Sore Throat (Pharyngitis)

In the United Slates, sore throats account for 40 million visits to medical facilities each year. Although many factors and circumstances promote them, the pain usually indicates inflammation of the pharynx, which extends from the back of the mouth to the esophagus.

Common types of sore throats include:

Viral infections, especially colds and flu. The most prevalent sore throats, these are self-limited and may be accompanied by fever, muscle aches, and a runny nose. Less commonly, a sore throat may result from mononucleosis or viral pneumonia.

Bacterial infections, especially streptococcal bacteria. A strep throat typically comes on suddenly, is acutely painful, and is accompanied by fever. Such an infection usually occurs between the ages of 5 and 25 and if not treated promptly with antibiotics, it can spread to other organs and may cause irreversible heart and kidney damage.

Tonsillitis, usually due to infection and inflammation of the tonsils. Quinsy is a severe infection of the tonsils themselves or bits of tonsillar tissue left behind after a tonsillectomy.

Diagnostic Studies and Procedures

A doctor will ask about other symptoms, feel for swollen glands under the jaw and in the neck, and then inspect the throat using a bright light and magnifying devices. A sample of pus or other secretions may be taken for microscopic examination and a culture to identify any infecting organism.

Medical Treatments

If strep or another bacterial infection is suspected, a broad-spectrum antibiotic will probably be prescribed even before results of the culture are known. The medication may be changed later, depending upon the causative organism. For strep throat, the first choice of treatment is 10 days of penicillin. Erythromycin may be used instead for persons who are allergic to penicillin.

It is critical to complete the full prescribed course of antibiotics to fully eradicate the bacteria, even if symptoms disappear after two or three days. Otherwise, any surviving bacteria can cause a relapse or smoldering infection, which can damage vital organs.

Alternative Therapies

Aromatherapy. Therapists recommend oils of eucalyptus, geranium, lavender, and sage to alleviate discomfort. The oils can be massaged into the skin, from under the chin to the base of the throat, or they may be inhaled after placing them in a steam humidifier.

Herbal Medicine. Gargling with a sage preparation is said to alleviate a sore throat. Make an infusion of 1 cup of sage tea, and add a teaspoon each of honey and cider vinegar. Use as a gargle four times a day. Gargling with warm chamomile tea as often as needed may help. A Russian herbal remedy calls for drinking a mixture of a tablespoon of horseradish and a teaspoon each of honey and ground cloves added to a glass of warm water.

Naturopathy. Practitioners advise taking garlic capsules three times a day for their antibiotic properties, and sucking on a zinc lozenge every two hours for a week. Some also suggest high doses of vitamin C to hasten recovery or act as a preventive, but this remains unproven. In any event, these should not substitute for antibiotics to treat strep throat.

Self-Treatment

The body gets rid of most sore throats by itself in a few days, but to ease discomfort, you can:

• Add a teaspoon of salt to cup of warm water and gargle with it every few hours. Or try gargling with 3 percent hydrogen peroxide (1 part to 4 parts of water).
• Drink extra fluids, especially warm broth, herbal teas, and fruit juices. A time-tested home remedy calls for sipping a mixture of 1 tablespoon each of honey and cider vinegar or lemon juice in 1 cup of warm water.
• Suck on honey, eucalyptus, or other lozenges. A throat spray containing phenol helps temporarily, but ask a doctor before using it on children.
• Use a humidifier to keep air moist.
• Take aspirin, acetaminophen, or ibuprofen to lower a fever and alleviate pain. However, do not give aspirin to anyone under the age of 18 who has a viral infection. In this situation, aspirin is linked to an increased risk of Reye's syndrome.

Other Causes of Sore Throats

Excessive shouting or singing, allergies, environmental irritants, tobacco use, polyps, and oral or throat cancer are among the many noninfectious causes of sore throats. The infectious causes include chickenpox, mumps, diphtheria, and herpes.