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Ear, Nose, and Throat Disorders

Sore throat while talking

02/22/2007

Question:

I have been to the doctor about a sore throat, while talking. He/she has said that, it is due to post-nasal drip, where the mucus has dripped down to the back to my nose and down into the throat, which is giving me irritation and all.

I have been suffering from this type of sore throat for about 6+ months now.

I did scream to the top of my voice about 6 months ago (about 3 hours straight) and one morning when I woke up, the middle part of my throat/neck started hurting.

I started going to the doctor and he found an infection. I took the antibiotics, but later on, things changed in the throat. I started developing minor pains on the side of the throat next to the middle part, of course.

I asked many people around and also been to a ENT specialist, who did a thorough check of my larynx and all (I think!!!). He said everything was normal. All he gave to take was, "DEMAZIN" and "DIAZEPAM". I took it for 1 month, but had to stop as it was TOO DROWSY and STRONG. It did get rid of the pain a bit, but it started again.

So, now, I`m back to the same situation and this time, a new doctor said, I have post-nasal drip which was the same thing, the ENT specialist also said.

My only question is, can this mucus congestion or post-nasal drip hurt my throat, WHEN I TALK?

Also, if possible, can u let me know, if I damaged my Voice Box by screaming to the top of my voice 6 months ago, but stopped later? By the way, my voice seems alright and it`s clear. The only problem I experience is that, I can`t raise my voice.

Please explain these problems.

Thanks

Answer:

Your story sounds very interesting.  When you scream, you can cause swelling of the vocal cords that may take days to weeks to clear.  That is usually not associated with a lot of pain, just an abnormal voice.

The post nasal drip diagnosis, I believe, is way over-diagnosed.  I always tell my patients that the sinuses make about a quart of mucus every day, all day.  We swallow one quart of mucus a day and we are not even aware that we are doing it.  This is not to say that post nasal drip does not exist.  I usually find that when people are aware of mucus draining into their throat, they are also blowing it out of the front of their nose as well.  Many people who complain of mucus in their throats have acid reflux affecting their throat. This condition will usually cause some of these symptoms:  hoarseness, cough, mucus accumulation in the throat, a lump sensation in the throat, difficulty swallowing, throat pain or discomfort, and maybe a bad taste in the mouth that may be associated with bad breath.

In my practice, I will usually have your voice box examined by our voice pathologist so that we can get some very detailed pictures.  I would also start you on medication for acid reflux.  Most patients need to be on these kind of medications for 3-6 months before their symptoms resolve.  We also recommend some dietary and lifestyle modifications to help this condition.

It is important to understand that this form of acid reflux does not usually cause heartburn or indigestion as major complaints.  This is really hard for some patients to understand.  When ENT doctors talk about reflux, we talk about the throat and voice box symptoms.  In some studies it has been shown that up to 70% of patients with documented acid reflux do not have heartburn or indigestion as a symptom.

I would encourage you to see another ENT if you are not getting any results.

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Response by:

Keith M Wilson, MD Keith M Wilson, MD
Associate Professor of Otolaryngology, Director of Head and Neck Division
College of Medicine
University of Cincinnati