course of action.


Tonsillitis

In most cases, tonsillitis is treated with antibiotics. If the condition returns frequently, then your healthcare provider may recommend a tonsillectomy.


Environmental pollutants

Sometimes smoke, chemicals or other environmental pollutants can cause chronic pharyngitis. In these cases, you must avoid all situations in which you’re exposed to these triggers. This should promote healing and reduce symptoms.

An image of a pack of cigarettes warning of the increased risk of cancer from smoking


Allergic reactions

Oftentimes, nasal sprays and other over-the-counter medications can effectively treat chronic pharyngitis caused by allergies. In severe cases, you may need to schedule an appointment with an ear, nose, and throat (ENT) specialist.


Acid reflux

People with laryngo-pharyngeal reflux (LPR) may benefit from certain lifestyle changes, such as stress reduction, losing weight, and altering their diet. Proton-pump inhibitors (medication) can also help reduce symptoms eg Nexium / Pariet

Photo from scope of swollen larynx affected by GERD

Throat cancer

If you have throat cancer, you will need to undergo staging scans followed by definitive treatment, such as surgery, chemotherapy or radiation therapy, or a combination of these modalities. Ultimately, the specific treatment will depend on the type, stage, and location of the cancer.


Q: Doc, how can I manage symptoms of chronic pharyngitis?Are there any home remedies I can try?

Addressing the underlying cause is the only way to treat chronic pharyngitis. However, there are a few chronic pharyngitis home remedies you can try to ease your sore throat symptoms:

  • Drink lots of water.

  • Take over-the-counter pain relievers, such as acetaminophen, naproxen sodium, or ibuprofen.

  • Gargle with warm salt water a few times a day.

  • STOP smoking.

Q: What happens if chronic pharyngitis is left untreated?

In some cases, a chronic sore throat can have serious health consequences. So, it is vitally important to schedule a visit with your GP right away if your symptoms do not go away after 2 weeks. If needed, your GP may recommend you see an ENT Specialist for further evaluation.


If you would are experiencing symptoms of sinusitis, laryngitis, or prolonged sore throat, please feel free to make an appointment with us today.


Here are some useful references for more reading, if you are keen to learn more:


REFERENCES:

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