Welcome to another health update from the Port Moresby General Hospital. Do you frequently experience sore throats?
Do you know what’s causing your throat pain? When should you see a doctor?
What is a Sore Throat?
A sore throat refers to pain or irritation of the throat and can come from many causes however viral infections are most common. A sore throat can affect people of all ages, however the risk for a sore throats is higher for those who work in health care, with children, smokers or exposure to secondhand smoke, people with allergies, those with a compromised immune system, dry air or pollution/irritants in the air or sharing close space with others. The symptoms relating to sore throats will depend on the underlying cause however a sore throat caused due to a viral infection such as the common cold cannot be treated with antibiotics as they will not be effective. Rest and pain management are advised for those suffering from viral infections. As a sore throat can sometimes be caused due to a bacterial infection such as strep throat, it is important to see your doctor if symptoms are severe as antibiotics may be required. See your doctor if you have any other medical problems such as asthma, heart disease, HIV, diabetes, or are pregnant as you may be at a higher risk for complications.
Tip: Most sore throats don’t require medical attention however, see your doctor if your sore throat lasts for longer than one week or if your pain is severe, you have a high fever, rash or bloody mucous, red tonsils or white spots on the back of your throat or changes in breathing or swallowing or frequent sore throats.
Common Causes of Sore Throats -
A Cold or Flu: A sore throat is often the first sign of a cold and often gets better after a few days. If your sore throat is caused by a cold, you may also experience a runny nose, congestion, sneezing, cough, mild body aches, and headache. The flu usually comes on suddenly, and those with the flu often have a fever, fatigue, muscle and body aches while some people may experience vomiting and diarrhoea. Over the counter medications and lozenges may provide some relief from symptoms. (Lozenges should not be given to young children) Antibiotics cannot treat a cold virus as antibiotics are only effective against bacteria.
HIV: The first stage of HIV infection (the primary stage) presents its self as a “flu-like” illness and symptoms such as fever, headaches, sore throat, fatigue, chills, rash, muscle pain, swollen lymph nodes while some may not experience any symptoms at all. Also, a person who is HIV-positive may have a chronic or a recurring sore throat due to a secondary infection. Get tested!
Mononucleosis: (mono) usually caused by the Epstein-Barr virus (EBV) typically occurs in teenagers. Mono can be spread through contact with saliva, mucus from the nose and throat. Because the virus can be spread through saliva, it is nicknamed the kissing disease. People with mono often have a high fever, swollen lymph glands, sore throat, weakness, and fatigue. There's no specific treatment for mononucleosis as antibiotics don’t work against viral infections. Bed rest, and drinking plenty of fluids is advised. See your doctor to confirm the cause of your symptoms.
Tonsillitis: is an inflammation of the tonsils (tissue masses located at the back of the throat) and can be caused by both viruses and bacteria. Those who have tonsillitis may have throat pain, redness or a white/yellow coating on the tonsils, hoarseness or loss of voice, headache, earache, difficulty swallowing or breathing, swollen glands in the neck or jaw area and bad breath. If the tonsillitis infection is bacterial then antibiotics will be given however if the infection is viral antibiotics will not help and the virus must run its course for the symptoms to resolve. Taking an over the counter pain reliever may help. For those experiencing tonsillitis regularly, they may benefit from a tonsillectomy (removal of the tonsils).
Strep Throat: Caused by an infection of streptococcus bacteria and spreads by having contact with an infected person's saliva or nasal secretions. Those who are infected with strep throat may experience a severe sore throat, red, and swollen tonsils, sometimes with white patches, painful swallowing, tender lymph nodes in the neck and fever. It is important that if strep throat is suspected that medical attention is sought, or it may lead to more serious health complications such as rheumatic fever (a disease that may harm the heart valves). Strep throat is treated using antibiotics, which kill the bacteria causing the infection. It is important to take medications exactly as prescribed by your doctor including finishing the course even if you feel better.
Diphtheria: A bacterial infection which causes severe inflammation of the nose throat and windpipe and is easily spread. Signs and symptoms may vary from mild to severe and usually start with a sore throat and fever two days after exposure. In severe cases, a grey patch develops in the throat which can block the airway. The neck may swell due to large lymph nodes. If it’s left untreated, diphtheria can cause severe damage to your kidneys, nervous system, and heart. If suspected talk to your doctor. Vaccinations are available for Diphtheria.
Measles: (rubeola), is a viral infection of the respiratory system. Measles spreads when people breathe in or have direct contact with virus-infected fluid, such as the droplets sprayed into the air when someone with measles sneezes or coughs. Symptoms include a distinct rash, cough, fever, red eyes, runny nose, sore throat and tiny white/blue spots in the mouth. Talk to your doctor about vaccination. Whooping cough: is contagious and spreads through contaminated droplets in the air produced during coughing. Whooping cough usually evolved over a period weeks and usually starts with a sore throat, fever and a cough which worsens over time. Antibiotics are required in the early stages of infection.
Allergies: to pet dander, moulds, dust and pollen can cause a sore throat. The problem may be complicated by postnasal drip (when mucus runs down the back of your throat), which can irritate and inflame the throat. If you also experience sneezing, and a runny nose regularly talk to your doctor about allergy medications.
Dryness: Dry indoor air (especially when using heating) can make your throat feel rough and scratchy. Breathing through your mouth often due to chronic nasal congestion can also cause a dry, sore throat.
