What is Chronic Pharyngitis?
Suffering from a sore throat? You may be experiencing Chronic Pharyngitis, a frequent type of pharyngitis characterized by inflammation and soreness of the throat. Symptoms include swollen glands in the neck, a tickling sensation, dryness, hoarseness, difficulty swallowing, earache, and bad breath. Fortunately, treatment is available and includes antibiotics, lifestyle changes, and oxygen therapy. Diagnosis is based on a thorough physical examination and medical history, and relief is often quick with minimal side effects. It's important to note that Chronic Pharyngitis can take an acute form and become chronic if left untreated.
What is Chronic Pharyngitis?
Chronic pharyngitis is an inflammation of the pharynx that can last for extended periods of time. The pharynx is the part of your throat that is situated between your nasal and oral cavities. It’s responsible for sending air and food to their respective destinations.
Chronic pharyngitis can be caused by a variety of factors, including infection, poor diet, exposure to environmental toxins, and more. It’s a condition that can lead to a range of different symptoms, including sore throat, difficulty swallowing, hoarseness, and loss of voice. It can range in severity and requires different treatments depending on the cause.
Causes of Chronic Pharyngitis
The most common cause of chronic pharyngitis is infection, typically bacterial or viral in nature. Bacteria such as streptococcus and viruses like the common cold virus can cause chronic throat inflammation. Other causes of chronic pharyngitis can include sustained irritation due to smoking or air pollution, acid reflux, or occupational hazards such as exposure to harsh chemicals.
Symptoms of Chronic Pharyngitis
The main symptom of chronic pharyngitis is a sore throat that will not go away. It can also cause difficulty swallowing, hoarseness, and a change in your voice. Other symptoms may include a cough, a lump in your throat, a feeling of something stuck in your throat, headaches, ear pain, or an itchy throat.
Diagnosis of Chronic Pharyngitis
Your doctor will do a physical examination and take a medical history to help diagnose your condition. This will include asking about your symptoms and their severity. Your doctor may also take a sample of your throat using a swab and have it tested for infection. This can help rule out or confirm a bacterial or viral infection. Your doctor will also look for possible causes such as acid reflux, environmental irritants, smoking, or occupational exposure.
Treatment of Chronic Pharyngitis
The main treatment for chronic pharyngitis is aimed at treating the underlying cause. If your condition is caused by a bacterial or viral infection, your doctor will prescribe antibiotics or antiviral medications. If your chronic pharyngitis is caused by acid reflux, your doctor may recommend some lifestyle changes such as avoiding smoking, eating smaller meals more frequently, and monitoring your diet.
Your doctor may also prescribe anti-inflammatory medications to help reduce throat inflammation and relax the throat muscles, as well as painkillers to help manage the pain and discomfort.
Risk Factors for Chronic Pharyngitis
You’re at an increased risk of developing chronic pharyngitis if you’re exposed to environmental irritants such as pollutants, and are a heavy smoker or consume large amounts of alcohol. It’s also more common if you have a weakened immune system due to disease or medication.
Possible Complications of Chronic Pharyngitis
Left untreated, chronic pharyngitis can lead to complications such as vocal cord paralysis, aspiration pneumonia, and difficulty in swallowing or breathing. If you’ve been diagnosed with chronic pharyngitis, it’s important to listen to your doctor’s advice and treatment plan. Left untreated, chronic pharyngitis can have serious consequences.
Preventing Chronic Pharyngitis
Making some simple lifestyle changes can help reduce your risk of developing chronic pharyngitis. These include:
Avoid Smoking and Second Hand Smoke
Smoking and being exposed to secondhand smoke can increase your risk of developing chronic pharyngitis, so avoiding smoke is the best way to protect yourself.
Eat a Nutritious Diet
Eating a balanced and healthy diet can help strengthen your immune system and reduce your risk of infection. Choose plenty of fruits, vegetables, and other healthy foods.
Avoid Occupational Hazards
Certain occupations, such as those in farming or construction, increase your risk of developing chronic pharyngitis. If you work in these industries, always wear the correct safety equipment to protect yourself from environmental hazards.
Get Vaccinated
Getting vaccinated against the common cold, flu, and other infections can help protect against chronic pharyngitis. Talk to your healthcare provider to find out which vaccines are recommended for you.
When to See a Doctor for Chronic Pharyngitis
If you’re experiencing any of the symptoms of chronic pharyngitis, it’s important to seek medical advice from your doctor. Your doctor can help diagnose and treat your condition and make sure any possible complications are avoided.
Chronic pharyngitis is an inflammation of the pharynx that can cause a range of symptoms from a sore throat to difficulty in breathing. It can be caused by infections, environmental irritants, acid reflux, smoking, and occupational hazards. Treatment for chronic pharyngitis is aimed at treating the underlying cause, and can range from antibiotics or antivirals to lifestyle changes and pain relief. To prevent chronic pharyngitis, it is important to avoid smoking and secondhand smoke, eat a nutritious diet, avoid occupational hazards, and get vaccinated.
