Sore Throat

Pain, irritation and scratchiness of the throat is typically characterized as a sore throat. Sore throats often become more painful when you swallow. 

The most common symptom of sore throat is pharyngitis, which is the inflammation of the throat or pharynx. But sometimes the words “pharyngitis” and ‘sore throat” are used interchangeably.

Viral infections like the flu or a cold are the primary cause of sore throat, and these typically resolve on their own at home with rest.

A less, but still common type of sore throat is strep throat, which is caused by streptococcal bacteria that leads to an infection. Strep throat requires additional treatment with antibiotics to get rid of the infection and prevent future complications.

Some of the symptoms of a sore throat that may vary depending on the cause are:

• Dry throat
• Scratchy or pain sensation in the throat
• Difficulty swallowing
• Pain that will worsen when talking or swallowing
• Swollen red tonsils
• Muffled or hoarse voice
• Sore and swollen glands in your jaw or neck
• Pus or white patches in the back of the throat and tonsils

Some infections that might cause sore throat may have other symptoms such as:

• Runny nose
• Chills
• Cough
• Fever
• Headache
• Body aches
• Vomiting or nausea
• Sneezing

If your child has a sore throat, the American Academy of Pediatrics recommends you consult a physician if the sore throat does not go away after your child's first drink in the morning. 

Get immediate assistance if:

• You have difficulty in swallowing and breathing
• You have unusual drooling which may indicate an inability to swallow

The American Academy of Otolaryngology recommends that you seek medical attention if you have a sore throat along with the following problems such as:

• Difficulty swallowing
• Sore throat that lasts longer than a week or is severe
• Difficulty opening your mouth
• Difficulty breathing
• Earache
• Joint pain
• Rash
• Blood in saliva or phlegm
• Fever higher than 101 F (38.3 C)
• Hoarseness that is lasting more than two weeks
• A lump in your neck
• Frequently recurring sore throats

The common cause of sore throat is a viral infection such as the flu or influenza, but some are due to bacterial infections.

Some of the viral infections that cause a sore throat are:

• Flu (influenza)
• Common cold
• Measles
• Mononucleosis (mono)
• Croup which is a common childhood illness that has a harsh, barking cough
• Chicken pox

Bacterial infections that cause a sore throat are:

• Whooping cough, which is a highly contagious respiratory tract infection
• Diphtheria, which is a serious respiratory disease
• Strep throat, which is an infection caused by Streptococcus pyogenes or Group A streptococcus

More health conditions associated with a sore throat are:

• Tonsillitis: An inflammation of the tonsils may cause pain when swallowing and fever.
• Laryngitis: Laryngitis is an inflammation of the voice box, which causes a hoarse voice, dry coughs, and constant clearing of your throat.
• Glandular Fever: It may cause fever and swollen glands, similar to symptoms of having strep throat.
• Quinsy: Quinsy is a collection of pus found at the back of your throat. It is painful and causes difficulty in swallowing or opening your mouth.
• Epiglottitis: This is an inflammation on the flap of tissue at the back of your throat. Just like quinsy, you will have difficulty swallowing or breathing.

With any of the above conditions, it is highly recommended to see a doctor so you can receive a proper treatment plan for you or your child. 

Some other causes of sore throat include:

• Allergies – The ducts and molds that can cause a sore throat can be complicated by postnasal drip that can inflame and irritate the throat.
• Irritants – Indoor pollution such as chemicals or tobacco smoking can cause chronic sore throat.
• Drinking alcohol, eating spicy foods, chewing tobacco and outdoor pollution can irritate your throat.
• Dry indoor air can make your throat feel scratchy and rough, especially in the mornings of winter when buildings are heated.
• Muscle strain such as shouting or yelling for long periods without rest can cause hoarseness and sore throat.
• HIV infection can have a chronic or recurring sore throat because of a secondary infection or a fungal infection such as oral thrush or cytomegalovirus infection.
• Gastroesophageal reflux disease (GERD) is a digestive system disorder that can make you have a sore throat or heartburn and hoarseness.
• Tumors in the throat can cause a lump in the neck, blood in saliva, phlegm and noisy breathing.
• An infected tissue or abscess in the throat can also cause a sore throat, but such conditions are very rare.
• Nausea – If you are experiencing nausea due to morning sickness or food poisoning, then the acid backed up to your throat as you vomit may cause it to burn. The acid burn may end up irritating your throat.

