Chronic Sore Throat

A chronic sore throat is considered as any persistent throat irritation, itchiness, or pain that lasts for more than 3 months. While a sore throat is usually thought of as pain, even slight irritation or itchiness of the throat can cause a level of discomfort that may be described as ‘sore.’

The causes of a chronic sore throat may be due to an infection, chemical or mechanical injuries, or some other cause of persistent inflammation. Identifying the cause depends on the other signs and symptoms present, apart from a sore throat, as well as considering the patient’s medical history.

Other signs and symptoms that may accompany a chronic sore throat include:

• Changes in the voice, especially hoarseness
• Painful swallowing (odynophagia)
• Difficulty swallowing (dysphagia)
• Chronic cough or constant clearing of the throat

Diagnosing the underlying cause of a sore throat may require a neck x-ray, CT scan, or laryngoscopy.

A child’s sore throat may be due to strep throat, sinusitis, tonsillitis, or all three at different times. Here is a simple breakdown of the three.

Tonsillitis is an infection of the tonsils caused by any virus or bacteria. It can be acute or chronic. Infections that cause tonsillitis can travel and cause sinusitis.

Strep throat is a specific bacterial infection of the throat. It can be acute or recurring. Because it infects tissues of the throat, strep can cause tonsillitis.

Sinusitis is an infection of the sinuses caused by any virus or bacteria. It can be chronic or acute. Infections that cause sinusitis can travel and cause tonsillitis.

Tonsils

The tonsils are two oval-shaped pads of tissue at the back of the throat–one tonsil on each side. They produce certain types of disease-fighting white blood cells and act as the immune system’s first line of defense against bacteria and viruses that enter the mouth.

Signs of tonsillitis include

• Inflamed tonsils
• Severe sore throat
• Bad breath
• Difficulty swallowing
• Pus on the tonsils
• Fever
• Enlarged cervical lymph nodes

The signs of strep include

• Sore throat
• Fever
• Pus on the tonsils
• Enlarged cervical lymph nodes

Doctors can easily test for strep using a throat swab and a quick in-office test.

Sinusitis is more common in children with allergies, as their mucous membranes are constantly inflamed.

Signs of sinusitis include

• Sore throat
• Fever
• Stuffy nose
• Runny nose with yellow, green or bloody mucus
• Ear pain and infection
• Pain and pressure around the sinuses

Since the sinuses and tonsils are close to each other, it’s common for the infection to travel between the two. Plus, the chronic infection in one can easily cause infection in the other.  

Children are most susceptible to these types of infections because they have shorter airways which makes it easier, for example, for infection to spread from the sinuses to the tonsils.

For many children, as they get older their immune systems get stronger so they have fewer issues with a sore throat. But for other children whose chronic issues persist, they may need medical management or surgical intervention to relieve symptoms.

Medical management of symptoms may include prescribed medications such as antibiotics (for bacterial infections) or antihistamines. Surgical intervention may include a tonsillectomy (the surgical removal of tonsils). Surgery is usually recommended for children who have had frequent, recurring episodes. Frequency is defined as follows

• More than seven episodes a year
• More than five episodes a year in each of the preceding 2 years
• More than three episodes a year in each of the preceding 3 years

If your child has been suffering from a chronic sore throat, contact Integrated ENT at (303) 706-1616 to schedule a consultation for evaluation and treatment.