If you’re experiencing any of the symptoms of chronic pharyngitis, it’s important to seek medical advice from your doctor. They can diagnose and treat your condition and ensure any possible complications are avoided.
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Also known as a persistent sore throat, chronic pharyngitis differs from acute pharyngitis in that it lasts for a considerably longer time and does not respond to treatments for acute pharyngitis.
Pharyngitis is an inflammatory condition of the back of the throat, the pharynx. Chronic Pharyngitis is more common, and symptoms usually resolve within ten days.[1] Treatment for Chronic Pharyngitis is usually focussed on treating the symptoms. Most cases of Chronic Pharyngitis are viral, but some are bacterial. Antibiotics are only helpful if bacterial infection is the cause for Chronic Pharyngitis. But even if it clearly is bacterial, which can sometimes be hard to tell, antibiotic treatment is not necessarily recommended for all patient groups. However, chronic pharyngitis can be caused by a number of different factors besides infection.
In chronic pharyngitis, the soreness either does not go away or recurs frequently. Pharyngitis may be chronic if the sore throat lasts for more than a few weeks. There are several underlying causes for chronic pharyngitis, and treatment depends on what the underlying cause is.
Symptoms of chronic pharyngitis
The symptoms of chronic pharyngitis resemble those of acute pharyngitis, and include:[2][3]
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Causes of chronic pharyngitis
Chronic pharyngitis has many potential underlying causes, and if a sore throat does not clear up even after a course of antibiotics, it is best to seek further medical advice. Chronic pharyngitis may be caused by factors such as:
Effect of Smoke and environmental pollutants on Chronic Pharyngitis
Smoke contains fine particles of solid, gas and liquid matter carried in air, and may include harmful chemicals as well as fragments of burnt material.[4] Smoke may be generated by burning tobacco, wood, grass, coal, plastic, structures, burn pits, landfill fires, traffic exhaust, industrial exhaust or almost any other combustible material or activity that involves carbon combustion.[5]
The exact chemicals and particles carried in smoke depend on what is producing the smoke. Fine particle pollution is a common problem in urban areas as well as in households and undeveloped areas that rely on wood and coal fires for heat and/or cooking.
The degree to which smoke and other airborne environmental pollutants can cause throat pain and lung problems varies from person to person, but, when problems occur, they commonly manifest as a dry, sore throat, runny nose and coughing.[6] Long-term or frequent exposure to smoke can cause persistent pharyngitis.
Persistent tonsillitis Chronic Pharyngitis
Another common cause of persistent sore throat is an infection of the structures in or surrounding the throat. In people who still have their tonsils, these are the structures most often affected. This is known as tonsillitis, and other symptoms that may be present include:[7][8]
Allergic rhinitis
Allergic rhinitis is also known as hay fever and is a condition in which the body’s immune system responds aggressively to harmless particles such as pollen, mold or pet dander. Depending on what triggers the immune response, allergic rhinitis can cause symptoms seasonally or all year.[9]
In allergic rhinitis, the body responds to the allergen by releasing histamines, which cause the lining of the sinuses, eyes and nostrils to become inflamed. Nasal congestion, sneezing, postnasal drip and an itchy throat are all common symptoms of allergic rhinitis.[10] See this resource on hay fever for more information.
Good to know: In postnasal drip, the mucus glands of the nose and throat produce excessive amounts of thick mucus, which can cause the pharynx to feel swollen and irritated.[11]Postnasal drip and the itchy, painful throat associated with allergic rhinitis can both cause a recurring or constant sore throat.
Laryngo-pharyngeal reflux
Laryngopharyngeal reflux (LPR) is a disorder associated with gastroesophageal reflux disease (GERD), in which reflux of digestive acids from the stomach reaches the back of the throat and the nasal airway. In adults, the symptoms include:[12]
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LPR can be caused by dietary problems, abnormalities of the sphincters of the esophagus and being overweight. In many cases, certain foods may be associated with LPR. These include:[13]
Stress and smoking can also cause LPR. It is possible to have LPR without having GERD, or to have GERD without having LPR.
Eosinophilic esophagitis
Eosinophilic esophagitis is a disorder of the esophagus, in which allergic reactions cause the esophagus to become irritated and sometimes to narrow.[14]. This irritation may result from food allergies or environmental allergies.It is not possible to diagnose eosinophilic esophagitis using standard allergy tests, and it is difficult to pinpoint which foods are causing the problem, as allergic reactions are often delayed in this disorder.[15]
Symptoms of eosinophilic esophagitis include:[14][15]
Children with this disorder may refuse to eat, fail to thrive or vomit after meals, in addition to the above symptoms.
Food becoming lodged in the esophagus (food impaction) is a medical emergency in children and adults, and if it occurs, medical help should be sought immediately.
