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What is the cause and treatment for recurrent sore throat?

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Posted on Mon, 28 Jul 2014
Question: I like it when there is something wrong with me physically. E.g . I like that I have asthma, I like it that I have an ankle injury that flares up, I like that I get dermatitis. Why would I like it?
However I hate that I have had a sore throat that has lasted for over 2 and a half years, and no one (not even an ENT) can figure out what it is. I hate not being able to sing without my throat getting worse. I have tried natural remedies, medications etc. One doctor said it could be psychological, I'm not sure.
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Answered by Dr. Naveen Kumar (1 hour later)
Brief Answer:
Laryngo-pharyngeal reflux...

Detailed Answer:
Hi

Thanks for posting the query. I do understand your problem and I am sorry for the emotional turmoil you are undergoing. I will assure you, I will try my best to help you with this problem.

Recurrent sore throat could be due to various reasons such as recurrent sinusitis, allergy, laryngo-pharyngeal reflux, recurrent tonsillo-pharyngitis, etc

After going through your history, I do presume you could be suffering from Laryngo-pharyngeal reflux which is the root cause for all your problems.

The symptoms are noticed when food and acid from the stomach and upper digestive tract regurgitate all the way up into the back of the throat. The regurgitated acid thus burns the throat and induces inflammation of the mucosa. The inflamed mucosa gives rise to a sensation of the lump in the throat, tiring of the voice, frequent throat clearing, sensation of phlegm struck in the throat, etc.

My suggestions to you are:
1. You may require medicines such as proton pump inhibitors and prokinetics for the treatment of same.
2. Stroboscopy to assess the movement of the vocal cords.
3. Gastroenterologist's consultation to rule out the cause of the reflux.
4. Meanwhile, drink plenty of warm water and do steam inhalation.
5. Avoid coffee/tea, fizzy drinks, chilled food and beverages.

Hope this answers your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Naveen Kumar (7 hours later)
It is interesting what you are saying, because the ENT that I visited also suggested that I might have silent reflux (that is the same thing right?). That is when he put me on acid reflux tablets for six weeks. It didn't make a difference. Would other medications help?
The ENT noticed little white lumps in the back of my throat, which implied that I either had an alergy or silent reflux. He couldn't find any other signs of a chronic sore throat.
My sinuses do get very blocked up. I get sinus headaches and infections all the time, but I always assumed that it was because I work in Childcare where there are a lot of germs floating around.

Note: I had an endoscopy to see if there was any reason why I am having runny bowel movements often, and frequent gas. Nothing was out of the ordinary.



doctor
Answered by Dr. Naveen Kumar (16 hours later)
Brief Answer:
Life style modifications are necessary

Detailed Answer:
Hi

Thanks for writing back

In treating Laryngo-pharyngeal Reflux (LPR), medicines alone will not be sufficient enough. Certain life style modifications has to be made, as I suggested in my previous response.

Do
- Have the small quantity of food, at regular intervals
- Drink plenty of warm water
- Give a gap of at least 1 hour after the dinner, before you retire to bed in the night

Avoid or reduce the following:
- Stress
- Alcohol
- Fried/Fatty Foods
- Spicy Foods
- Citrus fruits
- Fizzy drinks

Along with proton pump inhbitors, you will also require prokinetics for gastric emptying and tightening the lower esophageal sphincter.

Also, sinusitis can cause throat discomfort and recurrent throat infections. If the nose is blocked, an individual tends to open the mouth and breathe. Mouth breathing takes away all the moisture from the throat into the lungs, leaving throat dry and irritated. The dry mucosa is an open invitation for the bacteria to invade the mucosa-hence frequent throat infections.

- Steam inhalation and saline nasal spray will be helpful in managing the sinus related problems.

Hope this piece of information will be helpful to you.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Naveen Kumar

ENT Specialist

Practicing since :2001

Answered : 2498 Questions

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What is the cause and treatment for recurrent sore throat?

Brief Answer: Laryngo-pharyngeal reflux... Detailed Answer: Hi Thanks for posting the query. I do understand your problem and I am sorry for the emotional turmoil you are undergoing. I will assure you, I will try my best to help you with this problem. Recurrent sore throat could be due to various reasons such as recurrent sinusitis, allergy, laryngo-pharyngeal reflux, recurrent tonsillo-pharyngitis, etc After going through your history, I do presume you could be suffering from Laryngo-pharyngeal reflux which is the root cause for all your problems. The symptoms are noticed when food and acid from the stomach and upper digestive tract regurgitate all the way up into the back of the throat. The regurgitated acid thus burns the throat and induces inflammation of the mucosa. The inflamed mucosa gives rise to a sensation of the lump in the throat, tiring of the voice, frequent throat clearing, sensation of phlegm struck in the throat, etc. My suggestions to you are: 1. You may require medicines such as proton pump inhibitors and prokinetics for the treatment of same. 2. Stroboscopy to assess the movement of the vocal cords. 3. Gastroenterologist's consultation to rule out the cause of the reflux. 4. Meanwhile, drink plenty of warm water and do steam inhalation. 5. Avoid coffee/tea, fizzy drinks, chilled food and beverages. Hope this answers your query; I will be available for the follow-up queries. Regards Dr. Naveen Kumar N. ENT and Head & Neck Surgeon