Causes and when to see a doctor

A chronic or persistent sore throat can result from smoking, allergies, infections, mouth breathing, and other causes. It can also stem from an underlying condition, such as gastroesophageal reflux disease (GERD) or cancer.

Chronic throat pain often results from lingering throat infections, irritants or allergens in the air, or dry air conditions. People with allergies or asthma may be especially sensitive to these triggers.

Some causes of a chronic sore throat require medical treatment. See a doctor if a sore throat lasts longer than 5–10 days.

In this article, we look at common reasons why a chronic sore throat develops.

Share on PinterestPossible causes of a chronic sore throat include smoking, air pollution, and allergic reactions.

Inhaling smoke irritates the sensitive tissues lining the throat. This irritation results from inhaling the hot, dry air and toxic chemicals in tobacco smoke. People who smoke regularly may experience a sore throat that does not go away.

Smoking also makes a person more susceptible to health conditions that can cause a sore throat, including a cold, the flu, and respiratory tract infections. This is because smoking weakens the functioning of the immune system. It also increases a person’s risk of throat cancer, and a lasting sore throat can be a symptom of the disease.

If a person smokes and develops a sore throat that does not go away or comes and goes regularly, they should see their healthcare provider. A doctor can also provide assistance to anyone who wants to quit.

Smog and air pollution are common in larger cities and in areas near industrial factories or power plants. Breathing in smog or air pollution has similar health consequences to inhaling smoke from a cigarette. Inhaling smog on hot days can be particularly harmful.

People who breathe in polluted air may experience symptoms such as:

• pain in the chest
• a sore throat
• coughing
• other asthma symptoms

Allergens are substances that cause an allergic reaction. Allergens can include foods, pollen, and chemicals in cleaning products or cosmetics, for example.

People with seasonal allergies may notice lasting throat irritation during warm months and other times when the pollen count is high.

Allergies can cause postnasal drip, which involves excess mucus draining down the back of the nasal passage into the throat. Postnasal drip can lead to a persistent, raw sore throat.

Colds and the flu, reactions to medication, and certain weather conditions can also trigger postnasal drip.

A person allergic to an airborne substance such as pollen, grass, or mildew may experience any of the following symptoms when exposed to the allergen:

• itchy eyes
• a runny nose
• coughing and sneezing
• watery eyes
• postnasal drip

A person can develop a sore throat from breathing through their mouth for a long period. This is most likely to occur while a person sleeps.

A person may be breathing through their mouth overnight if they wake up with a dry mouth that goes away after drinking or eating.

Obstructions to the nasal passage — from enlarged tonsils or excess mucus, for example — can cause a person to breathe through their mouth while asleep.

Anyone who consistently wakes up with a sore throat should consult a healthcare provider.

A lingering cold or flu can cause pain in the throat for weeks after the main infection has begun to subside.

Colds and the flu are caused by viruses, and viral infections are the most common cause of sore throats. They usually go away on their own with time.

Otherwise, a bacterial infection — such as strep throat — may be the underlying issue. Antibiotics can treat bacterial infections, but they will not treat infections caused by viruses.

Share on PinterestSymptoms of tonsillitis include swollen tonsils, a fever, and difficulty swallowing.

Tonsillitis is a throat infection that causes inflammation. Both viruses and bacteria can cause tonsillitis.

Children are more prone to tonsillitis, but it can affect people of any age. The treatment will depend on whether the infection is bacterial or viral.

Some additional symptoms of tonsillitis include:

• red or swollen tonsils
• a fever
• chills
• difficulty swallowing
• a hoarse or scratchy voice
• a severe sore throat
• yellow or white spots on the tonsils
• bad breath

Mononucleosis — typically referred to as mono — can last for up to 2 months. Mono often causes flu-like symptoms, which can include a sore throat.

In some cases, the sore throat lasts for the duration of the infection.

