Pharyngitis |
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Also Listed As: |
Sore Throat; Throat,
Sore |
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Pharyngitis is inflammation of the back of the throat. This results in a sore
throat, which is discomfort, pain, or scratchiness in the throat. Swallowing can
be mildly painful as well. Sore throats, which are often caused by an infection,
are very common, especially in children. |
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Signs and Symptoms |
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The symptoms of pharyngitis may include the following:
- Sore throat
- Pain when swallowing
- Fever
- Enlarged lymph nodes in your neck
- Runny nose and postnasal drip
- Headache
- In rare cases, difficulty breathing
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Causes |
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Certain viruses or bacteria can infect your throat and cause it to swell. You
can catch such organisms through direct contact with someone who has one of
these infections. They are passed via nasal secretions and saliva. Viruses that
cause pharyngitis include the common cold, the flu, and mononucleosis (often
called "mono"). Bacteria like Group A sterptococcus (commonly known as strep
throat) can also cause pharyngitis. |
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Risk Factors |
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- Cold and flu seasons
- Someone living in your house has a sore throat or cold
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Diagnosis |
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Your health care provider will check your temperature and examine your
throat, sinuses, ears, nose, lungs and neck, including feeling for swollen lymph
nodes which may indicate strep throat. A swab from your throat may be taken to
test for strep infection. A blood test may be done to check for mononucleosis.
If concerned about possible mono, your doctor will also examine your abdomen
looking for an enlarged liver or spleen and feel for lymph nodes in your body in
places in addition to your neck. |
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Preventive Care |
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- Avoid kissing or sharing cups and eating utensils with anyone who has
pharyngitis, a cold, flu, mononucleosis, or bacterial infection.
- Avoid any irritants that might affect your throat, such as smoke from
cigarettes, cigars, or pipes.
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Treatment
Approach |
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If your healthcare provider suspects that you have the bacterial form of
pharyngitis, or that is confirmed by a strep test, he or she will prescribe an
antibiotic. Pharyngitis that stems from a viral cause has no specific treatment
beyond bed rest and simple forms of self-treatment, such as gargling and aspirin
or acetominophen (Tylenol). (Note: aspirin should not be used in children
because of the risk of Reye's syndrome, a disorder that affects the liver and
brain.) |
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Lifestyle |
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- Rest
- Drink lots of fluid
- Avoid drinking alcohol
- Gargle several times per day with ½ tsp. of salt in a glass of warm
water
- Try throat lozenges but do not give to a child under 3 years old
because this is a choking hazard.
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Medications |
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If you have a bacterial form of pharyngitis like strep throat, your health
care provider will prescribe an antibiotic. Penicillin or, if you have an
allergy to penicillin, erythromycin are most commonly prescribed.
If you have the viral form of pharyngitis, your health care provider will
probably advise you to treat yourself at home. Aspirin, acetominophen (Tylenol),
or other over-the-counter pain medicines will help relieve the pain and soreness
in your throat. However, aspirin should not be given to children under 18
because of the risk of Reye's syndrome, as mentioned above.
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Nutrition and Dietary
Supplements |
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Because supplements may have side effects or interact with medications, they
should be taken only under the supervision of a knowledgeable healthcare
provider.
Although not without controversy, certain supplements may help reduce the
length of time of your cold and, therefore, its symptoms. Such supplements
include:
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Herbs |
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The use of herbs is a time-honored approach to strengthen the body and treat
disease. Herbs, however, contain active substances that can trigger side effects
and interact with other herbs, supplements, or medications. For these reasons,
herbs should be taken with care and only under the supervision of a practitioner
knowledgeable in the field of herbal medicine. Also, your physician should know
about all herbs you are taking or considering taking.
Barberry (Berberis vulgaris)
Barberry is used to ease inflammation and infection of the respiratory tracts
including pharyngitis, sinusitis, rhinitis (nasal congestion), and
bronchitis.
Echinacea (Echinacea angustifolia/Echinacea pallida/Echinacea
purpurea)
Echinacea, also called purple coneflower, is used to shorten the duration of
the common cold and flu and to relieve the symptoms associated with them, such
as sore throat, cough, and fever.
Eucalyptus (Eucalyptus globulus)
Eucalyptus is commonly used in remedies to treat coughs and the common cold.
It can be found in many lozenges, cough syrups, and vapor baths throughout the
United States and Europe. Herbalists recommend the use of fresh leaves in teas
and gargles to soothe sore throats and treat bronchitis and sinusitis.
German Chamomile (Matricaria recutita)
Chamomile has been used traditionally to treat a range of conditions
including chest colds and sore throats. While there are some animal studies that
show that chamomile may reduce inflammation, there are few studies on people to
test such uses. With that said, many people find chamomile tea quite soothing
for a sore throat.
Goldenrod (Solidago virgaurea)
Although studies have not confirmed the value of this use, goldenrod has been
used traditionally by herbalists to treat sore throats and laryngitis.
Goldenseal (Hydrastis canadensis)
Many professional herbalists recommend goldenseal in herbal remedies for hay
fever (also called allergic rhinitis), colds, and flu. It is also available in
mouthwashes for sore throats and canker sores.
Licorice (Glycyrrhiza glabra)
Licorice is a flavorful herb that has been used in food and medicinal
remedies for thousands of years. As an herb, it has long been used by
professional herbalists to relieve respiratory ailments, such as allergies,
bronchitis, colds, and sore throats. It can be used as a lozenge or tea. Do not
take licorice if you have high blood pressure. Use of any licorice product is
not recommended for longer than four to six weeks. People with obesity,
diabetes, or kidney, heart, or liver conditions should also not use this herb
nor should you use it if you are pregnant, breastfeeding, have decreased libido
or other sexual dysfunction.