Making a diagnosis of the cause of your sore throat is done during physical exam.

Consult your doctor or your child’s pediatrician if you or your child has a sore throat and in some instances your doctor may refer you to an ENT that specializes in ear, nose and throat disorders, or an allergist that specializes in allergies.

Bring a family member or a close friend with you. Write down the symptoms you are experiencing, and if someone in your family recently had a flu or cold. Write down the list of supplements and medications that you are taking.

Some of the questions that you can ask your doctor include:

• What is causing my symptoms?
• What are other possible causes?
• What tests do I need?
• What are the treatments?
• Is this contagious?
• Am I allowed to go back to school or work?
• What are other alternative medicines available?

Your doctor will likely ask you some questions such as:

• What other symptoms do you have aside from sore throat?
• When did it begin?
• Do you have trouble breathing?
• Do you have a fever?
• Is it recurring?
• Do you smoke?
• Do you have allergies?
• Are you exposed to a secondhand smoke?

While waiting for the appointment, you can follow some of these steps such as:

• Keeping your hands clean and covering your mouth when sneezing and talking
• Do not share personal items
• Gargle with 1 teaspoon (5 grams) of table salt in 8 ounces (237 milliliters) of warm water
• Have enough rest and drink plenty of fluids
• Take pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol)
• Be cautious enough not to give aspirin to children and teenagers for it may cause Reye’s syndrome

Your doctor will conduct a physical exam that will likely include:

• Listening to your breathing through the use of a stethoscope
• Using lighted instruments to look at your throat, nasal passages and ears
• Palpating your neck to look for swollen glands (lymph nodes)
• Throat swab – Your doctor will get a sample of your throat secretion by rubbing a sterile swab over the back of your throat. Then it will be checked for streptococcal bacteria, and the results will be delivered within 24-48 hours.
• You have a bacterial infection as the cause of your sore throat if the swab comes back positive, while you have viral infection if it comes back negative.
• CBC – This will indicate if an infection is more likely caused by a viral or bacterial agent.
• Allergy tests – You may be referred to an allergist if your doctor suspects that your sore throat is related to an allergy.

If you have a frequent or chronic sore throat, you may be referred to an ENT doctor or other specialist because you may have a serious condition other than sore throat.

There are various types of ways you can relieve your sore throat. It may be through medicine or you can find natural remedies for sore throat. Your treatment will depend on the cause of the sore throat.

The most common cause of sore throat is viral infection, and that mostly lasts up to seven days and does not need professional medical treatment. Over-the-counter cold and flu medications can be helpful in treating the symptoms and lessening the pain and discomfort of your sore throat.

Here are some ways on how to relieve a sore throat:

• Taking over-the-counter medicine such as ibuprofen or paracetamol helps relieve the pain in your throat. Paracetamol is recommended for children and those who are allergic or sensitive to ibuprofen.
• Aspirin may help with the pain, but do not give it to children under 16 years old.
• You can find medicated lozenges or sprays that help relieve a sore throat. Hard sweets or ice cubes can help as well. These can be bought in your local grocery store or pharmaceutical.

If the sore throat is caused by bacterial infection, your doctor will give you antibiotics such as penicillin that you will take orally, usually for 10 days. You have to take the antibiotics as prescribed by your doctor to prevent spreading or worsening of the disease, and if you do not complete the full course of antibiotics you might not get better. If you have strep throat and it doesn't go away, this can also lead to kidney inflammation and rheumatic fever.

There are additional treatments that will be considered depending on the diagnosis by your doctor.

Avoiding the germs that cause sore throats and practicing good hygiene is the best way to prevent contracting a virus or bacteria that will cause a sore throat.

The germs that cause bacterial and viral infections are contagious.