A peritonsillar abscess results from a bacterial infection in the tonsil.

A peritonsillar abscess can develop when tonsillitis does not fully heal. The abscess forms as a pus-filled bump on one tonsil, and the infection then spreads to surrounding tissue.

Symptoms of a peritonsillar abscess are very similar to those of tonsillitis, but they are often much more severe. If a person receives treatment for tonsillitis, but the infection does not appear to go away, they should consult a doctor.

Gonorrhea is a very common sexually transmitted infection in the United States. The Neisseria gonorrhoeae bacterium causes it.

In addition to affecting the genitals, gonorrhea can also develop in the throat, after oral sex.

Acid reflux occurs when a muscle at the top of the stomach weakens and leaks acid into the esophagus, which is the tube that connects the mouth and stomach.

This causes a painful burning sensation known as heartburn.

Acid reflux can cause a sore throat. Anyone who suspects that they have acid reflux should speak to their doctor about treatments. Over time, it can damage the esophagus and cause further health problems.

Learn more about sore throats and acid reflux.

A person with a weakened immune system is more likely to experience a chronic sore throat. This is because their body is less able to fight off infections when bacteria and viruses enter the body.

If a person has any of the following, they may have weakened immune system function:

• rheumatoid arthritis
• lupus
• HIV
• AIDS
• cancer and other conditions that require chemotherapy

Throat cancer, which is also called laryngeal cancer, can cause a chronic sore throat.

Some other symptoms of laryngeal cancer include:

• hoarseness or voice changes
• constant coughing
• difficulty or pain when swallowing
• trouble breathing
• weight loss
• a lump or mass in the neck

If cancer starts developing above the voice box, people may not notice hoarseness or voice changes.

The American Cancer Society recommend seeing a doctor if hoarseness or other voice changes last for more than 2 weeks.

Share on PinterestIf a sore throat lasts longer than 5–10 days, a person should consider seeing a doctor.

A person should see a doctor if a sore throat lasts longer than 5–10 days, according to the American Academy of Otolaryngology – Head and Neck Surgery.

Sore throats are often easy to diagnose and treat. However, seek immediate medical attention if any of the following occurs:

• a high fever
• difficulty turning the head
• swelling in the throat that impairs breathing, talking, or swallowing
• severe pain on one side of the throat and swollen glands
• a lump or obstruction in the throat

People can often relieve the pain of a sore throat using over-the-counter treatments and home remedies.

Read about 15 natural remedies for a sore throat.

Sore throats are common and can result from a variety of conditions and illnesses.

If sore throats occur frequently or become persistent — lasting longer than 5–10 days — speak to a doctor.

A healthcare provider can determine the cause and suggest effective treatments.

Causes and when to see a doctor

A chronic or persistent sore throat can result from smoking, allergies, infections, mouth breathing, and other causes. It can also stem from an underlying condition, such as gastroesophageal reflux disease (GERD) or cancer.

Chronic throat pain often results from lingering throat infections, irritants or allergens in the air, or dry air conditions. People with allergies or asthma may be especially sensitive to these triggers.

Some causes of a chronic sore throat require medical treatment. See a doctor if a sore throat lasts longer than 5–10 days.

In this article, we look at common reasons why a chronic sore throat develops.

Share on PinterestPossible causes of a chronic sore throat include smoking, air pollution, and allergic reactions.

Inhaling smoke irritates the sensitive tissues lining the throat. This irritation results from inhaling the hot, dry air and toxic chemicals in tobacco smoke. People who smoke regularly may experience a sore throat that does not go away.

Smoking also makes a person more susceptible to health conditions that can cause a sore throat, including a cold, the flu, and respiratory tract infections. This is because smoking weakens the functioning of the immune system. It also increases a person’s risk of throat cancer, and a lasting sore throat can be a symptom of the disease.

If a person smokes and develops a sore throat that does not go away or comes and goes regularly, they should see their healthcare provider. A doctor can also provide assistance to anyone who wants to quit.

