Recurrent sore throats
Most sore throats are viral and only last a few days. They are usually similar symptoms to those associated with the “common cold” like a cough, runny nose and lethargy. Most require no treatment apart from simple analgesia such as paracetamol and ibuprofen.
A bacterial infection of the tonsils (tonsillitis) is associated with more severe symptoms that last longer, usually a week or more. When you look at the tonsils they are red, inflamed and often covered in pus. The sufferer is usually unable to eat and drink and has a high fever. Symptoms of a common cold are also absent, especially the cough. Glands in the neck are usually tender and palpable as well.
If tonsillitis occurs frequently then removing them can be beneficial, especially if it is interfering with school and work attendance. The tonsils are removed under a general anaesthetic and most patients go home the same day. It is painful afterwards for a week or so, rather like having tonsillitis and there is a small risk of bleeding (1 to 2% of patients).
There are lots of causes of a hoarse voice. It happens because the vocal cords have changed in some way. People often worry that they may have a cancer of the voice box but this is not the most common cause. However, If you are or have ever been a smoker then it is a good idea to consult your doctor.
The most common cause is simple inflammation caused by a respiratory tract infection and this is called “laryngitis”. In addition a bad cough caused by a chest infection can cause the vocal cords to become inflamed as well because coughing causes them to collide and become swollen.
Reflux of gastric contents can also cause throat symptoms. This can happen without typical indigestion and we call this “silent reflux”. Symptoms can include a hoarse voice.
People who use their voice a lot, such as teachers, singers and sports coaches can have voice problems.
Whatever the cause, it is straightforward to diagnose. I use a small fibreoptic telescope in the clinic, which passes through your nose and looks at your voice box. It only takes about 30 seconds to perform and is not painful.
Difficulty swallowing food or liquid needs assessment by a doctor. Most cases are not serious, especially when it is intermittent and where you have not had to modify what you eat. However, if it is persistent and worsening and associated with weight loss then it needs urgent assessment.
Some people become aware of a sensation of a “lump in the throat”, which does not actually cause problems swallowing food. We call this “globus” and it requires no treatment. Sometimes this is a feature of acid reflux.
If you have a swallowing problem I can look at your throat with a fibreoptic telescope in the clinic. This tiny tube passes through your nose, is not painful and only takes about 30 seconds to perform.
Snoring and sleep apnoea
Snoring is a common problem and it is usually a greater concern for the partner who cannot sleep as a consequence. It is caused by partial collapse of the upper airway during sleep, which causes turbulent airflow and the snoring noise. It is made worse by being overweight and consuming alcohol which is a muscle relaxant.
If complete obstruction occurs it causes the sufferer to stop breathing in their sleep. This is called obstructive sleep apnoea and can be mild, moderate or severe. Patients with this feel tired and unrefreshed after sleeping and often fall asleep easily during the day. It is diagnosed with a sleep study but filming your partner sleeping on your mobile phone can help make the diagnosis.
Certain anatomical problems can make snoring worse such as a blocked nose, large tonsils, long palate, large tongue and small chin. Surgery can help depending on where the level of the snoring occurs.
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