Take into consideration some of these tips to promote good hygiene such as:

• Wash your hands properly - especially before eating, after using the toilet and after coughing and sneezing
• Do not share utensils, food and/or drinks
• Use alcohol-based hand sanitizers if there is no water available for hand washing
• Sneeze and cough into a tissue and throw it away
• Clean your TV remotes, keyboards and telephones
• Avoid touching public phones or touching drinking fountains to your mouth
• Avoid close contact with sick people
• Do not go outside on high pollution days
• Avoid smoking
• Avoid exposure to second hand smoke
• Wear a filtering mask to avoid inhaling dust
• Humidify your home if the air is dry

Maintaining a healthy lifestyle will also keep your body strong enough to fight infections that cause sore throats. These lifestyle practices will help in preventing sore throat:

• Get at least eight hours of sleep and avoid shouting or screaming.
• Avoid stress around work or school, managing your time to reduce any anxiety that may cause illnesses.
• Make sure that your home is free of any allergens or triggers that cause allergies and common sicknesses.
• Keep a healthy diet and exercise regime. Eat foods that are rich in vitamins and minerals for a better immune system. Exercise at least three times a week to get fresh air and better health.
• As much as possible, stay clean doing daily cleaning and disinfecting at least once a week.
• Get vaccinations against illnesses that cause sore throat. You can find vaccines against the flu and other viruses. Consult your doctor on when you can receive these vaccinations and how much they will cost.

There are alternative remedies for sore throat, but there is limited evidence about what works best and what does not work.

Consult your doctor first if you are going to use alternative medicines, especially for children, pregnant women, or people who have certain medical conditions.

Alternative remedies often come in forms such as teas, lozenges and sprays, and some of these are:

• Sage
• Slippery elm
• Marshmallow root
• Licorice root
• Honeysuckle flower
• Other Chinese medicine herbs

Additional home remedies include:

• Gargle with warm salt and water-  Make sure that the water isn't boiling hot, but enough to soothe the throat. Do not use too much salt, just a pinch is enough.
• Drink hot fluids, such as soup, tea, or water. Steer clear from any cold food or sodas, unless ice lollies or ice cubes help relieve the pain. If you suffer from tonsillitis, stay away from any spicy or sour food, focusing on cold and soft food such as gelatin or ice cream.
• If you suffer from a sore throat, it's best to stay at home and rest, or to at least stay away from places that cause allergies and irritate your throat. Stay indoors and away from the smoke pollution and chemicals outside.
• You may suffer from sore throat due to lack of sleep or stress at work. Take a break and recuperate for a day or so to ensure that you have the enough rest to continue work. It will also prevent infecting other people around you.
• Apple Cider Vinegar is known to help soothe a sore throat, as its high levels of acidity help kill bacteria quickly. If you don't like the sourness, mix it with honey for a sweeter taste. Honey is also known to help soothe the soreness as well. Mix a tablespoon of ACV and honey together with a cup of warm water.
• Sucking on a fresh clove of garlic- Garlic has allicin, which is a compound that kills bacteria causing strep. it also helps fight the germs that cause pain or irritation. Simply suck one piece of garlic clove on each cheek, similar to using a cough lozenge.
• Steam is known to help ease allergies and a sore throat, especially if you suffer from dryness. It also helps you breathe easier. To steam at home, use a large bowl and hot water, breathing in the steam. Use a towel to use as a tent for the steam.
• Cayenne pepper is another natural remedy for sore throat, as it contains capsaicin, which helps in relieving pain. Mix half a teaspoon (or less if you are sensitive to spice) of cayenne pepper with a cup of boiling water. Drink it when it turns warm.
• Baking Soda- This is one of the most popular and straightforward ways on how to get rid of a sore throat. It contains Alkaline PH that helps with skin irritation, which can also help with swollen tissues in your throat. Mix half a teaspoon of both baking powder and salt into warm water and let the mixture sit in your throat as you gargle.
• Ginger or chamomile tea has soothing properties that help with your colds and sore throat. It also helps with blood and oxygen circulation. Drinking a cup of warm tea a day helps, especially when paired with honey.

Follow some of these lifestyle tips that usually provide relief from sore throat:

• Rest your voice and get plenty of sleep.
• Drink plenty of water to prevent dehydration and to moisten the throat.
• Gargle saltwater of 1 teaspoon (5 grams) of tablet salt to 8 ounces (237 milliliters) of warm water.
• Drink warm liquids such as warm water with honey or caffeine-free tea. (Caffeine can sometimes act as an irritant.)
• Keep your home free from cleaning products and cigarette smoke.
• Humidify the air.
• Consider lozenges to soothe your throat, but avoid giving them to kids four years old and younger as they can be choking hazards. 
• Take Ibuprofen (Advil) or acetaminophen (Tylenol), but avoid giving aspirin to children or teenagers when possible because it can cause severe health conditions.

