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Sore throat (pharyngitis): Symptoms, Treatment

Inflammation of the throat (pharyngitis): investigations and diagnosis, Causes and risk factors, Course of the disease and prognosis

by Josephine Andrews
Published: Last Updated on 416 views
Sore throat

In pharyngitis, the mucous membrane in the throat is inflamed. Acute pharyngitis is usually a side effect of colds. In contrast, chronic sore throat results from excessive smoking or radiation therapy. Read more about the topic: What causes and symptoms of a sore throat? What to do about the complaints? How quickly does pharyngitis heal?

ICD codes for this disease: J31 | J02

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

Sore throat: description

The term pharyngitis stands for inflammation of the pharynx: the mucous membrane that lines the pharynx is inflamed here. Physicians distinguish between two forms of the disease – acute and chronic pharyngitis:

  • Acute pharyngitis: An acutely inflamed throat is very common and usually accompanies a cold or flu-like infection.
  • Chronic pharyngitis: This is inflammation of the lining of the throat that lasts longer than three months. It is not the result of an infection but of persistent factors that irritate the mucous membranes, such as tobacco smoke or chemical pollutants.

Sore throat: symptoms

The symptoms of acute and chronic pharyngitis are somewhat similar, but there are also differences:

Acute pharyngitis: symptoms

Acute pharyngitis usually announces itself with a scratchy and burning sensation in the throat. This further develops into a sore throat, which often radiates into the ears. Those affected also experience pain when swallowing. The dry and rough feeling in the throat causes patients to clear their throat or cough more often. The pharyngeal mucosa is reddened and – with additional cold – mucous.

If the sore throat is caused by the typical pathogens of acute respiratory diseases, there are often other symptoms. A runny nose and other cold symptoms such as hoarsenesscoughing, and possibly increased body temperature are typical.

Bacterial superinfection

Sometimes bacteria also settle on the virally inflamed pharyngeal mucosa (bacterial superinfection). This can usually be recognized because high fever and headaches accompany the other pharyngitis symptoms.

In addition, the mucous membrane in the throat is then colored crimson, and the tonsils are swollen and have whitish-yellow coatings (tonsillitis, angina tonsillitis). If the patient no longer has tonsils, the lateral cords are often red and swollen (lateral cord angina, lateral angina). These side cords are lymphatics that run down from the upper back pharyngeal wall on both sides.

Chronic sore throat: symptoms

If the inflammation lasts longer than three months, it is called chronic pharyngitis. Symptoms develop slowly over weeks. The throat feels dry, so people swallow or clear it more often. A lump in the throat may also occur. Difficulty swallowing (when swallowing empty), thirst, and a dry cough are symptoms of chronic pharyngitis.

The other symptoms depend on the type of chronic sore throat:

  • Atrophic form (pharyngitis sicca): The most common form of chronic pharyngitis. The pharyngeal mucosa is dry, pale, particularly delicate, and thin (atrophic), has a glossy sheen, and is covered with some viscous mucus.
  • Hypertrophic form: The pharyngeal mucosa is thickened, reddened, and covered with viscous mucus. There are either lens-sized lymph nodules on the back wall of the throat ( pharyngitis granulosa ) or thickened bulging side cords (pharyngitis lateralis).

Sore throat: causes and risk factors

Acute and chronic pharyngitis have very different causes:

Acute pharyngitis: causes

Acute pharyngitis is due to infection. It usually develops as part of cold or flu-like infection. This means that the sore throat is generally triggered by viruses responsible for specific respiratory diseases. These include adenoviruses, rhinoviruses, influenza viruses, and parainfluenza viruses.

Occasionally, the viral triggers of systemic diseases (diseases affecting the whole body) also lead to acute pharyngitis. These include cytomegaloviruses, Epstein-Barr viruses (causative agent of glandular fever ), measles, and rubella. Only rarely are other viruses to blame for an acute sore throat, such as the herpes simplex virus.

The viral infection in acute pharyngitis can weaken the immune system so that bacteria (especially beta-hemolytic streptococci) can colonize the inflamed mucous membrane. Doctors speak of bacterial superinfection. Purely bacterial pharyngitis, on the other hand, is very rare.

Danger:

Because pathogens cause it, acute sore throat is contagious.

