Definition and Overview

Sore throat, also known medically as pharyngitis, is defined as any pain, irritation or itchiness in the throat area that causes discomfort when swallowing. Sore throat can affect anyone in any age group. However, certain individuals such as smokers, young children, those with allergies and those with weak immune system, are at a higher risk of developing pharyngitis than others.

Symptoms of Sore Throat

As strongly suggested by its name, the main symptom of sore throat is an irritated, painful, scratchy, swollen throat. The pain is usually heightened when you try to swallow food. Depending on the underlying cause of your sore throat, you may also experience other symptoms including:

  • Fever
  • Headache
  • Sneezing and/or runny nose
  • Dry throat
  • Red and swollen tonsils
  • White patches in the throat or on the tonsils
  • Swollen glands in the neck
  • Hoarse or muffled voice
  • Abdominal pain and vomiting, usually in children

Causes of Sore Throat

Sore throat can be caused by a wide variety of factors with the most common ones being either viral or bacterial in nature. Common viral illnesses related to sore throat are as follows:

  • Common colds
  • Mononucleosis, an infectious disease caused by the Epstein-Barr virus that is usually transmitted through saliva (also known as the kissing disease)
  • Laryngitis (or croup), which is the infection of the voice box
  • Other possible related infections such as flu, measles, chickenpox, herpangina or mumps

Bacterial infection that results to sore throat can be a result of one of the following diseases:

  • Strep throat: throat inflammation caused by Streptococcal bacteria
  • Tonsillitis: an inflammation of the tonsils
  • Adenoiditis: an inflammation of the adenoids (nasopharyngeal tonsil)
  • Peritonsillar abscess: infection of the tissues surrounding the tonsils
  • Inflammation of the epiglottis (near the entrance of the larynx)
  • Inflammation of the uvula (the back of the roof of the mouth)
  • Other bacterial infections such as whooping cough and diphtheria

Other causes of sore throat include:

  • Allergies: Allergies can trigger irritation of the throat. Molds, pollen, dust, pet dander, and fiber are common triggers.
  • Irritants: Dry air, air pollution, along with exposure to cigarette smoke can also cause pharyngitis.
  • Dryness: Low humidity and dry indoor air, especially during cold winter months can cause sore throat.

Far less common causes of sore throat are throat strain (from yelling), physical injury to the throat, and gastro-esophageal reflux disease (GERD) that results in stomach acid irritating the throat. In more serious but even rarer cases, sore throat may be a symptom of throat cancer or sexually transmitted infection like HIV or gonorrhea.

Who to See and Types of Treatments Available

Most cases of sore throat do not require immediate medical attention. Home remedies described below are usually enough to heal sore throat in a few to several days. However, in cases where your sore throat persists for more than a week and if you experience the following discomforts, it is best to see your general practitioner immediately:

  • Difficulty breathing
  • Unusual drooling
  • Extreme difficulty in swallowing or ingesting food
  • Rashes
  • Abnormal earache
  • High fever
  • Chills
  • Bloody mucus
  • A lump that can be felt in the throat
  • Hoarseness in voice that lasts more than 2 weeks
  • Joint pains

Frequently recurring soar throats require immediate medical attention as well. Your general practitioner can refer you to an ENT (ears, nose and throat) specialist, also known as otolaryngologist for further diagnosis and treatment.

To properly identify the right treatment for sore throat, your GP will first diagnose its underlying cause. The doctor would ask you about possible triggers that may be directly linked to your condition. The doctor may also do a throat culture or a rapid strep test (or both) to determine if the condition is caused by a bacterial or viral infection. Blood tests may also be ordered to obtain more information.

If the sore throat is caused by bacterial infection, antibiotics or anti-bacterial medications are usually prescribed. Antibiotics have to be strictly taken from 7 to 10 days as prescribed in order to prevent recurrence and antibiotic resistance. If the cause is viral, antibiotics are usually not recommended, as they won’t work. Instead, your doctor will prescribe intake of lots of water, plenty of rest, and vitamin C supplementation.

Allergy-related sore throat is usually treated with antihistamines and complete avoidance of the identified allergen.

It is important not to self-medicate especially with intake of antibiotics for sore throat. As a rule, no matter how bad the sore throat is, antibiotics are never to be taken without the doctor’s prescription.

In general, patients with sore throat can safely take over the counter pain medication such as acetaminophen (Tylenol), ibuprofen (Advil), naproxen (Aleve), and aspirin for kids to alleviate pain. There are also home remedies proven to relieve sore throat discomfort, including:

  • Gargling with warm salt water (3 to 4 times a day)
  • Gargling with oral hexitidine antiseptic (like Bactidol) solutions
  • Taking throat lozenges
  • Installing a humidifier to minimize dry air
  • Drinking lots of warm fluids such as warm water, tea, and soup
  • Getting enough rest and sleep

Simple as they seem to be, sore throats can become complicated. For instance, persistent bacterial throat infections may lead to antibiotic resistance, which means that the bacteria-caused sore throat can no longer be treated with antibiotics. Persistent sore throat may also heighten the risk of infections, spreading into the bloodstream and affecting the heart. When this happens, your doctor may recommend a tonsillectomy to surgically remove the tonsils.

References:

  • Pharyngitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec08/ch089/ch089e.html.
  • Sore throats. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/soreThroats.cfm.
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