Sore throat

Sore throat (also called pharyngitis) is a painful inflammation of the mucousmembranes lining the throat.It is a symptom of many conditions, but most often is associated with colds or influenza. Sore throat may be caused by eitherviral or bacterial infections or environmental conditions. Most sore throatsheal without complications, but they shouldn't be ignored because some develop into serious illnesses.

Almost everyone gets a sore throat at one time or another, although childrenin child care or grade school have them more often than adolescents and adults. Sore throats are most common during the winter months when colds are morefrequent.

Sore throats may appear suddenly and last from three to about seven days, orthey may be chronic, lasting much longer. These chronic sore throats are often a symptom of an underlying condition or disease, such as a sinus infection.

Sore throats have many different causes, and may or may not be accompanied bycold symptoms, fever, or swollen lymph glands. Viruses cause 90% to 95% of all sore throats. Cold and flu viruses are the main culprits, inflaming the throat and occasionally the tonsils (tonsillitis). Cold symptoms almost alwaysaccompany a viral sore throat. These can include a runny nose, cough, congestion, hoarseness, conjunctivitis (eye inflammation), and fever. The level of throat pain varies from uncomfortable to excruciating, so that the patient can't eat, breathe, swallow, or speak without great discomfort.

Another group of viruses that cause sore throat are the adenoviruses, which also may cause infections of the lungs and ears. In addition to a sore throat,symptoms that accompany an adenovirus infection include cough, runny nose, white bumps on the tonsils and throat, mild diarrhea, vomiting, and a rash. The sore throat lasts about one week.

The coxsackie virus causes another type of severe sore throat linked to a disease called herpangina. Although anyone can get herpangina, it's most commonin children up to age ten and is more prevalent in the summer or early autumn. Herpangina is sometimes called summer sore throat. Three to six days afterbeing exposed to the coxsackie virus, an infected person develops a sudden sore throat with a fever between 102 and 104°F. Tiny grayish-white blistersform on the throat and in the mouth which turn into small ulcers. Throat pain is often severe, interfering with swallowing. Children may become dehydrated if they are reluctant to eat or drink because of the pain. In addition, people with herpangina may vomit, have abdominal pain, and generally feel ill and miserable.

Another common cause of a viral sore throat is mononucleosis, an infection caused by the Epstein-Barr virus that spreads to the lymphatic system, respiratory system, liver, spleen, and throat. Symptoms appear 30-50 days after exposure.

Mononucleosis, sometimes called the kissing disease, is extremely common; bythe age of 40, as many as 95% of Americans will have had the infection. Often, symptoms are mild, especially in young children, and are diagnosed as a cold. Since symptoms are more severe in adolescents and adults, more cases are diagnosed as monomucleosis in this age group. One of the main symptoms of mononucleosis is a severe sore throat.

Although a runny nose and cough are much more likely to accompany a sore throat caused by a virus than one caused by a bacteria, there is no absolute wayto tell what is causing the sore throat without a lab test. Viral sore throats are contagious and are passed directly from person to person by coughing and sneezing.

The other major cause of sore throats are bacterial infections, responsible for from 5% to 10% of painful throats. The most common bacterial sore throat results from an infection by group A streptococcus. This type of infection iscommonly called strep throat. Anyone can get strep throat, but it is most common in school age children.

Pharyngeal gonorrhea, a sexually transmitted bacterial disease, causes a severe sore throat as a result of having oral sex with an infected person.

Not all sore throats are caused by infection, however. Postnasal drip (causedby hay fever and other allergies) can irritate the throat and make it sore.Heavy smoking or breathing secondhand smoke or dry air, abusing alcohol, breathing polluted air or chemical fumes, or swallowing substances that burn or scratch the throat can also cause sore throat. People who breathe through their mouths at night because of nasal congestion often get sore throats that improve as the day progresses.

It is easy for people to tell if they have a sore throat, but difficult to know what has caused it without lab tests. Most sore throats are minor and healwithout any complications, but a few cases caused by bacterial infections can develop into serious diseases. Because of this, it's a good idea to see a doctor if a sore throat lasts more than a few days or is accompanied by fever,nausea, or abdominal pain.

Diagnosis of a sore throat by a doctor begins with a physical examination ofthe throat and chest. The doctor will also look for signs of other illness, such as a sinus infection or bronchitis. Since both bacterial and viral sore throat are contagious and pass easily from person to person, the doctor will ask whether the patient has been around other people with flu, sore throat, colds, or strep throat. If strep throat is a possibility, the doctor will do lab tests.

If mononucleosis is suspected, the doctor may do a mono spot test to look forantibodies indicating the presence of the Epstein-Barr virus. The test is cheap, takes only a few minutes, and can be done in a doctor's office. An inexpensive blood test can also determine the presence of antibodies to the mononucleosis virus.

Effective treatment varies depending on the cause of the sore throat. As frustrating as it may be to the patient, a viral sore throat is best left to runits course without drug treatment. Antibiotics have no effect on a viral sorethroat. They don't shorten the length of the illness, nor do they lessen thesymptoms.

Sore throat caused by bacteria must be treated with antibiotics. Patients need to take the full course of antibiotic prescribed, even if symptoms of the sore throat improve. Stopping the antibiotic early can lead to a return of thesore throat.

Because mononucleosis is caused by a virus, there is no specific drug treatment available. Rest, a healthy diet, plenty of fluids, limiting heavy exerciseand competitive sports, and treatment of aches with acetaminophen (Datril, Tylenol, Panadol) or ibuprofen (Advil, Nuprin, Motrin, Medipren) will help ease symptoms. Nearly 90% of mononucleosis infections are mild, and one infection confers immunity.

In the case of chronic sore throat, it's important to treat the underlying disease to heal the sore throat. If a sore throat caused by environmental factors, the aggravating substance should be avoided.

Regardless of the cause of a sore throat, there are some home care steps thatpeople can take to ease their discomfort. These include:

  • Taking acetaminophen or ibuprofen for pain. Aspirin should not be given to children because of its association with Reye's Syndrome, a serious disease.
  • Gargling with warm double strength tea or warm salt water made by adding one teaspoon of salt to eight ounces of water.
  • Drinking plenty of fluids, but avoiding acid juices like orange juice, which can irritate the throat. Suckingon popsicles is a good way to get fluids into children.
  • Eating soft,nutritious foods like noodle soup and avoiding spicy foods.
  • Refraining from smoking.
  • Resting until the fever is gone, then resuming strenuous activities gradually.
  • A room humidifier may make sore throat sufferers more comfortable.
  • Antiseptic lozenges and sprays may aggravatethe sore throat rather than improve it.

There is no way to prevent a sore throat; however, the risk of getting one orpassing one on to another person can be minimized by:

  • Washing hands well and often
  • Avoiding close contact with someone who has a sore throat
  • Not sharing food and eating utensils with anyone
  • Not smoking
  • Staying out of polluted air

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