The human body is a very delicate structure. One of the most delicate parts is the sensory orifices, ear, nose and throat. These three structures are interconnected and an infection in any one of them would normally be felt in the other. The throat, the one that is hidden within, with the mouth as opening, is as delicate as it is vocal. This therefore means that it is constantly moist, and therefore prone to infections. The most common throat infection is sore throat.
A sore throat (throat infection, pharyngitis) is caused when a virus (or bacteria) infects the area at the back of your throat (pharynx). This causes redness and swelling (inflammation) and can be painful, especially when you swallow. Viruses are the most common cause of sore throats.
Sore throat is a common reason for presentation in primary paediatric care. Because only minority of cases of pharyngitis is caused by bacteria, physicians have been guided by various recommendations on the judicious use of antibiotics to avoid over prescription. In the absence of guidelines, the treatment approaches between physicians may differ.
According to a Lagos doctor, Sunday Olalekan, a sore throat is pain, scratchiness or irritation of the throat that often worsens when you swallow.
He said: “The most common cause of a sore throat (pharyngitis) is a viral infection, such as a cold or the flu. A sore throat caused by a virus resolves on its own. Sore throats are very common and usually nothing to worry about. They normally get better within a week.
“Most are caused by minor illnesses, such as colds or flu and can be treated at home.
However, strep throat (streptococcal infection), on the other hand, is a less common type of sore throat caused by bacteria. It requires treatment with antibiotics to prevent complications. Other less common causes of sore throat might require more complex treatment.
Dr. Olalekan said: “Sore throats are common in kids. However, it can be difficult to sort out when your child has a sore throat that will get better on its own, or one caused by a more serious infection.
“Pharyngitis is most commonly caused by viral infections, such as the common cold, influenza or mononucleosis. Bacterial infections require antibiotics. The most common bacterial infection of the throat is strep throat, which is caused by group A streptococcus.”
According to Olalekan, the cause of a sore throat is not always obvious. But in most cases it’s a symptom of a viral or bacterial infection. Viruses that cause the common cold and flu (influenza) also cause most sore throats. Less often, bacterial infections cause sore throats.
Viral infections: Viral illnesses that cause a sore throat include: common cold, flu (influenza), mononucleosis (mono), measles, chickenpox and croup – a common childhood illness characterised by a harsh, barking cough.
Bacterial infections: A number of bacterial infections can cause a sore throat. The most common is streptococcus pyogenes or group A streptococcus, which causes strep throat.
Other causes of a sore throat include:
Allergies: Allergies to pet dander, molds, dust and pollen can cause a sore throat. The problem may be complicated by postnasal drip, which can irritate and inflame the throat.
Dryness: Dry indoor air, especially when buildings are heated, can make your throat feel rough and scratchy, particularly in the morning when you wake up. Breathing through your mouth – often because of chronic nasal congestion, which also can cause a dry, sore throat.
Irritants: Outdoor air pollution can cause ongoing throat irritation. Indoor pollution – tobacco smoke or chemicals – also can cause a chronic sore throat. Chewing tobacco, drinking alcohol and eating spicy foods also can irritate your throat.
Muscle strain: You can strain muscles in your throat by yelling, such as at a sporting event; talking loudly or talking for long periods without rest.
Gastroesophageal reflux disease (GERD): GERD is a digestive system disorder in which stomach acids or other contents of the stomach back up in the food pipe (esophagus). Other signs or symptoms may include heartburn, hoarseness, and regurgitation of stomach contents and the sensation of a lump in your throat.
HIV infection: A sore throat and other flu-like symptoms sometimes appear early after someone is infected with HIV. Also, someone who is HIV-positive might have a chronic or recurring sore throat due to a secondary infection, such as a fungal infection called oral thrush and cytomegalovirus (CMV) infection, a common viral infection that can be serious in people with compromised immune systems.
Both oral thrush and CMV can occur in anyone, but they’re more likely to cause a sore throat and other symptoms in people with weakened immune systems.
Tumours: Cancerous tumors of the throat, tongue or voice box (larynx) can cause a sore throat. Other signs or symptoms may include hoarseness, difficulty swallowing, noisy breathing, a lump in the neck, and blood in saliva or phlegm.
Rarely, an infected area of tissue (abscess) in the throat causes a sore throat. Another rare cause of a sore throat is a condition that occurs when the small cartilage “lid” that covers the windpipe swells, blocking airflow (epiglottitis). Both causes can block the airway, creating a medical emergency.
We all know that raw, scratchy feeling in the back of the throat. It could be seasonal allergies or a plain old cold. But it also could be a bacterial condition, like strep or a viral infection or something else. Only your health care provider can tell for sure.
However, you can look for a few signs on your own. Symptoms of a sore throat can vary, depending on the cause. Signs and symptoms might include: pain or a scratchy sensation in the throat, pain that worsens with swallowing or talking and difficulty swallowing. Others are: sore, swollen glands in your neck or jaw, swollen, red tonsils, white patches or pus on your tonsils and hoarse or muffled voice.
Common infections causing a sore throat might result in other signs and symptoms, including: fever, cough, runny nose, sneezing, body aches, headache and nausea or vomiting.
Diagnosis and treatments
According to an expert, your paediatrician can diagnose a sore throat in your child caused by a virus after examination and ruling out a bacterial infection. The best way to care for a sore throat caused by a virus is to keep yourself and child comfortable and making sure you get plenty of fluids and rest.
He said: “Your paediatrician may recommend acetaminophen or ibuprofen to relieve the fever and pain. For hand, foot and mouth disease, which is highly contagious, your child should stay home until the blisters begin to heal.”
