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Sore Throat

With pharyngitis a virus or bacterium irritates your throat or pharynx. Both viral and bacterial forms of pharyngitis can make your throat sore and make swallowing difficult. If you have a severe case you may find it hard to breathe. Most cases of acute pharyngitis last a few days with treatment. If you smoke face regular exposure to environmental irritants or have a continuing infection in your sinuses lungs or mouth you may develop chronic pharyngitis in which your symptoms will come back from time to time. The viral form of pharyngitis usually accompanies a cold flu or mononucleosis. Strep throat is the best-known example of a bacterial form of pharyngitis.

Signs and Symptoms

The symptoms of pharyngitis include the following.

bulletSore throat
bulletPain when swallowing
bulletIn rare cases difficulty breathing
bulletInflammation of the membrane lining your throat
bulletAn extra membrane or the appearance of pus in your throat (can appear as white patches on tonsils or back of throat)
bulletFever
bulletEnlarged lymph nodes in your neck

What Causes It?

Viruses or bacteria infect the pharynx—your throat—and cause it to swell. That accounts for the soreness and difficulties in swallowing. Viruses that cause pharyngitis usually come into your body with a cold the flu or a similar infection. Bacteria that cause the disease can enter the body through open wounds skin infections and common routes of sexually transmitted diseases.

What to Expect at Your Provider's Office

Your health care provider will examine your throat and take a swab from it to test whether a virus or bacteria have caused the infection. The provider may also take a blood sample to check your white blood cell count which can determine the cause of your pharyngitis.

Treatment Options

Treatment Plan

Bacterial pharyngitis is treated with antibiotics. Viral pharyngitis is treated with rest and over-the-counter pain medicines. If you have the viral type avoid irritants such as smoke and cold air. Do not drink alcohol. Gargling several times a day with half a teaspoon of salt in a glass of warm water reduces discomfort.

Drug Therapies

Prescription

bulletAntibiotics—preferably penicillin; cures pharyngitis and prevents rheumatic fever; various side effects but alternate antibiotics are available

Over the Counter

bulletAspirin acetaminophen ibuprofen—for pain and discomfort; do not give aspirin to children under 18 as it can cause Reye's syndrome
bulletThroat lozenges—relieve pain

Complementary and Alternative Therapies

Strep infection should be treated with antibiotics. Alternative treatments can be effective in cases of acute chronic or recurrent pharyngitis.

Nutrition

bulletZinc (30 mg per day or lozenges) boosts the immune system and relieves soreness.
bulletVitamin C (1 000 mg three to four times per day) is needed as your bowel tolerates for proper immune function and to strengthen mucous membranes.
bulletBeta-carotene (50 000 to 100 000 IU per day) restores the integrity of mucous membranes and supports immune function.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

bulletSlippery elm (Ulmus rubra): Soothes irritated tissues and promotes healing. Use as lozenge or tea.
bulletLicorice (Glycyrrhiza glabra): Antiviral and soothing to the throat. Use as lozenge or tea. Do not take licorice if you have high blood pressure.
bulletGarlic/ginger tea (Allium sativum/Zingiber officinalis): Antimicrobial and warming herbs. Use two cloves of garlic and two to three slices of fresh ginger root. Simmer in 1 cup of water for 10 minutes. Drink warm. May add lemon and honey for flavor.
bulletTincture of two parts coneflower (Echinacea purpurea) two parts goldenseal (Hydrastis canadensis) and one part propolis should be taken every three to four hours. Place 30 drops in 1/4 cup water. Gargle and swallow.

Homeopathy

Some of the most common remedies used for pharyngitis are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

bulletApis for red swollen throat with burning pains. Patient is thirstless and feels better with cold drinks.
bulletBelladonna for bright red throat and tongue that feels worse on the right side; especially if you are thirsty.
bulletLycopodium for dryness of throat; pain begins on right side and goes to left. Pain is relieved with hot drinks.

Physical Medicine

Chiropractic treatment may be a helpful adjunct especially in children.

Acupuncture

Acupuncture may be helpful in improving immune function.

Massage

Massage can reduce the effects of stress.

Following Up

Acute pharyngitis usually goes away within a week or two. Check with your health care provider if you still have symptoms after that time.

Special Considerations

Do not use goldenseal during pregnancy.

Supporting Research

Berkow R ed. Merck Manual. 16th ed. Rahway NJ: Merck Research Laboratories; 1992.

Larson DE ed. Mayo Clinic Family Health Book. 2nd ed. New York NY: William Morrow and Company; 1996.

Lewis WH Elvin-Lewis MPF. Medical Botany/Plants Affecting Man's Health. New York NY: John Wiley & Sons; 1977.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:5 28.