Laryngitis: Symptoms, Types, Causes and Treatment

Laryngitis, the inflammation of the larynx (voice box), is a frequent and impactful condition that can affect anyone—from professional singers to young children and older adults. Whether it appears suddenly or lingers for weeks, laryngitis can cause a range of symptoms, disrupt daily life, and sometimes signal underlying health concerns. In this article, we’ll explore the symptoms, types, causes, and evidence-based treatments for laryngitis, synthesizing the latest clinical insights and research findings.

Symptoms of Laryngitis

Laryngitis doesn’t just steal your voice—it can create a constellation of symptoms that affect communication, comfort, and even breathing. Recognizing these symptoms early can help guide timely and effective management.

Symptom	Description	Frequency/Severity	Source(s)
Hoarseness	Change in voice quality, raspy	Most common	1 7 13
Dysphonia	Difficulty speaking/voice fatigue	53% in chronic laryngitis	1
Sore Throat	Pain or discomfort	Common	1 5
Globus	Sensation of lump in throat	40% in chronic cases	1 4
Cough	Irritative, sometimes barking	33% in chronic, more in acute	1 7
Throat Clearing	Frequent urge to clear throat	28% in chronic cases	1
Dysphagia	Trouble swallowing	32% in chronic cases	1
Stridor	High-pitched breathing noise	Seen in subglottic/childhood	7
Dyspnea	Shortness of breath, rare but serious	Severe cases	2 7

Table 1: Key Symptoms of Laryngitis

Voice Changes: Hoarseness and Dysphonia

The hallmark of laryngitis is a change in voice quality—commonly described as hoarseness, weakness, or even complete loss of voice. In chronic laryngitis, over half of patients report persistent dysphonia, which can significantly impact daily communication and work, especially for those who rely on their voice professionally 1 13.

Throat Discomfort: Pain, Globus, and Clearing

Many patients experience persistent throat pain or soreness, and a sizable proportion (about 40%) describe a sensation of “something stuck” in the throat (globus). This globus sensation is often linked to irritation or inflammation from reflux or persistent coughing 1 4. The frequent urge to clear the throat is another common, sometimes habit-forming, symptom.

Cough and Swallowing Issues

Cough is a prominent symptom in both acute and chronic laryngitis. In acute cases, especially in children, the cough can be barking and alarming. Chronic sufferers may have a dry, tickling cough that lingers. Difficulty swallowing (dysphagia) is less common but can be distressing, especially if it is associated with pain or a feeling of obstruction 1 7.

Breathing Difficulties: Stridor and Dyspnea

While rare in adults, severe laryngeal inflammation—especially in children—can cause stridor (a noisy, high-pitched breath sound) or even breathing difficulty (dyspnea). These are medical emergencies requiring urgent attention 2 7.

Types of Laryngitis

Laryngitis is not a one-size-fits-all diagnosis. It can be acute or chronic, and each category has its own subtypes, causes, and clinical features.

Type	Duration/Features	Typical Causes	Source(s)
Acute	< 3 weeks, sudden onset	Viral/bacterial infection, overuse	2 3 7 13
Chronic	> 3 weeks, persistent	Reflux, irritants, allergy, autoimmune	1 2 3 8 10
Subglottic	Acute, mostly children	Viral, airway narrowing	7
Ulcerative	Chronic, post-infectious	Vocal fold ulcers, cough	5
Eosinophilic	Chronic, allergic	Inhaled allergens/pollution	10
Reflux-associated	Chronic, posterior larynx	Acid reflux	4 8 11 12 15

Table 2: Types of Laryngitis

Acute Laryngitis

Acute laryngitis is sudden in onset and typically lasts less than three weeks. It’s most often triggered by viral infections—such as those causing the common cold—but can also be due to bacterial infections or acute vocal strain (e.g., shouting, singing) 2 3 13. In children, acute laryngitis may present as “croup” or “acute subglottic laryngitis,” featuring a barking cough and potential breathing difficulties 7.

Chronic Laryngitis

Chronic laryngitis persists beyond three weeks and is typically more complex. Common causes include ongoing exposure to irritants (smoke, dust, pollutants), persistent acid reflux (laryngopharyngeal reflux), allergies, and sometimes autoimmune or idiopathic factors 1 2 3 8 10.

• Reflux-associated laryngitis: A frequent and sometimes under-recognized cause, with symptoms often worse in the morning or after lying down. The posterior larynx is especially vulnerable 4 8 12 15.
• Ulcerative laryngitis: Characterized by ulceration of the vocal folds after a prolonged cough, often following a respiratory infection 5.
• Eosinophilic laryngitis: Linked to inhaled allergens (e.g., house dust mite, pollution) and marked by eosinophilic inflammation 10.

Special Types

• Subglottic laryngitis (croup): Primarily affects children, causing airway narrowing and noisy breathing. It requires prompt recognition and management 7.
• Idiopathic forms: In some cases, no clear cause is found, despite extensive evaluation 5 11.

Causes of Laryngitis

Understanding what triggers laryngitis is essential for both prevention and effective treatment. The causes range from infections to environmental exposures, reflux, and autoimmune conditions.