Irritants: Outside air pollution, cigarette smoke (smoker or secondhand smoke) and exposure to chemicals can also cause chronic sore throats. Chewing tobacco, alcohol and eating spicy foods also can irritate your throat.
Muscle strain: Trying to talk to someone in a noisy environment, yelling or talking for long periods without rest can cause a sore throat and hoarseness.
Gastroesophageal Reflux Disease (GERD): a digestive condition that occurs when stomach acid flows back into the oesophagus (the tube that carries food from the mouth to the stomach). This condition can cause a sore throat, hoarseness, heartburn, regurgitation of stomach contents, nausea, dry cough, and the feeling of having a lump in your throat. If you have acid reflux, your doctor may suggest some diet and lifestyle changes and may prescribe medication.
Tumours: Cancerous tumours 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.
Tuberculosis: Also known as TB. Do you have a persistent cough? Or a sore throat due to coughing? Do you experience chest pain, pain when breathing or coughing, fatigue, night sweats, chills? Are you coughing up blood or have you lost weight recently? See your doctor for a TB test today.
When Should I See a Doctor?
Most sore throats don’t require medical attention however, see your doctor if your sore throat lasts longer than one week or if your pain is severe, you have a high fever, rash or bloody mucous, red tonsils or white spots on the back of your throat or changes in breathing, swallowing or you experience frequent sore throats. If you have any other medical problems such as asthma, heart disease, HIV, diabetes, or are pregnant as you may be at a higher risk for complications see your doctor. Make a note of when symptoms started. Have you been in contact with any recent, possible sources of infection, such as a friend or family member with a sore throat or a cold? If antibiotics are required (for a bacterial infection) they must be taken exactly as advised and completed (even if you are feeling better) or the infection may return. If your pain or symptoms are worsening even if you are taking antibiotics to let your doctor know. Get immediate care if you or your child are experiencing severe signs such as difficulty breathing or swallowing or unusual drooling (which may indicate an inability to swallow).
Risk factors for Sore Throats -
Although anyone can get a sore throat, some factors make you more susceptible:
Being a child or teenager: Children and teens are most likely to develop sore throats are most likely to have strep throat.
Exposure to tobacco smoke: Smoking and secondhand smoke can irritate the throat and also increases the risk of several types of cancer.
Having allergies: If you have seasonal allergies or ongoing allergic reactions to dust, moulds or pet dander you are more likely to experience sore throats.
Exposure to chemical irritants: common household chemicals can cause throat irritation.
Chronic or frequent sinus infections: increase the risk of a sore throat as drainage from the nose can irritate the throat or spread infection.
Living or working in close quarters: Viral and bacterial infections spread easily anywhere people gather.
Having decreased immunity: You're more susceptible to infections in general if your resistance is low. Common causes of lowered immunity include HIV, diabetes, those on chemotherapy drugs, stress, fatigue, and poor diet.
Testing and Diagnosis -
Before treating your sore throat, your doctor will need to determine the cause of your symptoms and will require a full medical history, list of medications or supplements you are currently taking and perform a physical examination. He or she will use a lighted instrument to look in your throat for signs of inflammation or white patches which may indicate strep throat. Your doctor will feel for swollen glands in the neck and check your breathing, a throat swab and blood test may be also required. If the cause for your sore throat is still unknown, you may be referred to an allergist or ENT (ear, nose and throat speciallist) for further testing.
Treatment of a Sore Throat -
If your sore throat is caused by a viral infection which is the most common cause, it will usually clear up on its own and will not require medical care. Over the counter pain management, bed rest and drinking plenty of fluids are advised. Bacterial infections such as strep throat will require antibiotics. If your sore throat is worsening, see your doctor. If you are experiencing difficulty breathing or swallowing see your nearest emergency department. If antibiotics are given they must be taken exactly as advised and completed even if you are feeling better or the infection may return.
Pain Management at Home:
No matter the cause for your sore throat these at home strategies may provide you temporary relief from pain:
Treat pain and fever: Take over the counter pain relief medication. Only take as advised and talk to your doctor if you have any questions or concerns.
Rest: Get plenty of sleep and rest your voice.
Drink fluids: Drink plenty of fluids to keep the throat moist and prevent dehydration.
Salt water gargles: 1/2 to 3/4 teaspoon salt to One cup of pure water can help soothe a sore throat. Gargle the solution and then spit it out.
Suck on a lozenge: Lozenges can soothe a sore throat, but you should not exceed the daily recommended dose as they can cause stomach upset. Lozenges are also a choking hazard for young children and shouldn’t be used for children under 4yrs.
Avoid aggravating your pain: Avoid harsh cleaning products and cigarette smoke.
Warm Drinks: Such as tea (caffeine free is best) warm water with honey, soup or broth may sooth a sore throat.
Try Ice blocks: This may soothe a sore throat.
Humidify the air: Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat or sit for several minutes in a steamy bathroom.
Prevention -
Practice good hygiene and prevent the spread of germs:
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.
Avoid contact: With shared surfaces: door knobs, kitchen benches, public handrails or drinking fountains.
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 hand washing when soap and water aren't available. Wash your hands as soon as you can.
Regularly clean: telephones, TV remotes, keyboards, and phones.
Avoid close contact: with people who are sick (kissing, hugging, shaking hands).
Wear a filtering mask: when cleaning to avoid inhaling dust or airborne particles from cleaning products.
If you smoke, quit: Talk to your doctor if you need help quitting.
Avoid exposure: to secondhand smoke, pollen, dust, and mould.
Humidify your home: if the air is dry and, you frequently experience sore throats.