Laryngitis is an irritation and swelling of the larynx and the surrounding
area. It can cause a patient's voice to become hoarse, and possibly to disappear
altogether. The condition can take both acute and chronic forms, although the
symptoms and treatment are often the same for both types. Acute laryngitis is
most common in late fall, winter, and early spring. In general, it resolves
within one or two weeks, with or without treatment. The chronic form is often
associated with external factors such as smoking and regular exposure to
industrial fumes and other allergens. The most common cause in pediatric cases
is acute infection, whereas laryngitis in adults tends to have a chronic,
Both acute and chronic laryngitis are usually caused by a viral
infection—influenza A, B, parainfluenza, adenovirus,
rhinovirus. They can occasionally result from a bacterial
infection—Streptococcus. Excessive use of the
voice, esophageal reflux, irritations, trauma, allergies to inhaled substances,
and autoimmune reactions can also lead to the condition. Laryngitis often
accompanies colds, and also appears during the course of a variety of other
ailments, including bronchitis, pneumonia, influenza, pertussis, measles, and
- Presence of upper respiratory tract infection
- Chronic bronchitis, rhinitis, sinusitis
- Allergy to and exposure to pollen, dust, and allergens in the
- Alcoholism, or excessive drinking
- Overuse or abuse of voice
|Signs and Symptoms|
- Unnatural change in the voice
- Tickling, scratchiness, and rawness in the throat
- A constant urge to clear the throat
- Fever, malaise, dysphagia may occur in more severe cases
- Difficulty breathing if the larynx is swollen
- Inflammation of the larynx's
- Gastroesophageal reflux disease
- Laryngeal cancer
- Throat cancer
- Vocal cord polyps
- Vocal cord nodules
- Thyroid disease
Examination of the throat may or may not reveal redness, suggesting the
possibility of strep throat. Indirect examination of the larynx may reveal a
mild to marked swelling of the organ's mucous membrane. This examination can
help to differentiate between laryngitis and diphtheria.
A throat culture will indicate the presence of strep throat or other
- Ask patient to describe symptoms completely
- Evaluate the throat and larynx by examination. Fiberoptic or indirect
- Virus or bacterial
If a bacterial infection has caused the laryngitis, appropriate antibiotics
should be prescribed. Laryngitis that results from viral causes has no specific
treatment. It can benefit from any one of a variety of relatively unaggressive
methodologies, depending on the extent of the condition. Treatment of
accompanying acute or chronic bronchitis can improve the laryngitis.
Advise patients to rest their voices for about a week, either by not speaking
or by whispering. Patients should also be warned to avoid irritants, such as
smoke, cold air, and alcohol. Advise patients to get plenty of rest, increase
fluid intake, and consider additional humidification. Such passive treatment
presents particular difficulties for children.
Antibiotics clear up the bacterial form of laryngitis: 250 mg penicillin or
250 mg erythromycin for 10 to 12 days. Typical medications include
broad-spectrum antibiotics such as amoxicillin and tetracycline, taken orally.
Antihistamines and inhaled steroids should be prescribed to treat allergies
related to laryngitis.
|Complementary and Alternative
Alternative treatments may be effective in cases of acute, chronic, or
recurrent laryngitis. Use nutritional support along with lozenges, teas, and an
appropriate gargle combination.
- Zinc lozenges (as commercially available): boost the immune system
and relieves soreness.
- Vitamin C (1,000 mg tid to qid): needed for proper immune function
and to strengthen mucous membranes.
- B-complex (50 to 100 mg/day): enhances immune function, especially
Herbs are generally a safe way to strengthen and tone the body's systems. As
with any therapy, it is important to ascertain a diagnosis before pursuing
treatment. Herbs may be used as dried extracts (capsules, powders, teas),
glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless
otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water.
Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for
roots. Drink 2 to 4 cups/day. Tinctures may be used singly or in combination as
- Slippery elm (Ulmus fulva) soothes irritated tissues and
- Licorice (Glycyrrhiza glabra) has antiviral properties and is
soothing to the throat. Licorice is contraindicated in
Gargles: Use 5 drops of each tincture listed below in 1/4 cup of
water. Gargle and swallow four to six times a day.
- Laryngitis gargle: Coneflower (Echinacea purpurea), sage
(Salvia officinalis), and marigold (Calendula officinalis) are
soothing and anti-inflammatory herbs.
- Antimicrobial gargle: Coneflower, goldenseal (Hydrastis
canadensis), and myrrh (Commiphora molmol) are antibacterial and
- Pain relief gargle: Propolis, peppermint (Mentha piperita),
and ginger (Zingiber officinalis) are antimicrobial and anodyne
An experienced homeopath should assess individual constitutional types and
severity of disease to select the correct remedy and potency. For acute
prescribing use 3 to 5 pellets of a 12X to 30C remedy every one to four hours
until acute symptoms resolve.
- Aconite for laryngitis that comes on after a shock
- Spongia tosta for laryngitis from coughing
- Phosphorus for hoarseness that is painless or with burning
- Arum for laryngitis from overuse
- Causticum for hoarseness that comes with every cold and is
relieved with cold drinks
Acupuncture may be helpful in enhancing immune function.
Therapeutic massage is helpful in reducing the effects of
Avoid abusing or overusing the voice, environmental irritants, and
Laryngitis usually resolves within one to two weeks. Children typically take
one week to recover their voices.
Caution with antibiotics. Goldenseal should be used with caution in
Ballenger JJ, Snow JB, eds. Otorhinolaryngology. 15th ed.
Philadelphia, Pa: Williams & Wilkins; 1996;30:535-555.
Berkow R, ed. Merck Manual of Diagnosis and Therapy. 16th ed. Rahway,
NJ: The Merck Publishing Group; 1992.
Berkow R, Beers MH, Fletcher AJ, eds. Merck Manual, Home Edition.
Rahway, NJ: The Merck Publishing Group; 1997.
Hoffman D. The New Holistic Herbal. New York, NY: Barnes & Noble
Larson DE, ed. Mayo Clinic Family Health Book. 2nd ed. New York, NY:
William Morrow and Company; 1996.
Copyright © 2007 Drugs Area
This publication contains
information relating to general principles
of medical care that should not in any event be construed as specific
instructions for individual patients. The publisher does not accept any
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