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by Lewy J

Sore Throat

(Pharyngitis; Tonsillopharyngitis; Throat Infection)

Definition

A sore throat is the general name for two common conditions:
  • Pharyngitis—swelling and inflammation of the pharynx (the back of the throat, including the back of the tongue)
  • Tonsillopharyngitis—swelling and inflammation of the pharynx and the tonsils (soft tissue that makes up part of the throat's immune defenses)
Sore Throat Due to Inflammation
IMAGE
Copyright © Nucleus Medical Media, Inc.

Causes

Many things can cause a sore throat, such as:
  • Infection with a virus, such as the viruses that cause influenza (the flu), herpangina, and the common cold
  • Infection with bacteria, such as the bacteria that cause strep throat
  • Infectious mononucleosis
  • Mucus from your sinuses that drains into your throat
  • Smoking
  • Breathing polluted air
  • Drinking alcoholic beverages
  • Hay fever or other allergies
  • Acid reflux from the stomach
  • Food debris collecting in small pockets in the tonsils
  • Certain immune or inflammatory disorders

Risk Factors

Sore throats are more common children, teens, or people aged 65 years and older. Other factors that may increase your chance of a sore throat include:
  • Exposure to someone with a sore throat or any other infection involving the throat or nose
  • Exposure to cigarette smoke, toxic fumes, industrial smoke, and other air pollutants
  • Having hay fever or other allergies
  • Having other conditions that affect your immune system, such as HIV infection or cancer

Symptoms

Along with the sore throat, you may have other symptoms, such as:
  • Pain or difficulty when swallowing
  • Runny nose or stuffy nose
  • Fever
  • Enlarged lymph nodes in your neck
  • Hoarse voice
  • Red or irritated-looking throat
  • Swollen tonsils
  • White patches on or near your tonsils
  • Cough
  • Difficulty breathing

When Should I Call My Doctor?

Call your doctor if you:
  • Experience a worsening of your sore throat or the symptom lasts longer than you or your doctor expect
  • Have difficulty swallowing or breathing
  • Have developed other symptoms, such as:
    • White patches on tonsils (may be a sign of strep throat)
    • Enlarged lymph nodes on your neck
    • Rash
    • Fever
    • Earache
    • Lightheadedness
    • Nausea or vomiting
    • Muscle or joint aches
    • Fatigue
    • Blood in saliva
The American Academy of Pediatrics suggests calling your child's doctor if your child has a sore throat that goes on for more than 1 day (no matter what other symptoms are present).
If you think you have an emergency, call for medical help right away.

Diagnosis

Your doctor will do a physical exam. This involves looking closely at your mouth, throat, nose, ears, and the lymph nodes in your neck.
  • This physical exam may include:
    • Using a small instrument to look inside the nose, ears, and mouth
    • Gently touching the lymph nodes (glands) in your neck to check for swelling
    • Taking your temperature
  • The doctor will ask questions about:
    • Your family and medical history
    • Recent exposure to someone with strep throat or any other infection of the throat, nose, or ears
  • Other tests include:
    • Rapid strep test or throat culture—using a cotton swab to touch the back of the throat to check for strep throat
    • Blood tests—to identify some conditions that may be causing the sore throat
    • Mono spot test—if mononucleosis is suspected

Treatment

Treatment depends on the cause of the sore throat. Options may include:

Medications

  • Pain relievers or fever reducers
    • Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
  • Antibiotics for a sore throat caused by a bacterial infection
  • Throat lozenges
  • Decongestants and antihistamines to relieve nasal congestion and runny nose
  • Numbing throat spray for pain control in older children and adults, although the relief is very short-lived
  • Corticosteroids if there is trouble breathing

Home Care

Self-care steps you can do at home:
  • Get plenty of rest
  • Drink plenty of fluids
  • Try warm liquids (tea or broth), or cool liquids
  • Gargle with warm saline several times a day
  • Avoid irritants that might affect your throat, such as tobacco smoke and cold air
  • Avoid drinking alcohol

Prevention

To help reduce your chance of a sore throat:
  • Wash your hands frequently. Do this especially after blowing your nose or after caring for a child with a sore throat.
  • If someone in your home has a sore throat, keep their eating utensils and drinking glasses separate from those of other family members. Wash these objects in hot, soapy water.
  • If a toddler with a sore throat has been sucking on toys, wash the toys in soap and water.
  • Immediately get rid of used tissues, and then wash your hands.
  • If you have hay fever or another respiratory allergy, see your doctor. Avoid the substance that causes your allergy.

RESOURCES

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov

CANADIAN RESOURCES

Canadian Society of Otolaryngology http://www.entcanada.org

Health Canada http://www.hc-sc.gc.ca

References

Brink AJ, Cotton MF, et al. Guideline for the management of upper respiratory tract infections. S Afr Med J. 2004;94:475-483.

Choby BA. Diagnosis and treatment of streptococcal pharyngitis. Am Fam Physician. 2009;79(5):383-390.

Pharyngitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 25, 2014. Accessed September 29, 2014.

Sore throat. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/sore-throat.html. Updated May 2014. Accessed September 29, 2014.

Sore throat. Patient UK website. Available at: http://www.patient.co.uk/health/sore-throat-leaflet. Accessed November 20, 2013. Accessed September 29, 2014

The difference between a sore throat, strep and tonsillitis. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/The-Difference-Between-a-Sore-Throat-Strep-and-Tonsillitis.aspx. Updated May 28, 2014. Accessed September 29, 2014.

Throat problems. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/throat-problems.html. Accessed September 29, 2014.

Vincent MT, Celestin N, et al. Pharyngitis. Am Fam Physician. 2004;69(6):1465-1470.

11/10/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P. Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. BMJ. 2009;339.

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