Pharyngitis

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.

Signs and Symptoms

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

Causes

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.

Risk Factors

• Cold and flu seasons
• Someone living in your house has a sore throat or cold

Diagnosis

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.

Preventive Care

• 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.

Treatment Approach

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.)

Lifestyle

• 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.

Medications

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.

Nutrition and Dietary Supplements

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:

• Vitamin C
• Zinc

Herbs

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.

Other
Other herbs that may reduce cold symptoms including, possibly, sore throat include:

• Garlic (Allium sativum)
• Ginger (Zingiber officinale)

Homeopathy

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.

Other Considerations

Prognosis and Complications

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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