The following measures can often help soothe a sore throat:
Take Ibuprofen or paracetamol. Paracetamol is better for children and for people who cannot take Ibuprofen (note that children under 16 should never take aspirin), drink plenty of cool or warm fluids and avoid very hot drink; eat cool, soft foods; avoid smoking and smoky places; gargle with a homemade mouthwash of warm, salty water, hard sweets, ice cubes but don’t give young children anything small and hard to suck because of the risk of choking.
“There are also products such as medicated lozenges and sprays sold in pharmacies that you may want to try. There is not much scientific evidence to suggest they help, although some people find them worth using.
“Antibiotics are not usually prescribed for a sore throat, even if it is caused by a bacterial infection, as they are unlikely to make you feel better any quicker and they can have side effects,” Olalekan said.
Research shows that recurrent sore throat is caused mainly by viruses and bacteria that get into the upper respiratory tract. It is highly contagious and it is contracted via respiratory droplets of an infected person. Sore throat gives a burning, itchy and scratching sensation of the throat. Sore throat caused by viruses is usually self-limiting and most of the home remedies target this group.
Generally, symptoms of sore throat are cough, itchy and burning throat sensation, difficulty in swallowing, nasal discharge and congestion. The tonsils, which are a group of round lymphatic organs found in the throat, are enlarged and this accounts for the difficulty in swallowing. The causative agent for your sore throat can be identified but only by microbiological culture from a swab specimen taken from the throat.
Numerous home remedies are available for relieve of symptoms caused by sore throat.
Warm water gaggle with salt: This provides a soothing relief for sore throat. Salted water is hypertonic in nature (concentration greater than that of the organisms). By diffusion, water is extract from the bacteria (movement of water from a region of low concentration to that of a higher salt concentration) making the organism devoid of water and thus shrinkage and subsequently death of the organism.
Add about 2g of salt in a glass of warm water for a gaggle. It is advisable that you gaggle for about five minutes 4-6 times daily.
Honey: Honey has been known as a potent soothing and healing agent, especially when there is an inflammation of the mucosa or the skin. Honey coats the inflamed throat, provides nutrient for the regeneration of the damaged throat epithelium and it is also a potent antibacterial agent because it neutralises the viruses and bacteria implicated in causing sore throat.
Vitamin C: This is a potent antioxidant and anti-inflammatory agent. Vitamin C helps by promoting the healing of the mucosa of the throat. It also helps in boosting the immune system to fight the organism.
Quit smoking: Smoking irritates the throat causing addition injury to the delicate lining of the throat. Smoking also destroys the natural protective mechanism found in the throat by destroying the ciliated hair in the throat and the glands that secretes IgA containing mucus.
Antibiotics: are also very effective in the treatment of sore throat, especially for sore throat caused by bacteria. If after taking OTC antibiotics for about a week without any improvement, it is advisable to consult your physician for a possible throat swab culture for proper identification of the causing organism.
Boost your immune system by eating fruits and vegetables, natural flavonoids.
Chewing sugar-free gum can also ameliorate the burning sensation caused by sore throat. Chewing gum increases the secretion of alkaline saliva, which helps in soothing the sore throat.
The best way to prevent sore throats is to avoid the germs that cause them and practice good hygiene. Follow these tips and teach your child to do the same:
• Wash your hands thoroughly and frequently, especially after using the toilet, before eating, and after sneezing or coughing.
• Avoid sharing food, drinking glasses or utensils.
• Cough or sneeze into a tissue and throw it away. When necessary, sneeze into your elbow.
• Use alcohol-based hand sanitisers as an alternative to washing hands when soap and water aren’t available.
• Avoid touching public phones or drinking fountains with your mouth.
• Regularly clean telephones, TV remote controls and computer keyboards with sanitising cleanser. When you travel, clean phones and remote control in your hotel room.
• Avoid close contact with people who are sick.
When to see a doctor
The American Academy of Paediatrics recommends that you take your child to a doctor if your child’s sore throat does not go away with the first drink in the morning.
According to an expert, get immediate care if your child has severe signs such as: difficulty breathing, difficulty swallowing and unusual drooling, which might indicate an inability to swallow.
Also, according to American Academy of Otolaryngology, if you are an adult, see your doctor whenever you have a sore throat and any of the following associated problems occur: a sore throat that is severe or lasts longer than a week and difficulty opening your mouth.
Others include: joint pain, earache and rash, fever higher than 101 F (38.3 C), blood in saliva or phlegm, frequently recurring sore throats, a lump in your neck and hoarseness lasting more than two weeks.
Although anyone can get a sore throat, some factors make you more susceptible, including:
Age: Children and teens are most likely to develop sore throats. Children are also more likely to have strep throat, the most common bacterial infection associated with a sore throat.
Exposure to tobacco smoke: Smoking and secondhand smoke can irritate the throat. The use of tobacco products also increases the risk of cancers of the mouth, throat and voice box.
Allergies: Seasonal allergies or ongoing allergic reactions to dust, molds or pet dander, make developing a sore throat more likely.
Exposure to chemical irritants: Particles in the air from burning fossil fuels and common household chemicals can cause throat irritation.
Chronic or frequent sinus infections: Drainage from your nose can irritate your throat or spread infection.
Close quarters: Viral and bacterial infections spread easily anywhere people gather, whether in child care centers, classrooms, offices or airplanes.
Weakened immunity: You are more susceptible to infections in general if your resistance is low. Common causes of lowered immunity include HIV, diabetes, treatment with steroids or chemotherapy drugs, stress, fatigue, and poor diet.