Sore throat is a common reason for consultation. It is a symptom rather than a disease in itself. It can be diffuse or localized to the tonsils, pharynx or larynx.
Locations of sore throat
– Pharyngitis: it is an inflammation of the tissues of the throat (pharynx). Swallowing, talking or even breathing can become painful.
– In tonsillitis (tonsillitis) the pain is more localized and sits at one or both tonsils, and causes significant difficulties in swallowing. The pain can also radiate in the ear.
– Epiglottitis is an inflammation of the epiglottis (small cartilaginous tongue closing the larynx during swallowing). It is rare but potentially serious because of respiratory difficulties
Causes and symptoms of sore throat
Sore throats can be tingling, pain, or burning, sometimes associated with difficulty swallowing or talking, and other symptoms depending on the location and cause of the disease.
In 80% to 90% of cases, sore throat is caused by a virus.In 10 to 15% of cases, angina is due to infection with a bacterium.
Sore throat of viral origin. It can be pharyngitis or the beginning of a viral rhino-pharyngitis which is then completed by coughing, sneezing and nasal obstruction as in the flu, for example.
Viral tonsillitis is usually accompanied by a moderate fever (between 38 and 39 °). They may be due to many common viruses, but also to mononucleosis or herpes, measles, chickenpox …
Sore throat of bacterial origin. Several types of bacteria can infect the throat.
Strep throat (see angina pox) is caused by type streptococci (more rarely B or C). It is accompanied by fever, a swelling of an amygdala, which may be red or strewn with white spots; in the neck, there is often a swollen and painful ganglion on the affected amygdala side. This angina can be serious when the streptococcus is group A because it can have repercussions on the whole body, the kidney and the heart in particular. It must be treated quickly with antibiotics.
This disease most often affects young people from 5 to 15 years of age, but can also affect adults.
Two very particular angina pectoris, diphtheria which has practically disappeared from developed countries with vaccination, and scarlet fever, which is accompanied by a rash
Chronic tonsillitis refers to inflammation of the tonsils usually occurring after repeated tonsillitis, which is responsible for minor swallowing pain or discomfort but may increase during warming episodes. The tonsillar crypts can be filled with hard whitish secretions, the caseum, with a foul odor.
The epiglottitis is generally due to bacteria causing pneumonia and meningitis, Haemophilus influenzaetype B (Hib). This disease has become exceptional since the generalization of vaccination against Haemophilusinfluenzae in children
Irritative causes of sore throat
Sore throats can also be due to:
- An allergic reaction to animal hair, mold or pollen.
- Dry air, especially in winter when houses are heated or in summer because of air conditioning.
- Pollution or chemical irritants such as tobacco smoke or evaporation of products such as glues, paints, household products …..
- Pharyngolaryngeal inflammation after vocal overwork.
- Gastroesophageal reflux causing pharyngitis due to the rise of acidic fluid from the stomach to the throat.
A sore throat that persists for more than 1 week may be a sign of a more serious problem:
- HIV infection, gonococcal infection.
- The presence of a tumor of the pharynx or larynx.
Most sore throats, although uncomfortable, fade on their own in 5 to 7 days. A sore throat of bacterial origin can lead to certain complications.
- Peri-tonsillar abscess (around the tonsils) or retropharyngeal abscess (behind the pharynx).
- Inflammation of the kidneys ( glomerulonephritis ).
- Acute rheumatic fever, which can damage the valves of the heart and other organs.
When to consult ?
It is best to have a medical consultation if the following symptoms are present:
- difficulty swallowing or breathing
- changes of voice or persistent cough more than a week
- excessive salivation (especially in children)
- swelling of the neck or tongue
- stiff neck or difficulty opening mouth
- Blood or mucus in saliva.
- fever over 38 °
- persistent fatigue
The consultation must be even faster (in the day or even in an emergency) in case:
- fever over 39 °
- Disease or treatment that disrupts immunity: HIV infection, treatment with corticosteroids, immunosuppressive agents or biotherapies used to treat rheumatism or chronic inflammatory bowel diseases, especially if breathing difficulties exist
Diagnostic of sore throat
It is sometimes difficult to discern a bacterial infection from a viral infection with the only symptoms of sore throat . The doctor usually uses the presence (or absence) of several symptoms to assess the likelihood of a bacterial infection. It is unlikely in children under 3 years of age or when it is accompanied by rhinitis or conjunctivitis. Thereafter, the doctor can detect if it is an infection. Streptococcus by a rapid diagnostic test, the TDR made by a sampling inside the throat. In this case, antibiotic treatment is necessary.
People at risk for sore throat
- Children and teenagers especially, but all ages may be concerned.
- People with seasonal allergies to pollens or allergic reactions to dust, mold or animals.
- People who have frequent or chronic sinus infections.
- People with weakened immune systems, such as people with HIV, diabetes, steroids, or chemotherapy.
- People who are stressed, tired or have a bad diet.
- Active or passive smoking.
- Exposure to chemical irritants such as products from the combustion of gasoline or household products that irritate the throat.
- Heating at high temperatures or air conditioning
- Live or work in the presence of many people (daycare, schools, and offices) which exposes to contamination by various viruses.
Prevention of sore throat
|Basic preventive measures|
Medical treatments of sore throat
Symptomatic treatments for sore throat
These treatments are not intended to cure the cause of sore throat, but to relieve the affected person. Symtomatic treatment is therefore an adjunct to the treatment of the cause of sore throat.
To relieve pain and fever, we can advise paracetamol-type analgesics, nonsteroidal anti-inflammatory drugs in the absence of contraindications, for a short time and if the sore throat seems viral (they have been accused of promoting complications of microbial tonsillitis)
Locally, mouthwashes, lozenges, mouthwashes or gargles with antiseptics can be used. The hot milk with honey or the honey / lemon combination have properties as pleasant as antiseptics
In case of fever it is necessary to compensate the risk of dehydration by drinking a lot.
Dry air can be fought by humidifiers.
If the sore throat is caused by a virus , you must take the trouble. The symptoms disappear as soon as the body has eliminated the virus. Most symptoms caused by a cold virus persist for 7 to 10 days. As for the symptoms of mononucleosis, they can last 4 weeks or more.
If the sore throat is caused by streptococcal bacteria , the doctor prescribes an antibiotic , to relieve acute symptoms faster, but especially to prevent some rare but serious complications .
Sore throat not associated with an infection requires special care, suppression or limitation of irritants, treatment of an allergy or gastro-oesophageal reflux or throat tumor
To relieve a mild sore throat without gravity:
- Do not take anti-inflammatories as they increase the risk of severe angina. Take a paracetamol or acetaminophen type painkiller instead;
- Gargle with warm salt water (1/2 teaspoon salt in 1 cup water), but it’s more of a preventative treatment if someone around you is affected;
- drink a lot especially if you have a little fever;
- Use a humidifier.
|Honey and lemon . The combination of honey and lemon gargle helps to relieve the irritation of the throat and reduce cough while having an antiseptic effect. Honey could reduce mucus and inhibit the reproduction of bacteria in the throat.|