Smog and air pollution are common in larger cities and in areas near industrial factories or power plants. Breathing in smog or air pollution has similar health consequences to inhaling smoke from a cigarette. Inhaling smog on hot days can be particularly harmful.

People who breathe in polluted air may experience symptoms such as:

• pain in the chest
• a sore throat
• coughing
• other asthma symptoms

Allergens are substances that cause an allergic reaction. Allergens can include foods, pollen, and chemicals in cleaning products or cosmetics, for example.

People with seasonal allergies may notice lasting throat irritation during warm months and other times when the pollen count is high.

Allergies can cause postnasal drip, which involves excess mucus draining down the back of the nasal passage into the throat. Postnasal drip can lead to a persistent, raw sore throat.

Colds and the flu, reactions to medication, and certain weather conditions can also trigger postnasal drip.

A person allergic to an airborne substance such as pollen, grass, or mildew may experience any of the following symptoms when exposed to the allergen:

• itchy eyes
• a runny nose
• coughing and sneezing
• watery eyes
• postnasal drip

A person can develop a sore throat from breathing through their mouth for a long period. This is most likely to occur while a person sleeps.

A person may be breathing through their mouth overnight if they wake up with a dry mouth that goes away after drinking or eating.

Obstructions to the nasal passage — from enlarged tonsils or excess mucus, for example — can cause a person to breathe through their mouth while asleep.

Anyone who consistently wakes up with a sore throat should consult a healthcare provider.

A lingering cold or flu can cause pain in the throat for weeks after the main infection has begun to subside.

Colds and the flu are caused by viruses, and viral infections are the most common cause of sore throats. They usually go away on their own with time.

Otherwise, a bacterial infection — such as strep throat — may be the underlying issue. Antibiotics can treat bacterial infections, but they will not treat infections caused by viruses.

Share on PinterestSymptoms of tonsillitis include swollen tonsils, a fever, and difficulty swallowing.

Tonsillitis is a throat infection that causes inflammation. Both viruses and bacteria can cause tonsillitis.

Children are more prone to tonsillitis, but it can affect people of any age. The treatment will depend on whether the infection is bacterial or viral.

Some additional symptoms of tonsillitis include:

• red or swollen tonsils
• a fever
• chills
• difficulty swallowing
• a hoarse or scratchy voice
• a severe sore throat
• yellow or white spots on the tonsils
• bad breath

Mononucleosis — typically referred to as mono — can last for up to 2 months. Mono often causes flu-like symptoms, which can include a sore throat.

In some cases, the sore throat lasts for the duration of the infection.

A peritonsillar abscess results from a bacterial infection in the tonsil.

A peritonsillar abscess can develop when tonsillitis does not fully heal. The abscess forms as a pus-filled bump on one tonsil, and the infection then spreads to surrounding tissue.

Symptoms of a peritonsillar abscess are very similar to those of tonsillitis, but they are often much more severe. If a person receives treatment for tonsillitis, but the infection does not appear to go away, they should consult a doctor.

Gonorrhea is a very common sexually transmitted infection in the United States. The Neisseria gonorrhoeae bacterium causes it.

In addition to affecting the genitals, gonorrhea can also develop in the throat, after oral sex.

Acid reflux occurs when a muscle at the top of the stomach weakens and leaks acid into the esophagus, which is the tube that connects the mouth and stomach.

This causes a painful burning sensation known as heartburn.

Acid reflux can cause a sore throat. Anyone who suspects that they have acid reflux should speak to their doctor about treatments. Over time, it can damage the esophagus and cause further health problems.

Learn more about sore throats and acid reflux.

A person with a weakened immune system is more likely to experience a chronic sore throat. This is because their body is less able to fight off infections when bacteria and viruses enter the body.

