​Hoarseness


Hoarseness is an abnormal change in the pitch, texture and volume of voice, resulting in the voice varying from being deep and harsh to strained, weak and raspy. Hoarseness is generally caused by an irritation of the vocal cord or an injury to the same. Our vocal cords are in a portion of the breathing tract in the voice box (larynx). When we speak, the vocal cords vibrate, producing a variety of different sounds.

When you suffer from common cold or a throat or a respiratory tract viral or bacterial infection, the vocal cords may get swollen due to inflammation, causing changes in your voice. Strenuously using your voice in such a condition may worsen hoarseness. Overusing your voice or misusing it over extended period, such as due to excessive yelling, speaking publicly without voice amplification instruments or singing loudly may also adversely affect your vocal cords. Besides these, allergies and thyroid problems may also lead to hoarseness.

GERD (Gastroesophageal Reflux), which occurs when stomach acid comes up the swallowing tube (oesophagus) and irritates the vocal cords, is another possible cause of hoarseness. Paralysis of vocal cords due to a neurological disorder can also lead to hoarseness; hence it is also a symptom of neurological disorders. Smoking is also a common cause of hoarseness. In rare cases, persistent hoarseness may be a sign of larynx cancer, and smokers must not ignore persistent hoarseness of voice as they are at a high risk for throat cancer.

People who are professional singers or those who have a history of smoking are more prone to suffer from hoarseness of the voice. Persistent hoarseness that stretches beyond two weeks must not be ignored and a visit to the doctor is recommended.

Hoarseness itself is usually a symptom of an underlying condition. Usual signs and symptoms which you may notice along with hoarseness include:

  • Your voice becomes raspy and harsh.

  • Changes in the pitch and volume of your voice.

  • Sore throat, common cold or cough.

  • Difficulty swallowing.

  • Difficulty breathing.

  • Fever.

  • Heartburn in cases of hoarseness caused by GERD (Gastroesophageal Reflux).

  • Watery and itching eyes with non-stop sneezing in cases where hoarseness occurs due to allergic disorders.

  • Sensitivity to hot or spicy foods.

  • Constant throat clearing.

  • Wheezing.

Hoarseness usually clears up within a week or two by taking care of yourself and limiting the use of your voice till it has recovered. However, if it lasts longer than two weeks, it could be a sign of another disorder and must be assessed by an ENT (Eye-Nose-Throat) professional. You can discuss your symptoms in a safe and secure environment with your ENT doctor working with the Eye and ENT Service Line at The Aga Khan University Hospital, where you will receive multidisciplinary healthcare from our team of highly qualified ENT specialists.

While hoarseness is a self-limiting disorder and usually clears up on its own, it should not be left untreated and undiagnosed if it lasts longer than two weeks. Fever along with hoarseness could also be a sign of a throat infection which may require antibiotics prescribed by your doctor.
Other serious symptoms which may occur along with hoarseness and must not be ignored include:

  • Coughing up blood.

  • Severe, persisting pain in the throat.

  • Pain in the ears.

  • Severe pain when swallowing which affects food intake.

  • Weight loss.

These symptoms could indicate the presence of a serious underlying condition. If you have any of the above symptoms along with hoarseness, visit an ENT specialist of the Eye and ENT Service Line at The Aga Khan University Hospital to get your hoarseness evaluated by a qualified medical professional.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

The first step towards assessing your disorder will be to take ask questions about hoarseness and associated symptoms, such as how long has your voice been hoarse, whether any accompanying symptoms have been present, such as difficulty swallowing, cold, throat infection, etc.

After a detailed medical history has been taken, a physical examination of the throat, head and neck will be made. Our team of highly qualified ENT doctors at The Aga Khan University Hospital is internationally trained in the diagnosis and treatment of ENT disorders. The doctor may use a long, lighted flexible tube (laryngoscope), which will be inserted inside the nose to examine the throat and vocal cords. In cases where the doctor may suspect signs of an infection, additional tests may be requested. In some cases, X-rays and CT (Computerized Tomography) scans may also be ordered, depending on the findings of the physical examination.

The treatment of your symptoms will depend on the underlying disease causing the hoarseness. In most cases, resting your voice will help reduce hoarseness in your voice. You may also be advised to stop smoking, avoid alcohol and caffeine and even avoid passive smoking. Drinking plenty of fluids is also a good idea to help restore your voice.  
If your hoarseness is due to an infection, antibiotics will be prescribed to help ease your symptoms. In cases of allergies, antihistamine medications will also be prescribed. Pain reliever medicines can also help provide relief from throat pain. In cases polyps or other lesions have developed on your vocal cords, surgery may be recommended.

In general, quitting smoking, staying hydrated, avoiding overuse of the voice by screaming or yelling, using a microphone when you need to project your voice, getting professional voice training for singers, and avoiding speaking or singing when your voice is affected are some measures you can take to prevent frequent hoarseness.

You must follow through with the treatment plan prescribed for you by your doctor. At The Aga Khan University Hospital, you can be sure of receiving high quality healthcare to help provide you relief from your symptoms.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.



The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.