Throat cancer
Throat cancer is a fairly rare cause of chronic sore throat, but is nevertheless quite serious should it occur. Throat cancer generally begins in the larynx (voice-box) or the pharynx,[16] and throat pain is only one of a number of symptoms. Other symptoms include:[16][17]
The most important risk factors for throat cancer are smoking and alcohol consumption.[16][17]
Diagnosis and treatment of chronic pharyngitis
Chronic pharyngitis often indicates the presence of an underlying problem, and treatment to relieve it includes treating the underlying cause.
To relieve the sore throat itself, people with chronic pharyngitis can gargle with warm saline solutions, stay well-hydrated, avoid smoking and manage pain with over-the-counter medication such as acetaminophen/paracetamol. However, the underlying cause must be addressed.
In cases of chronic pharyngitis caused by smoke or environmental pollutants, the person must be removed from the environment where the smoke is present.
Tonsillitis is generally treated with an intensive course of antibiotics. If the disorder recurs often, or is particularly severe, tonsillectomy may be considered. A tonsillectomy is a relatively minor surgical procedure and is not associated with much postoperative pain.[7] For more information, see this resource on tonsillitis.
Allergic rhinitis is often treated with nasal sprays, saline sprays and over-the-counter allergy medications.[18] In more severe cases, an ear, nose and throat (ENT) specialist should be consulted. For more information, see this resource on allergic rhinitis.
Laryngo-pharyngeal reflux can be treated with lifestyle changes to remove triggers, such as stress and excess weight, dietary changes and medication. Proton-pump inhibitors, such as esomeprazole or omeprazole are often the first-line medications used to treat LRP in cases where lifestyle changes do not seem to be sufficient.[19]
People whose LPR is the result of physical abnormalities in the esophagus may need surgery to alleviate the disorder.
Eosinophilic esophagitis is usually diagnosed by a gastroenterologist or an ENT specialist and is treated with elimination or elemental diets to isolate and then remove the food triggers. Alongside the diet plan, symptoms may be treated with corticosteroids,[14] and proton-pump inhibitors.[15]
Throat cancer treatment depends on the type of cancer, its location, and how advanced it is.[16]
If a diagnosis of throat cancer is confirmed, treatment options include surgery, radiotherapy and chemotherapy. Surgery results in cure for up to eight in ten cases of early-stage throat cancer[20], while radiotherapy is also often successful. In some cases, surgery and radiotherapy may be used in combination.[20]
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Medscape. “Pharyngitis Follow-up”. 11 April 2018. Accessed 22 May 2018. ↩
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Medchrome. “Chronic Pharyngitis: Causes,symptoms and treatment.” 11 September 2010. 30 May 2018. ↩
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Medscape. “Pharyngitis Clinical Presentation”. 11 April 2018. Accessed 22 May 2018. ↩
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Airnow.gov. “How Smoke from Fires Can Affect Your Health”. January 2017. Accessed 30 April 2018. ↩
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New York State Department of Health. “Exposure to Smoke from Fires”. October 2016. Accessed 30 April 2018. ↩
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Victoria State Government Better Health Channel. “Wood fires and breathing problems”. Accessed 30 May 2018. ↩
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Patient.info. “Tonsillitis”. 15 July 2017. Accessed 4 May 2018. ↩ ↩
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BMJ Best Practice. “Tonsillitis: History and exam”. Accessed May 23 2018. ↩
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American Academy of Allergy Asthma and Immunology. “RHINITIS (HAY FEVER)”. Accessed 4 May 2018. ↩
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Medscape. “Allergic Rhinitis”. 14 November 2017. Accessed 30 April 2018. ↩
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American Academy of Otolaryngology-Head and Neck Surgery. “Post-Nasal Drip”. 30 April 2018. ↩
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American Academy of Otolaryngology-Head and Neck Surgery. “What is LPR?”. 30 April 2018. ↩
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Cleveland Clinic. “Laryngopharyngeal Reflux (LPR)”. 16 April 2012. Accessed 4 May 2018. ↩
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Eosinophilic Esophagitis Home. “What is Eosinophilic Esophagitis (EoE)?”. Accessed 30 April 2018. ↩ ↩ ↩
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American Academy of Allergy Asthma and Immunology. “EOSINOPHILIC ESOPHAGITIS (EOE)”. Accessed 30 April 2018. ↩ ↩ ↩
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Cancer Council Australia. “Throat cancer”. 31 May 2017. Accessed 30 April 2018. ↩ ↩ ↩ ↩
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Cancer Treatment Centers of America. “Throat cancer symptoms”. 30 April 2018. ↩ ↩
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WebMD. “Understanding Hay Fever — the Basics”. 16 February 2017. Accessed 30 April 2018. ↩
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Cincinnati GI. “What is the treatment for GERD?”. 30 April 2018. ↩
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Texas Oncology. “Early Stage Throat Cancer.”. Accessed 30 April 2018. ↩ ↩
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Interesting topic
It’s certainly one that deserves further exploration!
+1 Great question!