If a person has any of the following, they may have weakened immune system function:

• rheumatoid arthritis
• lupus
• HIV
• AIDS
• cancer and other conditions that require chemotherapy

Throat cancer, which is also called laryngeal cancer, can cause a chronic sore throat.

Some other symptoms of laryngeal cancer include:

• hoarseness or voice changes
• constant coughing
• difficulty or pain when swallowing
• trouble breathing
• weight loss
• a lump or mass in the neck

If cancer starts developing above the voice box, people may not notice hoarseness or voice changes.

The American Cancer Society recommend seeing a doctor if hoarseness or other voice changes last for more than 2 weeks.

Share on PinterestIf a sore throat lasts longer than 5–10 days, a person should consider seeing a doctor.

A person should see a doctor if a sore throat lasts longer than 5–10 days, according to the American Academy of Otolaryngology – Head and Neck Surgery.

Sore throats are often easy to diagnose and treat. However, seek immediate medical attention if any of the following occurs:

• a high fever
• difficulty turning the head
• swelling in the throat that impairs breathing, talking, or swallowing
• severe pain on one side of the throat and swollen glands
• a lump or obstruction in the throat

People can often relieve the pain of a sore throat using over-the-counter treatments and home remedies.

Read about 15 natural remedies for a sore throat.

Sore throats are common and can result from a variety of conditions and illnesses.

If sore throats occur frequently or become persistent — lasting longer than 5–10 days — speak to a doctor.

A healthcare provider can determine the cause and suggest effective treatments.

Constant pain and itching in the throat

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Contents

• Causes of constant sore throat

Patients with chronic sore throat come to our clinic every day. However, diseases of the pharynx are the most complex and polyetiological in otorhinolaryngology. In order to make a correct diagnosis, it is necessary to carry out a number of diagnostic measures.

Clinical manifestations of persistent sore throat are approximately the same: the phenomena of chronic tonsillitis and/or chronic pharyngitis. However, the same clinical manifestations can cause different causes. Not a single good eye specialist can tell what nature this inflammation is. And drugs prescribed without knowledge of the etiology of the disease are often ineffective.

1. Bacterial infections. The most dangerous bacterial causative agent of sore throat is B-hemolytic streptococcus group A. It can cause complications, such as frequent exacerbations of sore throat, paratonsillar abscesses, nephritis, arthritis, myocarditis (complications can occur after 20-30 years from an acute process) . In order to exclude the presence of streptococcal infection on the surface of the tonsils, there is Streptatest (express diagnostics for hemolytic streptococcus), performed in the clinic in 5 minutes. To assess the general condition and streptococcal intoxication, it is necessary to conduct a biochemical blood test (Antistreptolysin O, Rheumatoid factor, C-reactive protein). To exclude concomitant pathogenic flora, it is necessary to carry out sowing from the pharynx for flora and sensitivity to antibiotics and phages. Often found the presence of Staphiloccocus aureus, Pseudomonas aeruginosa. Knowing the pathogen and its sensitivity, it is possible to treat with phage preparations without resorting to systemic antibiotic therapy.
2. Viral infections. There are a number of chronic persistent viral infections that can cause persistent sore throat , such as chronic persistent herpes infections (Cytomegalvirus, Epstein-Barr virus, HSV type 6). By adulthood, almost every one of us has met with these infections and had been ill. The disease is acute once (often disguised as SARS), the virus remains in the body for life. But with a decrease in immunity, a replica of the virus (reproduction) is possible. How to find out? PCR studies of saliva are often not informative (70-80% reliability), the most informative for assessing the persistence of blood ELISA (determination of antibodies). To the Epstein-Barr virus, our body produces antibodies Ig M (capsid) in the acute phase of primary inflammation (infectious mononucleosis), Ig G capsid – antibodies to surface antigens, can be slightly increased throughout life, and Ig G nuclear (nuclear) – its increase indicates active viral replication and speaks of chronic persistent Epstein-Barr virus infection of unknown date of infection. There are also Ig M and G antibodies to Cytomegalvirus, an increase in the titer of Ig G antibodies to CMV by tens and hundreds of times indicates a persistent infection. Less common are Ig G antibodies to HSV type 6.
3. Fungal infections. Such infections are more likely to occur in people after a long-term illness, after several courses of antibiotic therapy, patients with immunosuppression (taking cytostatics, hormones, chemotherapy, tuberculosis, HIV infection, etc.). To diagnose and verify the pathogen, you can take culture from the pharynx for fungi and sensitivity to antimycotics.

