What are Throat Ulcers?
A throat or mouth ulcer is a break in the skin (an open wound) that originates in your throat. Throat ulcers can form both in your throat (often on your esophagus – the tube leading to your stomach) and your vocal cords. Throat ulcers result from a break in the lining of your throat or when a mucous membrane ruptures and fails to heal. These ulcers could be bright red, inflamed, and swollen. You experience difficulty eating, drinking, and often talking [1].
What Causes Throat Ulcers?
The list of causes of throat ulcers is long, but viral infections often play a role. These include:
- Ebola,
- dengue fever,
- HSV (herpes simplex virus),
- measles,
- and herpangina [2].
Infection with the bacterium Helicobacter pylori can weaken the lining of your esophagus, making it easier to damage and ulcerate [2].
Chemotherapy and radiation therapy might leave healthy cells in your mouth and throat dead, which can lead to ulcers [2]. Nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics might cause throat ulcers [2].
Gastroesophageal reflux disease (GERD), in which the stomach acid comes up into your throat, can erode the lining of your throat and lead to ulcers [2]. Scarfing down acidic foods or alcohol can also scorch the lining of your throat to the point of ulceration. [2]
Excessive talking, singing, or even coughing can cause irritation, leading to ulcers on the vocal cords [1]. In serious cases, a ventilator can also cause throat ulcers [2].
Certain lifestyles can similarly increase one’s risk of a throat ulcer, such as smoking: it has been implicated as a major risk factor for peptic ulcers in many clinical and epidemiologic studies [4].
Finally, some nutrient deficiencies, such as vitamin B12 or iron, can cause throat ulcers [2].
Are Ulcers on the Back of the Throat Serious?
Some chronic or long-term ulcers that develop on the back of our throats can be alarming, depending on the cause. These can be triggered by viral infections, bacterial infections, chemotherapy, radiation therapy, and certain medicines [2, 1].
Ulcers that don’t heal or have no obvious cause could be a persistent symptom of throat cancer, along with lumps in the throat, unusual bleeding or numbness, changes in voice, swollen lymph nodes in the neck, and persistent cough – possibly with blood [2].
Ulcers on the back of the throat (pharyngeal ulcers) can be serious and require medical attention, especially if they cause significant pain, difficulty swallowing, or persist for an extended period. Here are some key points based on the provided articles:
- Potential Causes: Pharyngeal ulcers can be caused by viral infections (e.g., herpes simplex, cytomegalovirus, HIV) [8], [10], [9], bacterial infections, fungal infections, radiation therapy [11], [12], chemotherapy, medications (e.g., doxycycline, emepronium bromide) [13], [14], gastroesophageal reflux disease (GERD), and other conditions like Behcet's syndrome [15].
- Symptoms: Pain or discomfort in the throat, difficulty swallowing, white or red patches in the throat, fever, bad breath, and a lump in the neck [16].
- Serious Complications: Persistent or non-healing ulcers may be a symptom of throat cancer [8]. Ulcers can also lead to complications like esophageal perforation, mediastinitis, or pericarditis in rare cases [13].
- Diagnosis and Treatment: Endoscopy and biopsy may be required to determine the underlying cause and rule out cancer [17]. Treatment depends on the cause, such as antiviral medications for viral infections, antibiotics for bacterial infections, acid suppression for GERD, or discontinuing offending medications.
In summary, while not all throat ulcers are serious, they should be evaluated by a healthcare provider, especially if accompanied by severe or persistent symptoms, to determine the underlying cause and initiate appropriate treatment.
But they could also be caused by gastroesophageal reflux disease (GERD). GERD involves liquids from your stomach (known as gastric reflux) riding up into your esophagus. This backflow can burn your esophagus and cause ulcers. It can also cause heartburn in the chest, a bitter or sour taste, and regurgitation of pepsin-containing stomach contents up into your mouth [2].
Sometimes, ulcers on the back of the throat result from irritation, such as too much talking, singing, or coughing. Other possibilities for an ulcer include vomiting, nutrient deficiency, eating too many acidic foods or alcohol, and allergies [2].
In the worst cases, ulcers on the back of the throat can be profoundly painful. Eating, drinking, and even swallowing for days can be difficult. After interviewing 14 adult patients with hypopharyngeal ulceration, researchers counted seven who had undergone a gastrostomy, ostensibly to help keep them nourished and ease subsequent scarring [5].
Treatment of Throat Ulcers
Treatment of throat ulcers depends on their cause. Only general interventions are recommended for mild illness: rest, fluids, and antipyretics such as Tylenol to control pain and fever [2].
Antibiotics, antifungal medications, and antiviral drugs can treat the infection that causes a throat ulcer. Pain medications and a doctor-prescribed mouthwash can also help manage symptoms [2, 1].
Antacids, H2 receptor blockers, or proton pump inhibitors can neutralize acid or reduce production if an esophagus ulcer is present [1].
For vocal cord ulcers, voice rest, speech therapy, treatment of gastroesophageal reflux disease (GERD), and surgical treatment in more severe cases are some of the treatments generally used [1].
Home remedies are also useful: avoiding alcohol and tobacco, as well as foods that can exacerbate GERD symptoms, such as spicy and acidic food; eating only cool food and drinks; drinking plenty of fluid [2].
Chinese herbal medicine has also been shown to help recover from viral oral ulcers in a few settings [6].
However, any ulcer that fails to heal within 12 to 15 weeks should be evaluated for malignant neoplasm and considered for surgical resection [7].