Cause	Mechanism/Trigger	Risk Factors/Notes	Source(s)
Viral Infection	Inflammation from viruses	Cold/flu season, all ages	2 3 7 13
Bacterial Infection	Less common, sometimes severe	Streptococcus, diphtheria	6 7 13
Acid Reflux	Stomach acid irritating larynx	GERD, hiatal hernia, nocturnal reflux	4 8 9 11 12 15
Irritants	Smoke, dust, chemicals	Smokers, pollution, workplace	9 10
Allergies	Airborne allergens	Environmental, seasonal	10
Vocal Overuse	Strain, shouting, singing	Teachers, singers, public speakers	3 8
Autoimmune	Chronic inflammation	Rare, associated with other autoimmune disease	2
Idiopathic	Unknown cause	Diagnosis of exclusion	5 11

Table 3: Causes of Laryngitis

Infectious Causes

Most acute laryngitis cases are viral, associated with upper respiratory tract infections—these are contagious but usually self-limiting. Bacterial laryngitis is less common but can be more severe and sometimes mistaken for other illnesses (e.g., diphtheria, pertussis) 6 7 13.

Reflux and Irritants

A significant proportion of chronic laryngitis arises from irritation due to acid reflux—when stomach contents travel back into the throat, especially at night or in those with hiatal hernia. This is increasingly recognized in both clinical and research settings 4 8 11 12 15. Environmental irritants like smoke (especially cigarette smoke), air pollution, and workplace chemicals are also major contributors, often in combination with other risk factors 9 10.

Allergies and Autoimmune Factors

Inhaled allergens (e.g., dust mites, pollen) can cause chronic eosinophilic laryngitis, with ongoing throat irritation and inflammation 10. Autoimmune processes can also inflame the larynx, though these are rarer and often associated with other systemic symptoms 2.

Behavioral and Idiopathic Causes

Vocal overuse or misuse—such as yelling or excessive throat clearing—can initiate or perpetuate laryngeal inflammation, especially when combined with other irritants 3 8. In some cases, no clear cause is found, and the laryngitis is termed idiopathic 5 11.

Treatment of Laryngitis

Treatment strategies depend on the type and underlying cause of laryngitis. While acute cases often resolve on their own, chronic laryngitis may require targeted therapy to address contributing factors and prevent complications.

Treatment Approach	Indication/Strategy	Notes/Effectiveness	Source(s)
Voice Rest	Acute/overuse	Promotes healing, avoid whispering	3 13
Hydration & Humidification	Acute, chronic	Soothe throat, thin secretions	3 13
Antibiotics	Bacterial only (rare)	Not useful for viral causes	6 13
Acid Suppression (PPIs, H2 blockers)	Chronic/reflux	Effective for many chronic cases	1 4 11 12 15
Antireflux Precautions	Chronic/reflux	Elevate head, avoid late meals	12 15
Allergy Management	Eosinophilic/Allergic	Allergen avoidance, nasal steroids	10 1
Environmental Changes	Irritant exposure	Smoking cessation, air quality	9 10
Voice Therapy	Chronic, vocal strain	Speech-language therapy	1 3 8
Surgical (rare)	Severe/refractory cases	For airway compromise or lesions	2 7

Table 4: Treatment Strategies for Laryngitis

Supportive Care for Acute Laryngitis

Most cases of acute laryngitis are viral and resolve within days to a week. Key recommendations include:

• Voice rest: Avoid talking, singing, or whispering excessively to allow vocal cords to heal.
• Hydration: Drink plenty of fluids; use humidifiers to keep air moist.
• Symptom relief: Analgesics or throat lozenges can ease discomfort.

Antibiotics are generally not recommended for uncomplicated acute laryngitis, as they don’t improve recovery in viral cases 13. They may be considered only if specific bacterial infections are diagnosed 6.

Targeted Therapy for Chronic Laryngitis

Acid Suppression and Antireflux Precautions

Chronic laryngitis driven by acid reflux responds well to antireflux strategies:

• Lifestyle measures: Elevate the head of the bed, avoid late-night eating, reduce spicy/fatty foods.
• Medications: Proton pump inhibitors (PPIs) like lansoprazole or omeprazole, and sometimes H2 blockers, are effective in many patients. Studies show symptom resolution in most cases when reflux is controlled 1 4 11 12 15.

Allergy and Environmental Management

For cases linked to allergies or environmental irritants:

• Allergen avoidance: Reduce exposure to dust mites, pollens, or occupational irritants.
• Medications: Nasal steroids and antihistamines may be helpful, although their role is less pronounced than acid suppression 1 10.
• Smoking cessation: Strongly encouraged for all patients, as smoking is a major risk factor for chronic laryngeal inflammation and pre-malignant changes 9 10.

Voice Therapy and Behavioral Modification

Speech-language pathologists can help patients modify vocal behaviors, especially those with habitual throat clearing, chronic cough, or excessive voice use. This can be particularly important for teachers, singers, and public speakers 1 3 8.

Managing Severe or Refractory Cases

In rare cases of severe airway obstruction or when medical therapy fails (e.g., severe subglottic laryngitis in children, or intractable ulceration/granuloma), more intensive interventions—such as corticosteroids, surgery, or even tracheostomy—may be required 2 5 7.

Conclusion

Laryngitis is a multifaceted condition with a broad spectrum of symptoms, causes, and treatments. Most cases are benign and self-limiting, but chronic or severe presentations require careful evaluation and targeted therapy.

Key Takeaways:

• Symptoms: Hoarseness, throat pain, globus sensation, cough, and sometimes breathing difficulties are hallmark symptoms.
• Types: Laryngitis can be acute or chronic, with subtypes including reflux-associated, eosinophilic, and ulcerative forms.
• Causes: Infections, acid reflux, environmental irritants, allergies, and vocal strain are major contributors.
• Treatment: Supportive care works for most acute cases, while chronic laryngitis often improves with acid suppression, lifestyle changes, and voice therapy.

Early recognition and tailored management are essential, especially to address underlying causes and prevent complications. If symptoms persist or worsen, consulting an otolaryngologist is recommended for further evaluation and care.