In conclusion, I would like to give you a clinical case:

In February 2018, patient A, 18 years old, came to our clinic with complaints of discomfort in the throat, a feeling of a foreign body in the throat, which appeared in August 2017. She was repeatedly consulted by an otorhinolaryngologist, local therapy was prescribed (gargling with antiseptics, antiseptic absorbable lozenges), with a temporary effect. The diagnosis is also suspected: pharyngoneurosis, consultation of a neurologist is recommended.

Objective data during endoscopic ENT examination of the pharynx: the oral mucosa is pink, clean, there is hyperemia of the anterior palatine arches. Tonsils 2 tbsp, soldered, cicatricially changed, in lacunae caseous masses. The back wall is pink, dry.

Diagnosed:
chronic tonsillitis, chronic pharyngitis.

Examination carried out. According to the results of the analyzes, the presence of Streptococcus puogenus in the throat, an increase in the titer of antistreptolysin O-350 and C-reactive protein – 6.4, an increase in nuclear Ig G to the Epstein-Barr virus – 500. Thus, the causative agents of the disease were verified, streptococcal infection and chronic persistent Epstein-Barr virus infection.

The patient was prescribed etiotropic treatment, a course of washing the lacunae of the tonsils No. 5, physiotherapy (K-laser nose/pharynx No. 10) with a pronounced positive effect.

Thus it becomes clear why self-treatment does not lead to a positive effect.

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Sore throat – causes

What can sore throat signal? About SARS? Angina? Tonsillitis? As it turns out, there could be many more reasons.

What can a sore throat signal? About SARS? Angina? Tonsillitis? As it turns out, there could be many more reasons.

Emelyanova Alexandra Nikolaevna, our permanent consultant, Candidate of Medical Sciences, otolaryngologist at LLC “Expert Clinic Kursk” told us about this and many other things.

－ Alexandra Nikolaevna, everyone has experienced a sore throat at least once in their life. What disease accompanies this symptom?

There are many. Pathologies of the pharynx itself: its injuries and wounds, foreign bodies, burns, inflammatory processes, fungal infections, tuberculosis and syphilis, purulent lesions (including palatine tonsils, cellular spaces of the pharynx), neoplasms.

In addition, soreness in the throat can appear with infectious mononucleosis, agranulocytosis, leukemia.

Sore throat can also occur with pathologies of organs adjacent to the pharynx – for example, with foreign bodies, inflammation and neoplasms of the larynx, diseases of the esophagus.

Sometimes the cause is associated with diseases of the nervous system, namely with neuralgia of some nerves (for example, vidian, glossopharyngeal, stellate and geniculate). Despite this, the patient can often first turn to an ENT doctor, and only then will be redirected to another specialist.

－ What could be the causes of a persistent sore throat?

These are the neurological syndromes that I mentioned earlier, the stylohyoid muscle syndrome, tumors in fairly advanced stages, as well as such a disease of the gastrointestinal tract as gastroesophageal reflux disease.

－ What is the difference between tonsillitis and tonsillitis?

If we are talking specifically about acute tonsillitis, then he and tonsillitis are one and the same. At the same time, otolaryngologists, for the convenience of classification, are in favor of retaining the term “acute tonsillitis” and the abolition of tonsillitis. Both definitions are in use today.

－ How often does acute tonsillitis become chronic?

