Laryngitis

With laryngitis, the larynx (voice box) and the area around it become irritated and swollen. When you have the condition, you will find your voice changing, becoming hoarse. You may find yourself unable to speak above a whisper, or even lose your voice entirely for a few days. Laryngitis rarely causes serious trouble in adults. But it can cause complications in children—notably croup, a swelling of the throat that narrows the airways and causes a "barking" cough.

Signs and Symptoms

• An unnatural change in your voice
• Hoarseness
• Loss of your voice
• Tickling, scratchiness, and rawness in your throat
• A constant urge to clear your throat
• Fever, general feeling of lethargy and tiredness, and difficulty breathing mark more severe cases

Causes

Certain viruses or bacteria can infect the larynx, or voice box, and cause it to swell. This produces irritation and soreness, and changes your voice, making you sound hoarse and unable to speak above a whisper, or even causing you to lose your voice entirely for a few days. Usually, the virus comes from another ailment, such as a cold, the flu, or bronchitis. Overuse of your voice, by screaming or shouting for long periods, can worsen the irritation and swelling produced by the infection. Smokers and people who work around fumes to which they are allergic often have chronic laryngitis.

Risk Factors

• Smoking
• Having an upper respiratory infection like a cold, flu, or bronchitis

Diagnosis

Your health care provider will examine your throat and take a culture if it looks infected. S/he will also examine your sinuses, neck, nose, and lungs. If you have had laryngitis for a long time, especially if you are a smoker, a referral to an Ear Nose and Throat (ENT) specialist (also called an otolaryngologist) may be made for a special test called laryngoscopy. This test involves use of a rigid or flexible viewing tube called a laryngoscope to see the back of the throat including the voice box.

Treatment Approach

In most cases, you can treat laryngitis yourself using some simple lifestyle measures. Antibiotics are almost never needed since most cases of laryngitis are caused by a virus. If your doctor is concerned about a possible bacterial infection, antibiotics might be considered (see Medications).

Lifestyle

• Try to rest your voice for a week or so.
• Getting plenty of rest can also speed your recovery.
• Avoid any irritants that might affect your larynx, especially tobacco smoke.
• Avoid drinking alcohol.
• Gargle several times a day with ½ tsp. of salt in a glass of warm water.

Medications

• Antibiotics — for laryngitis resulting from a bacterial infection
• Antihistamines — for laryngitis resulting from allergies
• Inhaled steroids — for laryngitis resulting from allergies

Nutrition and Dietary Supplements

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider.

Although not without controversy, certain supplements may help reduce the length of time of your cold and, therefore, its symptoms. Such supplements include:

• Vitamin C
• Zinc

Herbs
The use of herbs is a time-honored approach to strengthen the body and treat disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care and only under the supervision of a practitioner knowledgeable in the field of herbal medicine. Also, your physician should know about all herbs you are taking or considering taking.

Barberry (Berberis vulgaris)
Barberry is used to ease inflammation and infection of the respiratory tracts including pharyngitis, sinusitis, rhinitis (nasal congestion), and bronchitis.

Echinacea (Echinacea angustifolia/Echinacea pallida/Echinacea purpurea)
Echinacea, also called purple coneflower, is used to shorten the duration of the common cold and flu and to relieve the symptoms associated with them, such as sore throat (pharyngitis), cough, and fever.

Eucalyptus (Eucalyptus globulus)
Eucalyptus is commonly used in remedies to treat coughs and the common cold. It can be found in many lozenges, cough syrups, and vapor baths throughout the United States and Europe. Herbalists recommend the use of fresh leaves in teas and gargles to soothe sore throats and treat bronchitis and sinusitis.

German Chamomile (Matricaria recutita)
Chamomile has been used traditionally to treat a range of conditions including chest colds and sore throats. While there are some animal studies that show that chamomile may reduce inflammation, there are few studies on people to test such uses. With that said, many people find chamomile tea quite soothing for a sore throat.

Goldenrod (Solidago virgaurea)
Although studies have not confirmed the value of this use, goldenrod has been used traditionally by herbalists to treat sore throats and laryngitis.

Goldenseal (Hydrastis canadensis)
Many professional herbalists recommend goldenseal in herbal remedies for hay fever (also called allergic rhinitis), colds, and flu. It is also available in mouthwashes for sore throats and canker sores.

Licorice (Glycyrrhiza glabra)
Licorice is a flavorful herb that has been used in food and medicinal remedies for thousands of years. As an herb, it has long been used by professional herbalists to relieve respiratory ailments, such as allergies, bronchitis, colds, and sore throats. It can be used as a lozenge or tea. Do not take licorice if you have high blood pressure. Use of any licorice product is not recommended for longer than four to six weeks. People with obesity, diabetes, or kidney, heart, or liver conditions should also not use this herb nor should you use it if you are pregnant, breastfeeding, have decreased libido or other sexual dysfunction.

Marshmallow (Althea officinalis)
Marshmallow—the herb, not the white puffy confection roasted over a campfire—has been used for centuries as both a food and a medicine. The mucilage, or gummy secretion, in the leaves and particularly in the root may be helpful for soothing sore throats.

Peppermint (Mentha x piperita)
Peppermint and its main active agent, menthol, may feel soothing and calming for your sore throat.

Saw Palmetto (Serenoa repens/Sabal serrulata)
Early in the 20th century, saw palmetto was listed in the US Pharmacopoeia as an effective remedy for bronchitis and laryngitis, among other conditions.

Slippery elm (Ulmus fulva)
Slippery elm has been used as an herbal remedy in North America for centuries. The conditions for which slippery elm has received recognition from the U.S. Food and Drug Administration (FDA) as a safe and effective option include sore throat and respiratory symptoms, such as cough.

Other
Other herbs that may reduce cold symptoms including, possibly, sore throat include:

• Garlic (Allium sativum)
• Ginger (Zingiber officinale)

Homeopathy
There have been few studies examining the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for laryngitis based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

• Aconitum — for laryngitis that comes on after exposure to cold and may be accompanied by a dry cough
• Allium cepa — for hoarseness associated with a cold and clear, watery discharge
• Argenticum nitricum — for laryngitis in nervous, restless individuals that may be brought on by yelling or singing
• Causticum — most commonly used remedy for individuals who have laryngitis, particularly with mucus in the throat or laryngitis due to overuse of the voice; coughing is aggravated by chilly weather and relieved by cold drinks; symptoms worsen at night
• Hepar sulphuricum — for laryngitis with barking cough that worsens in the morning
• Kali bichromicum — for laryngitis with a cough that is characterized by a stringy yellow mucus; this remedy is most appropriate for individuals who have a tickling sensation in the back of the throat with symptoms that worsen after drinking
• Phosphorus — for individuals with a hoarse, dry cough and a burning sensation in the throat; symptoms tend to be relieved by cold liquids; this remedy is most appropriate for individuals who tend to be nervous if alone and prefer the company of others

Other Considerations

Warnings and Precautions

Call 911 if you have problems breathing or swallowing, or if your throat bleeds. Call your health care provider if you have a high temperature.

Prognosis and Complications

For adults, laryngitis rarely causes serious problems. Two conditions that may occur in children, however, include:

• Croup which narrows the airway passages, causes difficulty breathing, and leads to a "barking" cough
• Epiglottitis, which is inflammation of the epiglottis. The epiglottis is the flap of cartilage at the back of the tongue that closes off the windpipe when swallowing. If it swells, breathing can be come obstructed.

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