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Throat – persistently sore, tight, irritable

  

Sore throats are very common and usually nothing to worry about.


Assessment

Consider causes. These include reflux, dry throat due to nasal obstruction, post-nasal drip, asthma/COPD, poor air quality, stress/anxiety, voice strain, vicious cycle, ACE inhibitor, malignancy of pharynx, larynx or tonsil.

Management

Treat rhinitis. Try without ACE inhibitor. Treat reflux with at least 8 weeks of PPI in a treatment dose (bd 1 hour before eating, with an antacid such as Gaviscon Advance qds, 1 hour before eating and at bed time). Give advice on voice care.

Referral

Unexplained persistent sore or painful throat may be referred directly to Head/Neck as a Two Week Wait, rather than using the Referral Support Service. Refer routinely if expecting a benign cause.

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