Accurate statistics are hard to come by, but in practice this happens quite often.

－ Is chronic tonsillitis somehow coded in ICD-10?

Yes, its code for this classification is J35. 0.

－ What are the symptoms of chronic tonsillitis?

Discomfort, as well as recurrent sore throat, some fever (intermittent or constant), bad breath. In the lacunae of the tonsils there may be pus, their edges are reddened, the size may be increased. The lymph nodes of the neck are enlarged.

－ On what principles are clinical guidelines for the treatment of acute tonsillitis based?

Standardized clinical guidelines do not yet exist for the treatment of tonsillitis.

If the bacterial nature of the disease is proven, it is necessary to carry out general antibiotic therapy, prescribe anti-inflammatory drugs (systemically and locally), desensitizing drugs, and local use of antiseptics.

In the acute stage, washing of the tonsils should not be used, it is undesirable to lubricate them with drugs. With fever, physiotherapy is contraindicated.

－ Alexandra Nikolaevna, what methods are effective in the treatment of patients with chronic tonsillitis?

Here the range of treatment possibilities is wider, and the best treatment of chronic tonsillitis, as in many pathologies, is complex. Antibiotics may be used as indicated. Washing and lubrication of the palatine tonsils with drugs are used, the introduction of drugs into them using phono- and electrophoresis. It is extremely rare that antibiotics are injected into the tonsils and paratonsillarly. Sometimes bacteriophages are used topically.

General tonic preparations, vitamins, adaptogens, physiotherapy, hardening, spa treatment are shown.

－ Does chronic tonsillitis always involve removal of the tonsils? Or does this method have its pros and cons?

Not always. A few decades ago, this operation was carried out more often than at present. The issue of removing the tonsils is decided on an individual basis, taking into account the effectiveness of the treatment, the number of exacerbations of tonsillitis over a certain period of time, the threat of development or an existing complication of the disease, and some others.

A number of scientists are of the opinion that the removal of the tonsils is not a prevention of the development of possible complications of tonsillitis. It is believed that after tonsillectomy, inflammatory pathologies of various parts of the respiratory tract develop more often.

Despite this, as well as a wide range of non-surgical treatments, indications for surgery still exist today. Among them: the lack of effect of conservative therapy with a simple form of chronic tonsillitis or a toxic-allergic form of the first degree after 2-3 courses of therapy; toxic-allergic form of the second degree; the presence of paratonsillar abscess, parapharyngitis, acute and chronic tonsillar sepsis, rheumatism, suspicion of a malignant neoplasm of the tonsil and a number of others.

－ Is there a difference in the treatment of chronic tonsillitis in adults and children?

The principles are the same, however, in young children there are limitations in terms of manipulation interventions in the form of washing, lubricating, irrigation of the tonsils, physiotherapy.

－ Why is tonsillitis dangerous and what will happen if it is not treated?

Complications may develop – both local (for example, paratonsillar abscess, parapharyngeal or deep phlegmon of the neck, tonsillogenic sepsis), and remote (for example, various infectious lesions of organs associated with group A beta-hemolytic streptococcus, and some others). 0003

－ What is the prognosis for chronic tonsillitis?

It depends, among other things, on the form of the disease, the general reactivity of the body, the patient’s adherence to the prescribed treatment.

－ What is the prevention of exacerbations in chronic tonsillitis?

Medications, physiotherapy, various types of hardening, phytoadaptogens, immunomodulators according to indications are used. These courses are held twice a year. Even in the absence of an exacerbation, it is necessary to see an ENT doctor at least once a year.

－ If you often have a sore throat, which doctor should you consult?

In practice, the first doctor you should consult is an otolaryngologist. But since we already know that sore throats can also be associated with other ailments, after excluding “their” diseases, the patient can be referred for a consultation with an infectious disease specialist, hematologist, gastroenterologist, neurologist, endocrinologist.