Persistent Sore Throat: Causes & When to See an ENT Specialist
A persistent sore throat is one that lasts more than 2 weeks or keeps recurring. While most sore throats are caused by viral infections and resolve on their own, long-standing throat pain should never be ignored.
As an ENT specialist, I frequently see patients who have been treated repeatedly with antibiotics or lozenges without improvement. In many cases, the underlying cause is not infection but another throat or reflux-related condition that requires proper assessment.
What Does a Persistent Sore Throat Feel Like?
Patients often describe:
- Burning or scratchy throat
- Pain when swallowing
- Constant throat irritation
- Feeling of dryness
- Worse symptoms in the morning
- Voice fatigue
Persistent symptoms are different from a typical flu sore throat.
Common Causes of Persistent Sore Throat
1. Chronic Throat Infection
Repeated bacterial or viral infections may cause ongoing inflammation.
2. Acid Reflux (Laryngopharyngeal Reflux)
Stomach acid reaches the throat causing:
- Burning sensation
- Throat clearing
- Hoarseness
- Worse pain after meals or lying down
3. Post-Nasal Drip
Mucus from nose or sinuses irritates the throat.
4. Smoking & Vaping
Chemical irritation damages throat lining.
5. Voice Overuse
Teachers, singers, and sales professionals are at risk.
6. Tonsil Problems
Chronic tonsillitis or tonsil stones.
7. Throat Cancer (Rare but Serious)
Persistent one-sided pain, neck lump, or voice change may be warning signs.
🚨 When Should You Worry?
Seek ENT review urgently if you have:
- Sore throat lasting >2 weeks
- Pain on one side only
- Difficulty swallowing
- Voice change
- Neck lump
- Unexplained weight loss
Early diagnosis saves lives.
How an ENT Specialist Evaluates a Persistent Sore Throat
Assessment includes:
- Detailed symptom history
- Oral and throat examination
- Flexible nasoendoscopy
- Voice assessment
- Imaging or biopsy if needed
This allows accurate diagnosis and avoids blind treatment.
Treatment Options
✅ Cause-Based Treatment
- Reflux medication
- Allergy management
- Antibiotics (only when indicated)
- Voice rest & therapy
✅ Lifestyle Measures
- Stop smoking
- Avoid late meals
- Hydration
- Reduce throat clearing
✅ Surgical Treatment (Selected Cases)
- Tonsillectomy
- Lesion removal
Frequently Asked Questions (FAQ)
Q: Is a sore throat for 3 weeks normal?
No. Persistent symptoms need assessment.
Q: Can reflux cause sore throat without heartburn?
Yes. Silent reflux is common.
Q: Should I worry about cancer?
Most cases are benign, but red flags need evaluation.
When Should You See an ENT Specialist in Kuala Lumpur?
Consult an ENT specialist if:
- Symptoms persist despite treatment
- Pain keeps recurring
- You notice warning signs
- Throat pain affects work or sleep
ENT assessment ensures safe, targeted treatment.
👨⚕️ ENT Specialist’s Perspective
From an ENT standpoint, a persistent sore throat is a diagnostic symptom, not a condition itself. Direct throat visualisation is essential to exclude serious disease and to provide precise, evidence-based treatment.
Reviewed by Dr Ameen, ENT Specialist, Kuala Lumpur
Dr. Ameen, ENT Specialist in Kuala Lumpur 