Laryngitis: What it is, Causes, Treatment & More

What is Laryngitis?

The larynx, commonly known as the 'voice box', is the organ that helps us speak. It contains the vocal cords, a pair of folds of mucous membrane that stretch over the larynx and vibrate when one talks. When the larynx is inflamed due to infection, overuse, or irritation, the vocal cords tend to swell, affecting the sound produced and causing hoarseness or a complete loss of voice. Some people also experience throat discomfort, a dry cough, or difficulty speaking.

In most cases, the swelling improves once the underlying problem is treated and the vocal cords have had time to recover. While it is highly treatable, the condition can affect a person’s daily life, especially for those in professions that rely heavily on their voices.

What are the Types of Laryngitis?

Laryngitis has two primary types, based on how severe it is and how long the symptoms last. Here is an overview:

How Common is Laryngitis in India?

Laryngitis is a common condition in India, particularly among working adults. One Indian study found that the highest number of cases (30.10%) occurred in people between 31 and 40 years of age. Nearly three-fourths of the patients (74%) came from rural areas, while housewives accounted for the largest occupational group, making up 23.47% of the cases. Acute laryngitis was the most frequently diagnosed form, accounting for 28.57% of cases, followed by chronic laryngitis at 22.44%.

Smoking is a major cause, causing approximately one-third (33.16%) of all cases. Medical professionals are also increasingly linking the growing number of throat-related illnesses in India to worsening air pollution. Hospitals and ENT clinics in Indian cities are experiencing a significant increase in patients with hoarseness, sore throat, chronic cough, and persistent throat irritation. Experts say the trend is largely due to continuous high levels of PM2.5 and other hazardous air pollutants.

What are the Symptoms of Laryngitis?

The symptoms of acute and chronic laryngitis are generally similar. However, in chronic laryngitis, they persist for a longer duration, may become more severe, and often take longer to improve. Here are the common signs:

• Sore or irritated throat

• Cough (mostly dry)

• Irritated sensation in the throat

• Trouble in swallowing

• Temporary loss of voice in severe cases

• Feeling generally unwell

• Low fever (if laryngitis results from an infection)

• Runny or stuffy nose and other cold-like symptoms if a viral infection is the cause

• Enlarged lymph glands in the neck (if due to bacterial infection)

• A distinct cough that sounds like barking or noisy breathing (stridor) and difficulty in breathing in severe cases.

What Causes Laryngitis?

Laryngitis occurs when the voice box becomes inflamed. The inflammation can be caused by several reasons:

• Viruses: Viruses that cause common colds (rhinovirus), flu, and other infections of the respiratory tract can cause laryngitis. Sometimes, viruses that cause chickenpox, measles, rubella, or even COVID-19 can cause this condition.

• Bacterial Infections: Bacteria like Streptococcus and diphtheria, for example, may result in acute laryngitis. This cause is less common than viral infections but still a possibility.

• Vocal Stress: Yelling, speaking loudly for a long time, singing without using appropriate techniques, or screaming can put strain on your vocal cords, resulting in inflammation.

• Gastrointestinal Reflux Disease: The backflow of stomach acid into the throat can irritate the delicate larynx, causing inflammation.

• Smoking: Cigarette smoke has irritants that leads to inflammation of the vocal chords. It can make the chords thicker, leading to a hoarse or raspy voice.

• Allergies: Chronic allergic reactions may lead to postnasal drip, a condition that irritates the larynx.

Risk Factors of Laryngitis

Laryngitis can affect anyone, but certain factors increase the likelihood of developing it in some individuals.

• Heavy Alcohol Consumption: Frequently drinking alcohol can irritate the throat over the long run and increase the risk of developing laryngitis.

• Smoking or Exposure to Tobacco Smoke: Regular smoking, vaping, or frequent exposure to secondhand smoke can irritate the vocal cords and raise the risk.

• Respiratory Infections: Having a cold, bronchitis, sinusitis, or other respiratory infections, whether bacterial or viral, can lead to inflammation of the voice box.

• Voice Overuse: Speaking too loudly, shouting, singing, or simply talking excessively can strain the vocal cords and trigger laryngitis.

• Occupations Involving Heavy Vocal Use: Teachers, lawyers, singers, athletes, and radio hosts are particularly prone to chronic laryngitis due to the demands placed on their voice.

• Exposure to Irritants: Workplace chemicals, stomach acid from reflux, and other irritating substances can contribute to throat irritation and laryngitis.

• Weakened Immune System: Conditions that affect immunity, such as diabetes, can make a person more susceptible to infections that lead to laryngitis.

What are the Complications of Laryngitis?

Acute laryngitis usually has an uncomplicated course in most patients. However, in cases of severe laryngitis, recurrent laryngitis, or failure to receive appropriate treatment for the condition, the patient is likely to develop one or more of the following complications:

• Epiglottitis: The tissue at the entrance of the airway (epiglottis) gets swollen, resulting in breathing difficulty. This condition is a serious complication requiring urgent medical attention.

• Croup: In children, laryngitis may cause a disease called croup, which is known for producing symptoms like a characteristic "bark" cough, noisy breathing ("stridor"), and difficult breathing.