Chronic pharyngitis

In contrast to acute pharyngitis, chronic pharyngitis is not caused by viruses or bacteria and is therefore not infectious. The culprit for the chronic inflammation in the throat is instead a persistent irritation of the mucous membranes. This can have very different reasons:

  • excessive tobacco or alcohol use
  • heartburn (belching up acidic stomach acid into the throat)
  • dry room air in overheated rooms
  • frequent inhalation of chemical vapors or dust at work
  • obstructed nasal breathing (e.g., due to curvature of the nasal septum or greatly enlarged pharyngeal tonsils)
  • repeated inflammation of the sinuses (sinusitis)
  • Radiation therapy in the head or neck region
  • Hormonal changes during menopause
  • Excessive or improper use of voice (such as constant throat clearing and coughing)

A chronic sore throat can also develop with chronic inflammation of nearby organs and tissues. These include, for example, chronic colds (inflammation of the nasal mucosa), chronic angina (tonsillitis), and chronic bronchitis.

Inflammation of the throat: examinations and diagnosis

It starts with a detailed doctor-patient discussion: The doctor will ask you about your exact symptoms, for example, how long you have had a sore throat and whether there are any other symptoms. In the case of chronic sore throat, he will ask about possible triggers such as tobacco or alcohol abuse or chemical exposure.

The mirror examination of the throat provides the doctor with critical information: he examines the pharyngeal mucosa with the help of a small flashlight, a headlamp, or a forehead mirror. In addition, he presses the patient’s tongue down with a tongue depressor to be able to see better.

If the doctor discovers whitish deposits on the pharyngeal wall (suspected bacterial superinfection), he can take a smear to carry out a rapid streptococcal test.

If you have an earache, your doctor will also do an ear exam. Maybe it’s just radiating pain from the sore throat, and perhaps it’s a middle ear infection.

If the pharyngitis lasts longer, the doctor can use the mirror examination to determine the type of disease – chronic pharyngitis with tissue wasting (atrophic form) or tissue swelling (hypertrophic formation). He will also examine the nose if obstructed nasal breathing is suspected of causing chronic pharyngitis.

Sore throat: treatment

Treating a sore throat depends on whether it is acute or chronic and whether bacteria have colonized it.

Acute pharyngitis: therapy

Viruses usually trigger an acute sore throat (acute pharyngitis). So it can only be treated symptomatically. For this purpose, the doctor will prescribe you, for example, pain-relieving and fever-reducing preparations (with active ingredients such as ibuprofen or paracetamol). Lozenges, sprays, or gargle solutions with local anesthetic agents are also beneficial for sore throats.

In addition, the doctor prescribes antibiotics for a sore throat if bacteria have also settled in the throat or caused the infection. Most of the time, the germs are streptococci, so doctors prescribe penicillin —an antibiotic that works well against these bacteria.

Chronic pharyngitis: therapy

To get rid of a chronic sore throat, you first have to eliminate the triggering stimulus (tobacco, alcohol, chemicals, etc.) or at least avoid it as much as possible.

Once the cause of the irritation has been eliminated, the inflammation often heals on its own within a few weeks. This healing process can be supported with, for example:

  • anti-inflammatory drugs (ibuprofen, diclofenac etc.)
  • Inhalations and gargles (with salt water or sage solution)
  • Lozenges (with sage, salt, hyaluronic acid, or Icelandic moss)

If radiation treatment to the head or neck has damaged the salivary glands and thus reduced saliva production, the throat can be sprayed with artificial saliva. This helps against dryness-related chronic sore throat.

Surgery is sometimes necessary when obstructed nasal breathing is the cause of chronic pharyngitis. For example, the surgeon can straighten a deviated septum or enlarge the openings of the paranasal sinuses.

Surgery can also help with so-called lateral pharyngitis: the proliferating, excess (hypertrophic) tissue of the side cords are either burned or removed with a laser.

The tonsils are often surgically removed if chronic sore throat is associated with chronic tonsillitis.

Sore throat: home remedies

Many patients with acute sore throat use home remedies to quickly get rid of the symptoms.

