Sore throat
Sore throat is a painful sensation in the pharynx and larynx, which often increases when talking and swallowing. There are various causes that lead to sore throat: viral and bacterial diseases of the pharynx, allergic reactions and tumor processes, hypovitaminosis. To identify the etiological factor, instrumental examination of the respiratory tract, radiography, ultrasound, bacteriological and serological reactions are carried out. To relieve the pain that has arisen in the throat, warm alkaline drinking, rinsing, physiotherapy procedures are used.
Causes of sore throat
External factors
Viral diseases
Bacterial infections
Laryngitis
Candidiasis of the oral cavity
Allergies
Foreign bodies of the pharynx
Gastroesophageal reflux
Deficient states
Chronic diseases
Tumors
Complications of pharmacotherapy
Rare reasons
Diagnostics
Treatment
Help before diagnosis
Conservative therapy
Surgical treatment
Prices for treatment
Causes of sore throat
External factors
Particular reasons for the appearance of a burning sensation, tickling in the oropharynx, less often the larynx — prolonged stay in a room with low humidity or conditions of dry hot climate. There is dryness of the mucous membranes, lack of saliva. The pain is felt more strongly in the throat when talking, eating solid food. Discomfort is especially intense after waking up – due to the slightly open mouth in a dream, the mucous membranes dry up even more. In men, soreness is provoked by snoring. Patients report that in the morning the throat hurts and it hurts to talk, and to relieve the condition you need to drink water.
The throat can be very sore when inhaling polluted air — in mines, when working in sand pits, in large cities due to exposure to exhaust gases. The symptom occurs suddenly when going outside or entering industrial premises. The soreness is accompanied by a dry nasal cough. Periodic and short—term appearance of such signs is a variant of the norm. If unpleasant sensations bother a person for a long time, interfere with eating or talking, it is necessary to consult a specialist to find out the reasons why the throat hurts.
Viral diseases
Severe sore throat is characteristic of many respiratory infections that damage the mucous membranes of the pharynx, larynx. The causes of soreness are a direct pathogenic effect on the epithelium, systemic action of the pathogen, damage to nerve endings. In most cases, the symptom occurs against a background of high body temperature, weakness, signs of intoxication. Most often , a sore throat is provoked:
Viral pharyngitis. Initially, there is discomfort, a feeling of stinging, tickling in the pharyngeal region, gradually replaced by severe pain in the projection of the throat, a painful dry cough. For pharyngitis, the symptom of an “empty throat” is typical — unpleasant sensations increase when swallowing saliva.
Infectious mononucleosis. With the action of this reason, a person has a sore throat, eating is almost impossible, some patients refuse even water. Simultaneously with the manifestation of pain, regional lymph nodes increase and become inflamed.
Adenovirus infection. The throat usually begins to ache a day or two after the onset of a runny nose and lacrimation. The pain is moderate, it increases with swallowing and talking. Patients often notice a spotty whitish plaque on the tonsils, later a barking cough joins.
Herpetic process. It hurts in the throat with the development of a specific complication — herpangins. Soreness is noted against the background of an increase in temperature to 39-40 degrees. Grayish bubbles are visible on the pharyngeal mucosa, upon opening of which the pain syndrome increases.
Sore throat
Sore throat
Bacterial infections
If the throat hurts and it hurts to swallow, this may be a sign of angina (tonsillitis). First, there is discomfort and tickling in the throat, followed by a sharp pain. Pain radiates into the ear, neck, and back of the head. Sometimes patients themselves notice an increase and redness of the tonsils, the formation of spot pustules on them. Symptoms occur against the background of febrile fever, general weakness, arthralgia and myalgia. If the pain in the throat increases to the point where it is impossible to swallow even water, an intratonsillar abscess (phlegmonous sore throat) may form.
When a sore throat in children, and the pain is accompanied by respiratory disorders, we can assume epiglottitis — inflammation of the epiglottis. Due to the intense pain syndrome, the child refuses food and water, dysphagia phenomena increase within a few hours. To reduce discomfort and ease breathing, patients take a forced pose: they sit leaning forward, stretch their neck strongly and slightly open their mouth. Sore throat, localized on one side and occurring against a background of severe fever, is a sign of a pharyngeal abscess.
Laryngitis
With acute laryngitis, the throat often begins to ache simultaneously with an increase in temperature to subfebrile values, the appearance of weakness. The pain is strong, with the localization of inflammation along the back wall of the organ, the soreness increases during swallowing. The symptom is combined with a sharp barking cough without sputum, when the vocal cords are involved in the process, the voice temporarily disappears. Chronic laryngitis is characterized by a slight sore throat, rapid fatigue and a change in the timbre of the voice, constant hoarseness come to the fore.
Candidiasis of the oral cavity
With fungal lesions of the oral cavity and pharynx, the throat constantly hurts, the intensity of pain significantly increases when trying to eat. Massive white deposits are visible on the mucous membranes, candidiasis also causes cracks and painful jams in the corners of the lips. The reproduction of fungal flora is observed in people with reduced immunity: after organ transplantation, with oncological diseases, secondary immunodeficiency. In such cases, the process can spread to the entire respiratory tract, causing the corresponding symptoms.
Allergies
With allergic pharyngitis and laryngotracheitis, moderate pain occurs in the throat caused by the influence of a trigger factor. Suddenly, the throat begins to sting and tickle. The condition is accompanied by attacks of superficial dry cough, which does not bring relief. Sneezing, excessive lacrimation and itching are possible. Allergy-prone people report that their throat may hurt after inhaling the smell of flowers, contact with household chemicals or cosmetics. The symptom also occurs after eating certain foods.