• Narrowed or Obstructed Airway: Severe swelling of the larynx can make the airway narrower or obstruct it, especially in children. It can create speech and breathing problems.

• Infection to Surrounding Areas: If laryngitis is caused by an infection, the virus or bacteria can spread to nearby areas, such as the trachea (tracheitis) or lungs (pneumonia), and cause more problems.

When Should I See My Healthcare Provider?

While most cases of acute laryngitis can resolve with voice rest and home care, you should seek medical attention if:

• Hoarseness or voice loss persists for more than two to three weeks.

• You experience difficulty breathing, stridor, or a barking cough (especially in children).

• You have severe difficulty swallowing or experience drooling.

• You have noticed blood after coughing.

• You have a high fever that does not respond to over-the-counter medication.

• You are a smoker or heavy drinker with persistent hoarseness; this warrants urgent evaluation to rule out laryngeal cancer.

• A child develops symptoms of croup with significant breathing distress.

How is Laryngitis Diagnosed?

Diagnosing laryngitis typically involves a discussion of symptoms and a physical examination, with further tests recommended only in certain cases.

How is Laryngitis Treated?

Mild cases of laryngitis can resolve without medicines with voice rest and adequate hydration. However, the following treatments may be recommended for severe symptoms or cases of chronic laryngitis.

• Voice Rest: This method is by far the most crucial treatment measure. Voice rest means that the affected vocal cords will get enough time to recover. Whispering should be avoided since it stresses the vocal cords even more.

• Hydration: Taking plenty of warm drinks moisturises the larynx lining and accelerates the recovery process. Hot water, herbal teas, and hot broths have proven especially effective.

• Inhalations: Breathing in the steam of heated water or a steam inhaler moisturises the inflamed larynx.

• Throat Lozenges and Sprays: These drugs contain various substances, including analgesics, anaesthetics, and soothing herbs such as ginger and honey.

• Painkillers: In case there is an accompanying sore throat and mild fever, pain medication such as paracetamol or ibuprofen may be taken.

• Antibiotics: Doctors may prescribe antibiotics if the laryngitis is caused by bacteria.

• Medicines: Doctors can recommend corticosteroids (to reduce swelling), antifungal medicines (to resolve fungal infections), or proton pump inhibitors (to manage acid reflux), based on the cause of laryngitis.

• Speech Therapy: A speech therapist will help you learn the correct vocal techniques, which can prevent excessive use of voice leading to its rehabilitation.

• Surgery: If vocal cords have nodules, polyps, or cysts, surgery will be required through microlaryngoscopy.

Can Laryngitis be Prevented?

Laryngitis cannot be fully prevented, but the chances of developing it can be reduced through good vocal care habits, such as the following:

• Practice Vocal Hygiene: Do not shout or speak loudly for long hours. Take adequate voice rest if your work demands excessive use of your voice. Learn how to breathe and project your voice properly.

• Maintain Proper Hydration: Drink no less than 8-10 glasses of water a day to ensure that your vocal cords remain hydrated. Avoid consuming excess amounts of coffee and alcohol, which cause dehydration.

• Quit Smoking: One of the worst agents affecting the larynx is the smoke from tobacco products. By quitting smoking, you will minimise the chances of developing chronic laryngitis.

• Control Acid Reflux: You should avoid acidic, spicy, and fatty foods and consume smaller meals. Furthermore, do not lie down soon after eating to prevent developing GERD-related laryngitis.

• Prevent Upper Respiratory Tract Infections: Frequently wash your hands, limit exposure to people with infections, and take your influenza vaccination shots to prevent viral laryngitis.

What is the Prognosis of Laryngitis?

The outlook of patients suffering from laryngitis is excellent, especially those with acute laryngitis. Most people with acute viral laryngitis fully recover within a few days or two weeks without any complications, provided they get sufficient voice rest and hydration. In cases of acute bacterial laryngitis, a course of antibiotics can restore health completely.

The prognosis for chronic laryngitis depends on the diagnosis and treatment of the underlying cause. People who quit smoking, take proper medicines and treatment, treat acid reflux issues, and undertake voice training usually improve their vocal function considerably.

Does Health Insurance Cover Laryngitis?

Health insurance can cover treatment for laryngitis if it requires medically necessary hospitalisation, such as vocal chord surgery. Most standard health insurance policies cover inpatient hospitalisation for at least 24 consecutive hours, as well as eligible expenses such as surgery charges, diagnostic tests, prescribed medicines, room rent, and pre- and post-hospitalisation expenses.

However, most cases of laryngitis can be managed with home remedies and medicines, in which case, health insurance coverage will not be available. Some insurers may offer coverage for outpatient (OPD) consultations and medicines through optional OPD add-on benefits.

Note: It is advisable to read the policy documents carefully to understand the exact inclusions, exclusions, waiting periods, and applicable conditions.

How Much Health Insurance is Required for Laryngitis?

Health insurance coverage is offered for surgical procedures such as vocal cord surgery, which can be expensive. Given the rising cost of medical procedures in India, it is generally advisable to have a health insurance policy of at least ₹10 lakh. If you are at a higher risk of developing chronic or recurrent laryngitis, for example, if your job demands extensive voice use, such as teaching, singing, or public speaking, you may consider opting for a higher sum insured.