Teas for sore throat

Many patients find warm tea very pleasant when they have a sore throat. The following medicinal plants are particularly suitable as home remedies for sore throat because of their anti-inflammatory properties:

The following herbal teas are recommended for dry, irritating coughs:

When the fever starts, it is best to use medicinal plant teas that stimulate sweat production:

You can read more about the effect and the correct preparation of the teas in the respective medicinal plant articles.

ⓘ Note:

You can also support the healing process by inhaling the steam from the freshly brewed tea (e.g., chamomile). This mainly the mucous membranes and counteracts inflammation depending on the tea.

Gargle

You can also use cooled medicinal plant teas for gargling. Take a sip and rinse your mouth and throat with it.

Alternatively, you can also make a particular gargling solution: To do this, dissolve one of the following ingredients in a glass of lukewarm water:

  • two tablespoons of apple cider vinegar or
  • a tablespoon of lemon juice or
  • a teaspoon of sea salt

Stir well and gargle with the solution several times a day.

Neck wraps and pads

Other home remedies for sore throat are cold compresses on the neck. This relieves the pain and has a decongestant effect on the stressed mucous membranes.

Priessnitz neck wrap:

  1. Place a cloth in cold water (10 to 18 degrees), wring it out, and put it around your neck.
  2. Avoid the spine.
  3. Cover with a dry cloth for 30 minutes to several hours.
  4. After removing the wrap, protect your neck from the cold.

Cold quark dressing: Spread 250 to 500 grams of quark (room temperature) on one or two gauze compresses once or twice a day and put it on your neck. Cover and secure with the excess gauze and a cotton cloth. Leave the pad on for 20 minutes to several hours. After that, rest.

Healing clay pad: Mix the desired amount of healing clay with a bit of cold water to form a spreadable paste and apply a thickness of approx. 0.5 to 2 cm directly to the neck. Cover with a cloth and fix another fabric. Leave the pad for one to two hours until the healing clay is dry. Then clean, dry, and oil the skin. Use once or twice daily.

ⓘ Note:

Home remedies have their limits. If the symptoms persist over an extended period, do not get better, or even worsen, you should always consult a doctor.

Tips for everyday life

The following tips help to protect the mucous membranes in the event of a sore throat:

Avoid irritating substances: Factors that irritate the mucous membranes, such as nicotine, alcohol, and hot spices, should be avoided if you have a sore throat – especially if you have chronic pharyngitis.

Keep mucous membrane moist: If you suffer from a dry, sore throat (pharyngitis sicca), you should keep your throat mucosa moist as possible. That means, for example: drinking a lot. Warm honey milk and lukewarm blackcurrant juice are well suited. Also, avoid overheated rooms in winter and ventilate them regularly. A water vaporizer can also help.

Eating garlic: The bulb has a mild anti-inflammatory effect. If you suffer from chronic sore throat, feel free to cook or season with garlic more often.

Read more about the therapies.

Read more about therapies that can help here:

Inflammation of the throat: course of the disease and prognosis

Acute sore throat is generally harmless and goes away on its own within a few days. Bed rest, home remedies, and, if necessary, painkillers from the pharmacy have a supporting effect.

Complications of acute pharyngitis

If bacteria are involved, a purulent sore throat usually develops, which should be treated by a doctor. Otherwise, there is a risk of serious complications such as chronic tonsillitis (chronic tonsillitis). This, in turn, can be the starting point for severe secondary diseases such as rheumatic fever and kidney, heart, or joint inflammation. In unfortunate cases, the affected organs suffer permanent damage, such as heart valve defects.

As a further complication of a bacterial infection in the throat region, the local inflammation can spread to the surrounding connective tissue and lead to an encapsulated accumulation of pus ( abscess ) there – for example, near the tonsils (peritonsillar abscess). Such an abscess must be treated with antibiotics and punctured and drained. This prevents the inflammation from spreading to other body parts, such as the chest and heart (danger to life!).

Sometimes acute pharyngitis spreads to the larynx or vocal cords (see Laryngitis). The patient then becomes hoarse or has no voice at all. The essential tips for Laryngitis(laryngeal inflammation) are: Don’t talk or whisper but drink a lot (warm drinks!).

Chronic pharyngitis

The duration of the chronic sore throat depends on whether and how quickly the triggering stimuli (tobacco, alcohol, chemical exposure, etc.) can be eliminated.

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