Sore Throat: How to Get Better!

At our busy ENTcare specialist clinic in Singapore, we see many patients with recurrent or persistent sore throat conditions.

Everyone has suffered a bad sore throat in their lives at some point. But what can you do if your sore throat fails to get better?

There are many ENT conditions which lead to a chronic or persistent sore throat. The key to getting better is to reach the correct diagnosis.

Here is a list of what I see all the time as an experienced ENT specialist in Singapore.

• Acute pharyngitis (the "standard" sore throat infection)
• Acute tonsillitis (more painful than a "standard" sore throat)
• Postnasal drip (from sinus or nasal allergy issues)
• Acid reflux (also known as gastritis)
• Tumour

Most sore throats do get better and often, they are caused by viral infections. It doesn't just have to be Covid. Viruses which cause the common cold and influenza are just as likely to cause a nasty sore throat. Some patients have poor immunity as they may be on regular medications such as steroids and chemotherapy. If you have young kids at home, they will probably be bringing home more viruses from school which might spread to you in turn. So don't be surprised if you fall ill more often with young kids at home!

What do you need to watch out for? Some recurrent sore throats may be caused by Streptococcus. This is a nasty bacteria responsible for "Strep throat". You definitely need a course of antibiotics such as Augmentin (penicillin) to treat it quickly. Streptococcal throat infections are associated with a higher risk of complications such as tonsillitis and ear infections. You may also develop chest infections. There is a higher incidence of developing sinusitis and rarely, kidney infections (glomerulonephritis). Streptococcal throat infections may cause meningitis (infection of the brain lining) and endocarditis (infection of the heart valves).

So it is important to treat your sore throat early, especially if it is due to Strep throat infection. Throat swabs can sometimes detect the presence of Strep bacteria in your throat infection.

Postnasal drip can cause severe sore throat which can become chronic or persistent if left untreated. Nasal allergies due to allergic rhinitis can lead to blocked runny nose, backdrip and itchy throat symptoms too. Allergy testing in this instance can be helpful as well as a trial course of medications such as a saline nasal rinse, nasal steroid spray and antihistamines such as Telfast or Zyrtec.

Sometimes, sinus infections may develop from primary viral inflammation inside the nose, like the common cold or flu. The infected secretions flowing down from the back of your nose into the throat will irritate the throat and cause further inflammation, hence building up to then feel like a sore throat.

If you keep clearing your throat repeatedly to make funny noises, then it's likely to be the mucus backdrip from your nose irritating your throat. However, sometimes, it may well be due to underlying acid reflux or gastritis issues causing a chronic inflammation of your throat and voicebox. This may then result in a hoarse voice and sore throat. Some people may also feel that they have this constant "lump in throat " sensation, which we call "globus pharyngeus", usually a benign inflammatory condition.

But if this persists, of course, you still need to get this checked out by your experienced ENT specialist in Singapore to make sure it's not due to something growing inside your throat to cause obstruction.

Your ENT specialist in Singapore will usually perform a nasoendoscopy to check the inside of your nose, throat, voicebox and airway, in clinic, a quick and relatively painless procedure done in a matter of seconds. A nasoendoscopy is definitely the best way to examine the inside of your nose, postnasal space, throat, voicebox and airway. We can do this very safely in clinics for children too if needed, for proper assessment of their nose and airways, no matter how young they are.

What about smoking? Smoking and vaping are important risk factors which keep triggering sore throats due to infection, inflammation and acid reflux. Occasionally, we see more sinister throat pathology such as tonsil cancer or tongue base cancer too. Non-smokers also may grow such malignant tumours in their throat due to infection from HPV (Human Papilloma Virus). HPV may be detected in the cervical smears of women and it is linked to higher risk of developing cervical cancer, as well as throat cancer. It may also lead to the growth of genital warts. So basically, please stop smoking!