The laryngopharyngitis is a disease of the upper airways that causes an inflammation of the larynx and pharynx to the same time. The larynx corresponds to the vocal box, where the vocal cords that produce the voice are found. On the other hand, the inflammation of the pharynx corresponds to an inflammation of the back of the throat.
It is the most common explanation for a sore throat. Both conditions are usually viral in origin and it is very common for them to occur together. Other causes can be bacterial infections, gastroesophageal reflux, overuse of the voice, and excessive cigarette smoking, to name the most common causes of this disease.
Etiology and pathology of laryngopharyngitis
The major etiologic causes of laryngitis can be viral, such as the common cold virus, adenovirus, influenza or parainfluenza virus, rhinovirus, respiratory syncytial virus, and herpes simplex virus.
It can also be caused by bacteria such as syphilis, diphtheria, tuberculosis, or bacterial influenza. Fungal infections such as candida albicans or oral histoplasmosis can cause this symptomatology.
Allergies and symptoms such as angioedema can cause laryngitis, as can abuse of the vocal cords, excessive consumption of cigarettes or alcohol, and other traumatic events such as burns or corrosives.
In the case of pharyngitis, they usually present for the same causes, including viral mononucleosis. In the case of bacterial infections, it can be caused by the action of group 1 streptococci, in addition to chlamydia, anaerobic bacteria and gonorrhea. Pharyngitis can also be caused by the human immunodeficiency virus (AIDS).
When both symptoms occur together, it is most likely that it is a generalized viral picture. In this table we find that different types of viruses are involved such as adenovirus, influenza virus, parainfluenza virus, rhinovirus and respiratory syncytial virus. They can also be caused by enterovirus or mycoplasma infection.
In addition to this, there are factors that predispose patients to the spread of these infections, such as low temperatures, low humidity, environmental pollution, air conditioning and the condition of passive smokers.
Another very common cause is gastroesophageal reflux disease, a digestive disorder that affects the lower esophagus sphincter, that is, the closing valve between the esophagus and the stomach.
In this condition, the contents of the stomach are returned to the esophagus, since the sphincter is weak or does not relax properly, which generates the reflux of contents towards the upper part of the esophagus. This causes discomfort in the upper esophagus, where it connects to the throat.
In this place we find precisely the laryngopharynx, the last portion of the pharynx, which is located where the path that descends from the mouth is divided into the respiratory system (through the larynx) and the digestive system (beginning of the esophagus).
Here the laryngopharynx continues through the esophagus where it serves as a passage for air and food, since during the swallowing process, the esophagus allows the passage of food, temporarily preventing the passage of air.
During gastroesophageal reflux, the contents of the stomach rise through the esophagus reaching these structures, which do not have protective mechanisms of damage to their mucous membranes, therefore they present inflammation and irritation, with the consequent symptoms of chronic cough, excessive hoarseness, hoarseness and other complaints.
Symptomatology
This condition is usually accompanied by an upper respiratory infection that has recently occurred or is ongoing. If it occurs acutely, there may be moderate fever and also lymphadenopathy in the throat.
When the picture is acute, it usually appears suddenly, with a sore throat and difficulty swallowing. Other symptoms that may occur are cough, headache, and even diarrhea (enterovirus infection). During the physical examination the back of the throat is irritated and red.
If the patient also presents rhinitis, posterior discharge (permanent nasal drip behind the esophagus), sneezing, red eyes and conjunctivitis, an allergic condition should be suspected. In these types of cases, the internal mucosa of the throat is grainy in appearance.
In the case of being a chronic condition, gastroesophageal reflux is immediately suspected. In these cases, the most common symptom is heartburn that lasts for months, as well as a sore throat, possible chronic cough, hoarseness and difficulty swallowing. It is possible that excessive consumption of cigarettes and alcohol is found in the patient's history.
In chronic smokers who have these symptoms persistently, it is suggested to perform an examination to take a biopsy for the possible complication of a carcinoma in the larynx that is causing the symptoms.
Treatments
In the case of viral laryngopharyngitis, treatment is exclusively aimed at relieving symptoms, reducing pain and discomfort when swallowing, and decongesting the upper tract.
Anti-inflammatories, decongestant medications, and pain relievers are prescribed. Gargling can also be therapeutic and relieve discomfort. Avoiding speaking helps to not strain the vocal cords.
If the condition is of bacterial origin, antibiotic treatment is indicated. In these cases the characteristic symptoms are fever, a very red and swollen throat and enlarged lymph nodes. To combat it, antibiotics such as penicillins or cephalosporins are adequate.
In the case of allergic laryngopharyngitis, antihistamines and corticosteroids are the recommended medications.
If gastroesophageal reflux laryngopharyngitis is suspected, tests such as a laryngoscopy to study the vocal cords and endoscopy are recommended.
Treatment is usually a change in lifestyle and diet to reduce the amount of reflux. This includes avoiding foods that can be irritating like spicy condiments, citrus fruits, and mint; in addition to chocolate, fat, coffee and alcoholic beverages, which weaken the internal mucosa are part of the indications.
In most cases, following the recommendations and proper treatment, the symptoms of laryngopharyngitis are relieved without leaving permanent sequelae. It is important to make a proper diagnosis of the condition and request medical help in time to avoid possible complications in the future.
References
- Recovered from merriam-webster.com.
- Acute laryngopharyngitis. Recovered from bioportal.biontology.org.
- Laryngitis and Pharyngitis. Recovered from emedmd.com.
- Recovered from medicinenet.com.
- Recovered from Wikipedia.com.
- Sore Throats: Tonsillitis, Pharyngitis, Laryngitis. Recovered from frontshoo.co.za.
- Laryngitis and pharyngitis: Common ailments of the throat. Recovered from uniprix.com.