SORE THROAT

What is a Sore Throat?

A sore throat refers to pain, itchiness, or irritation of the throat. You may have difficulty swallowing food and liquids, and the pain may get worse when you try to swallow. Throat pain is the primary symptom of a sore throat. However, other symptoms may include a dry throat, swollen glands in the neck, white patches on the tonsils, and hoarseness.

A sore throat can affect people of all ages—however, the risk of a sore throat is higher in some people. This includes children, smokers, allergy sufferers, and people with a compromised immune system. Sharing a close space with others also increases the risk of upper respiratory infections that can present initially as a sore throat.

If you have a sore throat, you may also have:

• swollen tonsils (tonsillitis)
• enlarged and tender glands in your neck
• discomfort when swallowing

If your sore throat is caused by bacteria or a virus, you may also experience symptoms associated with common infectious conditions, such as:

• a high temperature (fever) of 38C (100.4F) or over
• aching muscles or tiredness
• a headache
• a cough
• a runny nose

Causes of a Sore Throat

There are several causes of a sore throat.

Viral Infection

The majority of sore throats are triggered by a viral infection. These are infections caused by a virus, such as the cold and flu.

Other types of viral infections include:

• mononucleosis: infectious disease typically transmitted through saliva
• measles: contagious illnesses characterized by a distinct rash and fever
• chickenpox: infection that causes skin sores
• croup: infection of the larynx

Bacterial Infection

A bacterial infection can also cause a sore throat. These types of infections include:

• strep throat: inflammation of the throat caused by the Streptococcal bacteria
• diphtheria: infectious disease that causes throat inflammation
• whooping cough: disease of the respiratory mucous membrane

Environmental Factors

Not all sore throats are viral or bacterial. There are several other causes of throat pain. If you’re allergic to mold, pet dander, pollen, or other irritants, exposure to these allergens can trigger post-nasal drip. This is when excess mucus accumulates in the back of your throat. This accumulation can irritate your throat and cause pain or inflammation.

Dry air can also make your throat feel raw and scratchy. Smoking cigarettes or exposure to cigarette smoke can trigger persistent sore throats, as well as throat strain from yelling or too much talking.

GERD

Gastroesophageal reflux disease may also cause your sore throat. This is a digestive condition characterized by the back flow of stomach acid into the esophagus. This condition causes an array of symptoms, such as a sore throat, hoarseness, heartburn, and nausea.

Other Causes

In very rare cases, a sore throat may be a sign of HIV or throat cancer.

Part 3 of 6: Diagnosis

Diagnosing a Sore Throat

Most sore throats do not require medical attention. However, see a doctor if your sore throat lasts for longer than one week and if you experience:

• difficulty breathing
• joint pain
• difficulty swallowing
• an earache
• a rash
• fever over 101 degrees F
• bloody mucus
• a lump in the throat
• hoarseness for longer than two weeks

Determining the cause of your sore throat can help your doctor treat your symptoms. Your doctor will do a physical examination and examine your throat with a lighted instrument. He or she will look for signs of inflammation or white patches, which might indicate strep throat. Your doctor will also feel your neck for swollen glands and check your breathing.

Because strep throat is a common cause of sore throats, your doctor may swab the back of your throat and examine the sample for the Streptococcal bacteria. He or she may also run a blood test to determine whether you have a viral or bacterial infection.

If your doctor is unable to diagnose your sore throat, he or she will refer you to an allergist or an ear, nose, and throat specialist. These specialists will determine whether allergens or a throat disorder is the cause of your sore throat.

Note that it can be difficult to diagnose a sore throat in infants and toddlers. In this age group, refusal to eat is a common sign of throat irritation.

How to Treat a Sore Throat

The treatment for a sore throat depends on the cause. However, you can treat many sore throats at home. Home treatment options include:

• gargling with warm salt water
• drinking plenty of warm fluids, such as teas, soup, and water
• avoiding allergens and irritants, such as smoke and chemicals
• taking throat lozenges
• reducing inflammation with ibuprofen or acetaminophen

If a bacterial infection causes your sore throat, your doctor will prescribe a course of antibiotics to kill the infectious organisms. You should take your medication for 10 days or as prescribed by your doctor to treat the bacterial infection. A sore throat may recur if you stop treatment early.

If you have a viral infection, your doctor may want to let the virus run its course. During that time, he or she may prescribe medications, such as decongestants and pain relievers, to ease your symptoms. In some cases, your doctor may want to try an antiviral drug to fight the virus.

Complications of a Sore Throat

In the case of persistent bacterial throat infections, your doctor may recommend a tonsillectomy to surgically remove the tonsils. This is a last resort treatment that should only be considered when sore throats do not respond to antibiotics.

How to Prevent a Sore Throat

Many underlying causes of sore throats are infectious, and there are certain steps you can help you prevent future infection. Repeatedly washing your hands throughout the day kills germs and bacteria that can cause viral and bacterial infections. Additional steps that you can take to prevent a sore throat include:

• Do not share drinking glasses or utensils with others.
• Use hand sanitizers whenever soap and water are not available.
• Limit contact with commonly touched surfaces.
• Reduce exposure to allergens, such as pollen, dust, and mold.
• Avoid cigarette smoke.
• Keep a humidifier in your house to eliminate dryness.

When to seek medical help

Make an appointment to see your GP if:

• you have a persistent high temperature above 38C (100.4F), which does not go down after taking medication
• your symptoms do not improve within a week

It's important to investigate the cause of your temperature because it may be the result of a more serious condition, such as:

• epiglottitis – swelling and redness (inflammation) of the epiglottis (the flap of tissue at the back of the throat, underneath the tongue); if left untreated, it can cause breathing difficulties
• quinsy – an abscess (a painful collection of pus) that develops between the back of the tonsil and the wall of the throat, usually caused by a bout of severe tonsillitis

Blood tests may be carried out if your GP suspects you have a type of viral infection called glandular fever (also known as infectious mononucleosis).

Emergency medical care

Contact your GP as soon as possible if you have a sore throat and you:

• are in severe pain
• have difficulty breathing
• are making a high-pitched sound as you breathe (stridor)
• start drooling
• have a muffled voice
• have difficulty swallowing (dysphagia) or are not able to swallow enough fluids

At-risk groups

While most sore throats can be treated at home, some people are more at risk than others of developing complications from a sore throat, and may need additional treatment.

See your GP at the first sign of infection if you:

• have HIV and AIDS (a virus that attacks the body's immune system)
• have leukaemia (cancer of the bone marrow)
• have asplenia (when your spleen, an organ behind your stomach, does not work properly or has been removed)
• have aplastic anaemia (when your bone marrow does not produce enough blood cells)
• are receiving chemotherapy
• are taking an immunosuppressant medicine (which stops your immune system working) – for example, because you have had an organ transplant
• are taking an antithyroid medication (to stop your thyroid gland producing too many hormones), such as carbimazole
• are taking a disease-modifying anti-rheumatic drug (DMARD) – for example, to treat arthritis (a common condition that causes inflammation in the joints and bones)