Consult your doctor if you have any other concerns.

Who is most susceptible to sore throat?

A sore throat can affect anyone, no matter a person's age. But there are certain people who are at higher risk of getting one.

Some risk factors for sore throat are:

• Having allergies – usually seasonal allergies or allergies to molds, dust or pets – puts you at risk for a sore throat.
• Children and teenagers are often more susceptible to the viruses and bacteria that lead to sore throat.
• Smoking or if you are exposed to secondhand smoke are both risk factors. Tobacco can also lead to cancers in the throat, voice box and mouth.
• Being exposed to chemical irritants such as household chemicals and fossil fuels puts you at risk of developing a sore throat.
• Having frequent and chronic sinus infections, because of the drainage from the nose (post-nasal drip), can be irritating to the throat.
• If you have a low resistance or low immunity to germs, you may catch illnesses in which a sore throat is a symptom.
• If you are in a classroom, office, prison, military base or even child care center, you may be exposed to germs due to crowded rooms and close contact.

Usually a sore throat would last for seven days, depending on the type of sore throat you have. Viral pharyngitis will usually go away in five to seven days. If you suffer from bacterial pharyngitis, you'll start to feel better after taking antibiotics for two to three days.

On average, a sore throat will last for four to seven days. If you take your antibiotics and natural remedies, then recovery time may be quicker.

Make sure that you continue to take your antibiotics even after feeling better, to avoid the sore throat from coming back again. Depending on what your doctor prescribes, take your prescribed medicine for up to ten days after feeling better.

Usually, you won't need to see a doctor if you have a sore throat. Most people wait for the symptoms to pass or use over-the-counter medicine and home remedies to relieve the pain.

You will need to see a doctor if the sore throat is caused by a sickness, or if you suffer from any of the following:

• Severe symptoms
• If the symptoms do not improve after seven days
• The sore throats are more frequent
• Your immune system is weak- For example, if you are undergoing chemotherapy, suffer from HIV, or if you take any medicines that weaken your immune system.

While sore throat is rarely a very serious issue, you need to seek immediate medical attention when:

• Your symptoms are very severe and quickly getting worse.
• You cannot breathe and have difficulty in swallowing
• You start drooling and cannot close or open your mouth properly. 
• You suffer from stridor, which is when you make high-pitched noises while you breathe

If you feel like the sore throat is not getting better and your problem persists even after a week, then it may be a more serious issue or condition that should get checked immediately.

Knowing what causes your sore throat may be confusing, as there are different causes with similar symptoms. Here are some ways you can tell if your sore throat is either a cold, tonsillitis, strep throat, or just the usual sore throat caused by allergens or viral infections:

A sore throat caused by a cold will usually go away in a day or two. They are caused by certain environmental factors or allergies. Aside from an irritated or slightly painful throat, you may also suffer from a runny nose or congestion during these two to three days.

There is no specific cure for sore throats, but to simply wade it out and take home remedies to soothe the pain is often what people do.

Strep throat causes a more severe sore throat, usually lasting longer. It's caused by a certain bacteria, which may even cause tonsillitis. You get strep throat not from allergens or from viral infections, but from being in contact with an infected person's saliva or nasal secretion. It's common in children, but adults suffer from it as well. Its common symptoms include white spots in the throat area, fever, and swollen lymph nodes.

Antibiotics prescribed by the doctor will help treat your strep throat. Those infected should stay at home for at least one day after they have begun taking their prescribed medicine in order to rest up and avoid spreading the infection.

Tonsillitis is an inflammation of your tonsils, where the tissue masses found in the back of the throat are swollen and red. It causes a very painful sore throat. The symptoms include nasal irritation and white or yellow spots on your tonsils. White spots will likely appear if you have strep throat causing the tonsillitis. You may also suffer from bad breath, fever, pain when swallowing, or swollen lymph glands.

You can treat tonsillitis by getting your tonsils out (only if you constantly suffer from tonsillitis or have trouble breathing and sleeping because of it). Other remedies include eating soft and cold foods or taking pain relievers and getting the proper amount of fluids and rest.