Marshmallow (Althea officinalis)
Marshmallow—the herb, not the white puffy confection
roasted over a campfire—has been used for centuries as
both a food and a medicine. The mucilage, or gummy secretion, in the leaves and
particularly in the root may be helpful for soothing sore throats.
Peppermint (Mentha x piperita)
Peppermint and its main active agent, menthol, may feel soothing and calming
for your sore throat.
Saw Palmetto (Serenoa repens/Sabal serrulata)
Early in the 20th century, saw palmetto was listed in the US Pharmacopoeia as
an effective remedy for bronchitis and laryngitis, among other conditions.
Slippery elm (Ulmus fulva)
Slippery elm has been used as an herbal remedy in North America for
centuries. The conditions for which slippery elm has received recognition from
the U.S. Food and Drug Administration (FDA) as a safe and effective option
include sore throat and respiratory symptoms, such as
cough. |
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Other
Other herbs that may reduce cold symptoms including, possibly, sore throat
include:
- Garlic (Allium sativum)
- Ginger (Zingiber officinale)
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Homeopathy |
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There have been few studies examining the effectiveness of specific
homeopathic remedies. Professional homeopaths, however, may recommend one or
more of the following treatments for sore throat based on their knowledge and
clinical experience. Before prescribing a remedy, homeopaths take into account a
person's constitutional type. In homeopathic terms, a person's constitution is
his or her physical, emotional, and intellectual makeup. An experienced
homeopath assesses all of these factors when determining the most appropriate
remedy for a particular individual.
- Aconitum — for sore throats that come
on suddenly after exposure to cold and are accompanied by a high fever and
thirst; this remedy works best if given immediately after symptoms begin
- Apis mellifica— for shiny red, swollen
throats with stinging, burning, and dry pains; this remedy is most appropriate
for individuals who feel better with cold drinks but have little thirst; they
may also have difficulty swallowing and may have the sensation of a fishbone
being stuck in the throat; they also tend to be bothered by anything around the
neck
- Arsenicum album— for a burning
sensation in the throat accompanied by thirst, chills, and restlessness;
symptoms are relieved by warm liquids; nasal discharge often occurs before the
development of a sore throat
- Belladonna— this is usually the first
homeopathic remedy considered for sore throats, particularly if there is sudden
onset of intense pain on the right side of the throat along with redness,
swelling, and a feeling of constriction; individuals also generally have a
fever, may experience pain when swallowing (although the individual wants to
drink despite the pain), and often describe a hot sensation in the throat; this
remedy works best if used during the first 24 hours of throat soreness
- Hepar sulphuricum— for stinging throat
pain that is often described as a stick in the throat; throat pain is often
accompanied by enlarged tonsils; pain may extend to the ears and is generally
better from warm drinks; individuals for whom this remedy is appropriate are
often very irritable and sensitive to cold, touch, motion, noise, and light
- Lachesis — for throat pain with
swelling that is initially worse on the left side but may spread to the right;
symptoms are worsened by warmth, warm liquids, swallowing (including saliva),
and constrictive clothing
- Lycopodium— for throat pain with a
choking sensation, as if having a ball stuck in the throat; individuals for whom
this remedy is appropriate often have pain that begins on the right side and may
spread to the left; symptoms are relieved by warm drinks
- Mercurius— for throat pain accompanied
by fever, weakness, red spots on the tonsils as well as possible pus, and bad
breath; Mercurius is most appropriate for individuals who may be
sensitive to both heat and cold and tend to salivate, drool, or perspire,
particularly at night
- Phytolacca— for a dark red, purple, or
bluish swollen throat accompanied by excessive aching, fever, and pain with
swallowing; individuals for whom this remedy is appropriate may also have a
shooting pain that extends to the ears, and an acute pain at the base of the
tongue when protruded; these symptoms are worsened by warm drinks and motion
- Rhus toxicodendron— for throat pain
accompanied by restlessness that is worse with initial swallowing, but is
relieved by subsequent swallows as well as warm liquids; symptoms may be
initiated by cold air or straining the voice
- Sulphur— for a burning, lingering sore
throat; symptoms are worsened by warm drinks and food; tonsils tend to be
swollen, breath may be foul, and gums and nasal passages are dry.
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Other
Considerations |
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Prognosis and
Complications |
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Pharyngitis usually goes away fairly quickly on its own. If you have had a
sore throat for over a week, however, or you have a fever, swollen lymph nodes,
or a rash, you should call your doctor right away. Fever, swollen lymph nodes,
or a rash may indicate strep throat or its complications like rheumatic fever.
Strep throat requires antibiotics to prevent its potential complications which
include:
- Scarlet fever, which can cause fever and a particular type of rash
- Rheumatic fever, which can cause joint inflammation or damage your
heart valves
- Glomerulonephritis (kidney inflammation)
- Infection in the blood stream
- Shock
Other potential complications of pharyngitis include an abscess which needs
to be removed or drained surgically. |
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Supporting Research |
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Review Date:
June 2003 |
Reviewed By:
Participants in the review process include:
Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma and
Senior Medical Editor A.D.A.M., Inc.; Richard A. Lippin, MD, President, The
Lippin Group, Southampton, PA; Leonard Wisneski, MD, FACP, George Washington
University, Rockville, MD; Elizabeth Wotton, ND, private practice, Sausalito,
CA.
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