Sore Throat
Introduction
The dry scratchiness and painful swallowing that are the hallmarks of a sore throat — known medically as pharyngitis — can be miserable. Yet a sore throat isn't a disease. Most often, it's a symptom of another illness — usually a viral infection such as a cold or the flu (influenza). In many cases, a sore throat is the first indication that you're getting sick.
Sore throats are so common they're one of the main reasons Americans see a doctor. But many of those office visits aren't necessary. Most sore throats are caused by a virus and go away on their own in about a week. Only a small percentage are bacterial infections that may require medical care.
Bacterial infections are sometimes treated with antibiotics, although drugs don't always speed healing or prevent infections from recurring. And antibiotics aren't effective against viruses, which respond best to self-care measures such as resting and drinking plenty of fluids. Until you're feeling better, salt-water gargles, throat lozenges or warm water with honey and lemon can help make having a sore throat rash easier to swallow.
Signs and symptoms
A sore throat pain usually occurs with other signs and symptoms. These can vary considerably, depending on the type of infection you have. Most often, a throat sores accompanies a viral infection, such as a cold or the flu. You can usually distinguish between the two based on your symptoms. For example, in addition to a sore throat, a cold is likely to cause:
- Sneezing
- Watery eyes
- Cough
- A low fever — less than 102 F
- Slight body aches or mild headache
- Fatigue
- Body aches
- Chills
- Sweats
- A fever over 102 F
- Swollen lymph nodes in your neck and armpits
- Swollen tonsils
- Headache
- Skin rash
- Loss of appetite
- Soft, swollen spleen
- Liver inflammation
- Measles
- Chickenpox
- Croup
Bacterial infections that can cause a severe sore throat include strep throat, tonsillitis and diphtheria — a serious respiratory illness that causes breathing difficulties and painful swallowing. Diphtheria is rare in industrialized nations but remains a threat in developing countries.
Causes
Most sore throat pain is caused by viruses — the same germs that cause colds and flu. A much smaller number are due to bacterial infections. Viruses and bacteria both enter your body through your mouth or nose — either because you breathe in particles that are released into the air when someone coughs or sneezes, or because you have hand-to-hand contact with an infected person or use shared objects such as utensils, towels, toys, doorknobs or a telephone. Touch your eyes or nose after such contact and you're likely to become sick yourself.
Because the germs that cause sore throats are contagious, they can spread easily wherever large numbers of people congregate: schools, child care centers, offices and yes, your own home. Even so, not all sore throats result from viral or bacterial infections. Other common causes of sore throat include:
- Allergies. The same pet dander, molds and pollens that trigger allergic reactions such as red, swollen eyes and a runny nose can also cause a throat sores.
- Dryness. Dry indoor air, especially in winter when rooms tend to be overheated, can make your throat feel rough and scratchy, particularly in the morning when you first wake up. Breathing through your mouth — often because of chronic nasal congestion — can also cause a dry, sore throat.
- Pollution and other irritants. Outdoor air pollution can cause ongoing throat irritation. But indoor pollution — especially tobacco smoke — is an even greater cause of chronic sore throat. What's more, inhaling secondhand smoke is often just as damaging as smoking itself. Smokeless tobacco, alcohol and spicy foods can also inflame your throat.
- Muscle strain. You can strain muscles in your throat just as you can strain them in your arms or legs. If you've ever gotten a sore throat after yelling at a concert or sporting event, you've likely strained your throat muscles.
- Acid (gastroesophageal) reflux disease (GERD). This occurs when stomach acid backs up into your food pipe (esophagus). Normally, a circular band of muscle (lower esophageal sphincter) blocks acid from coming up into the esophagus. But if the sphincter relaxes abnormally or weakens, stomach acid can back up, irritating your throat as well as your esophagus. Throat irritation caused by GERD doesn't occur with other symptoms of a viral illness, and it tends to be persistent, rather than lasting just a few days. It's also far more common in adults than in children. In many cases, you can prevent or reduce acid reflux with simple lifestyle changes — losing weight, avoiding foods that cause you discomfort and not eating right before bed, for example. When these aren't effective, over-the-counter or prescription medications may offer some relief.
- HIV infection. HIV-positive people with low CD4 counts sometimes develop a chronic sore throat. This isn't due to HIV itself but to a secondary infection such as oral thrush or cytomegalovirus, a common viral infection that can be extremely serious in immunocompromised people.
- Tumors. If you smoke or abuse alcohol, you're at high risk of tumors of the throat, tongue and voice box. In some people these tumors cause few, if any, signs and symptoms. In others, they can lead to hoarseness, difficulty swallowing and sore throat rash.
Although anyone can get a sore throat, some factors make you more susceptible to throat problems. These factors include:
- Age. Children and teens are most likely to develop sore throats. In the United States, children between ages 5 and 18 may have as many as five sore throats a year, whereas adults have less than half that number. Children are also far more likely to have strep throat, the most common bacterial infection associated with a sore throat.
- Smoking or exposure to secondhand smoke. Tobacco smoke, whether primary or secondary, contains hundreds of toxic chemicals that can irritate the throat lining.
- Allergies. If you have seasonal allergies or ongoing allergic reactions to dust, molds or pet dander, you're more likely to develop a sore throat than people who don't have allergies.
- Exposure to chemical irritants. Particulate matter in the air from the burning of fossil fuels as well as common household chemicals can cause throat irritation.
- Chronic or frequent sinus infections. Drainage from nose or sinus infections can cause throat infections as well.
- Living or working in close quarters. Viral and bacterial infections spread easily anywhere people gather — child care centers, classrooms, offices, prisons and military installations.
- Poor hygiene. Washing your hands carefully and often is the best way to prevent many viral and bacterial infections.
- Lowered immunity. You're more susceptible to infections in general if your resistance is low. Common causes of lowered immunity include diseases such as HIV and diabetes, treatment with steroids or chemotherapy drugs — even fatigue and poor diet.
Most sore throats go away without treatment, often within a week or so. That's a good thing, because no medical therapy exists for sore throats caused by viral infections. But increasing your fluid intake and getting extra sleep can help speed your recovery.
When you're sick, choose fluids such as water, soups and broths — not sodas or drinks that contain caffeine, which can dehydrate you further. If you find it extremely painful to swallow, try sipping warm broth through a straw or sucking on ice chips. You may also find that jello slides down easily.
Treating bacterial infections
At one time, doctors automatically treated all sore throats with antibiotics, both to cure the infection and to prevent dangerous complications such as rheumatic fever. Now, though, doctors are much less likely to prescribe medication because the overuse of antibiotics has led to an alarming increase in antibiotic-resistant strains of bacteria. What's more, antibiotics such as penicillin do little to hasten recovery from strep throat or to reduce signs and symptoms, and they don't prevent infections from recurring. Be sure your doctor performs a rapid strep test before prescribing any antibiotic for a sore throat.
If your doctor does recommend antibiotics for you or your child, take the entire course of medication, even if you feel better. This helps prevent the infection from coming back. It also prevents bacteria from becoming resistant to the medication. If children on antibiotic therapy feel well and don't have a fever, they often can return to school or child care when they're no longer contagious — usually 24 hours after beginning treatment.
Information Obtained From National Institute Of Health