Sore Throat: How to Get Better

At our busy ENT specialist clinics in Singapore, we see many patients who suffer from recurrent or persistent sore throat conditions due to many different causes.

Everyone has suffered a bad sore throat in their lives at some point but what do you do if your sore throat doesn’t seem to be getting 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. So what are the Top 5 causes of throat pain then? Here is a list of what I see all the time as an experienced ENT specialist in Singapore.

1. Acute pharyngitis (the “standard” sore throat infection)
2. Acute tonsillitis (usually way more painful than a “standard” sore throat)
3. Postnasal drip (from sinus or nasal allergy issues)
4. Acid reflux (also known as GERD, gastro-oesophageal reflux or gastritis)
5. Tumour (obviously not great)

1. Acute pharyngitis and tonsillitis

Most sore throats do get better and often, they are caused by viral infections. It doesn’t just have to be Covid as viruses which cause the common cold and influenze 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.

Sometimes, sore throats may be caused by Streptococcus, a nasty bacteria responsible for “Strep throat”. This definitely needs 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 pneumonia and other chest infections. There is 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.

2. Postnasal drip

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.

3. Acid Reflux

But if this persists, the 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 clinic in 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 a 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!

So what are Dr Annabelle’s tips to help your Sore Throat get better?

1. Gargle with antiseptic gargle (Difflam or Thymol or Betadine is fine and may be bought from pharmacies)
2. Drink plenty of fluids, especially water. (Coffee and tea don’t count as they just dehydrate you further)
3. Try using a Sinus rinse or nasal saline irrigation to wash out any trapped nasal mucus.
4. Try taking some Gaviscon medication to soothe any underlying gastritis or acid reflux.
5. Stop smoking
6. Minimise alcohol intake.
7. Taking some lozenges can help to soothe your throat inflammation (doesn’t matter which brand, Strepsils sill do too).
8. Antihistamines such as Zyrtec or Clarityn can help to reduce nasal mucus backdrip and hence ease your sore throat
9. Get any nasal or sinus conditions treated because constant mouth-breathing will also lead to a sore throat as your nose is blocked
10. Recurrent sore throats in the morning may be due to dry mouth: Breathing through your mouth often makes your mouth and throat dry. Could it be due to your blocked nose issues or could it be sleep apnea causing the airway obstruction?

Remember, if your sore throat doesn’t improve, then you should visit your friendly ENT specialist in Singapore for a check-up!

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