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Sore Throat

    What is Sore Throat?

    A sore throat, also called pharyngitis, is discomfort, pain, or scratchiness in the throat. A sore throat often makes it painful to swallow. Sore throats are common and most of the time the soreness is worse in the morning and improves as the day progresses.Sore throat may be acute: of a few days duration, or chronic / recurrent, which is longstanding and keeps happening. Like colds, the vast majority of acute sore throats are caused by viral infections. Many people have a mild sore throat at the beginning of every cold. When the nose or sinuses become infected, drainage can run down the back of the throat and irritate it, especially at night. Or, the throat itself can be infected. Some viruses can cause specific types of sore throat.Strep throat is the most common bacterial cause of acute sore throat. Because strep throat can occasionally lead to rheumatic fever, antibiotics are given. Strep throat often includes a fever (greater than 101degree Fahrenheit), white, draining patches on the throat, and swollen or tender lymph glands in the neck.Fungal infection, with Candida (thrush) may sometimes be associated with severe pain in the throat, especially in diabetics, or those taking steroid inhalers for asthma.Chronic sore throat, or constant and recurrent irritation in the throat is often allergic / irritant in nature, set off by irritation due to dust, pollutants, excess spices, fried food etc.This chronic irritation in the throat is now frequently correlated with GERD: Gastro-esophageal reflux, where reflux of acid from the stomach irritates the throat and gives a sensation of food sticking in the throat, burning, pain etc. Both these factors make the person more prone to develop bacterial/viral acute sore throat / pharyngitis.

    What are the causes?

    Breathing through the mouth (can cause drying and irritation of the throat)Common coldFluInfectious mononucleosisSomething stuck in the throat Strep throatSurgery such as tonsillectomy and adenoidectomyViral pharyngitisAcid reflux (GERD)Fungal infection

    Seek professional help?

    Seek medical care:If you have been in contact with someone with strep throat and you have a sore throat, it is reasonable to have a strep test done. If your sore throat is associated with a fever, swollen glands (lymph nodes), or white patches on the back of your throat.If your sore throat is not associated with other cold symptoms (runny nose, watery eyes, sinus congestion).Any sore throat that has a sudden onset and is associated with a fever.If you are having trouble swallowing liquids (pain with swallowing is to be expected with a sore throat). If your sore throat persists for more than a week.If you have a sore throat and the front of your neck is sore and stiffAnalgesics like paracetamol may be taken to reduce the pain. Anti-histaminics / anti-allergics are prescribed to reduce the irritation. Anti-reflux medication may be prescribed to take care of GERD as a cause, and minimise the effects of other medication on the stomach. Gargles with antiseptics like Povidone iodine (Betadin), tantum etc. may be prescribed.Usually, treatment with antibiotics gets delayed until laboratory test results are known. Doctors often begin treatment of a sore throat immediately if there is a family history of rheumatic fever or if the patient has scarlet fever. Antibiotics are usually not wise if the strep test or throat culture is negative, and they can have serious side effects.For a sore throat caused by bacterial tonsillitis, antibiotic treatment may be recommended. Some tonsillitis is viral and will clear up without treatment (surgery is rarely necessary). Recurrent or persistent sore throats without bacterial infection may be due to allergies and require anti-allergy treatment.Surgery of Tonsillectomy (removal of tonsils) is only indicated if there are more than 4-5 episodes of severe acute tonsillitis per year in children, or 2-3 very severe episodes in adults, or a history of complications like peritonsillar abscess.

    What is the treatment?

    Home careMost sore throats get cured soon but here are some home remedies that may help:Drink warm liquids. Honey or lemon tea is a time-tested remedy.Gargle several times a day with warm salt water (1/2 teaspoon of salt in 1 cup water).Sucking on hard candies or throat lozenges can be very soothing, because it increases saliva production. Use a cool-mist vaporiser or humidifier to moisten and soothe a dry and painful throat.

    What are the prevention?

    Clean your hands frequently, especially before eating. This is a powerful way to help prevent many sore throat infections. Sore throats may be avoided by reducing contact with people with sore throats, but often these people are contagious even before they have symptoms, so this approach is less effective. A cool mist vaporiser or humidifier can prevent some sore throats caused by breathing dry air with an open mouth.