Foreign bodies of the pharynx
If fish or meat bones are accidentally swallowed, they can get stuck in the throat and cause sharp pains. Painful sensations of a stabbing or cutting nature often have a clear localization. The manifestation is combined with a strong inconclusive cough, sometimes there is redness and swelling of the face due to painful cough paroxysms. The person begins to suffocate. In children, the throat may hurt if small parts from toys get into the respiratory tract. With foreign bodies of the pharynx, emergency medical care is required.
Gastroesophageal reflux
In adults, possible causes for which the throat also hurts are periodic discharges into the throat and respiratory tract of acidic contents from the stomach with GERD. The intensity of pain varies throughout the day: a strong pain syndrome is observed in the morning after sleep, because the horizontal position contributes to the flow of acid into the pharynx. Sore throat is combined with a persistent dry cough, a constant feeling of tickling and discomfort. Also, patients report that they are worried about acid belching and heartburn attacks. These symptoms are typical for hyperacid gastritis, gastrointestinal ulcers, esophagitis.
Deficient states
For the normal regeneration of the pharyngeal mucosa, the presence of many biologically active substances and vitamins is necessary. With an unbalanced diet or a defeat of the gastrointestinal tract, accompanied by impaired absorption of the components of food, vitamin deficiency can develop, one of the manifestations of which is a sore throat. The probable causes of pain are such deficient conditions as:
Hypovitaminosis B2. Patients complain that the throat burns and hurts when talking, eating. Painful cracks form in the corners of the lips (angular cheilitis) and inflammation of the tongue.
Hypovitaminosis B12. There are burning pains in the tongue and throat, while the tongue is bright red and shiny. Patients may complain of numbness and paresthesia in the lower extremities.
Hypovitaminosis With . With a lack of ascorbic acid, sore throat is associated with ulcerative defects of the mucous membranes. Patients report a metallic taste in the mouth, bleeding gums.
Chronic diseases
The defeat of internal organs is accompanied by the accumulation of toxic metabolites and nitrogenous metabolic products in the blood. Pain, perceived as discomfort in the throat, is caused by chronic inflammation and atrophic processes in the pharynx. Pain can be provoked by an increase in blood glucose levels, which is combined with dry mouth and catarrhal processes. The throat can often hurt with the following somatic diseases:
Diseases of internal organs: CRF, liver damage.
Endocrine pathology: diabetes mellitus, Itsenko-Cushing syndrome, hypothyroidism.
Tumors
Prolonged sore throat with swallowing disorders that do not respond to standard conservative therapy may be a sign of the growth of neoplasms in the larynx. With benign tumors, patients complain of a constant feeling of pressure and bursting, there is choking while eating. Sharp pain in the neck and throat, accompanied by hemoptysis, may indicate the development of cancer of the pharynx or larynx as the main cause of soreness. The patient also notices a gradual loss of voice, hoarseness, and periodic dry coughing.
Complications of pharmacotherapy
Common causes that provoke sore throats are long—term use of certain medications. When instilling vasoconstrictive nasal drops, the medicine flows down the back of the pharynx, causing chronic irritation and inflammation in the mucous membrane. Patients note a constant feeling of tickling and burning, there is a dry cough. The throat may also ache after taking glucocorticosteroids or antibacterial drugs for a long time, which provoke a decrease in local immunity. A person complains of dry mouth, increased pain when talking.
Rare reasons
Xerostomia.
Odontogenic process: periodontitis, galvanism, pathology of teething.
Heart diseases: unstable angina, atypical form of myocardial infarction.
Pathology of adjacent organs: pharyngeal-esophageal (Cenker fistulas), thyroid diseases.
Nerve lesions: pharyngeal neurosis, lingopharyngeal nerve neuralgia.
Spinal lesion: cervical osteochondrosis, tuberculous spondylitis, sciatica.
Needle-Sterling hypoglyphic syndrome.
Diagnostics
An otolaryngologist is engaged in clarifying the cause that provoked the sore throat. Diagnostic search involves a comprehensive examination of the oral cavity and respiratory tract using instrumental and laboratory methods, in the presence of concomitant symptoms, visualization of the thoracic and abdominal cavities is performed. The following methods are considered the most informative for the diagnosis of acute sore throat:
Instrumental inspection. For a detailed study of the state of the respiratory system, pharyngoscopy, indirect laryngoscopy is effective. To exclude the otogenic cause of sore throat, an otoscopy is performed. During the study, the appearance of the mucous membranes, the presence of plaque and ulceration foci are evaluated.
Bacteriological analysis. For bakposev, a smear from the pharynx, sputum or plaque samples are taken. The method is necessary to confirm the most common diseases accompanied by a sharp sore throat — sore throat, viral or bacterial pharyngitis. Express diagnostics includes a REEF of flushes from the pharynx.
Sonography. With acute pain in the neck, throat, which are observed for a long time, ultrasound examination is necessary to exclude pathology of adjacent organs. The method allows to identify local accumulations of pus in the near-pharyngeal tissue, the presence of cysts and bulky formations. It is also mandatory to prescribe ultrasound of the thyroid gland.
X-ray examination. If there is severe pain in the neck and throat, an X-ray of the larynx is indicated to exclude the tumor process. A CT scan of the larynx is recommended for detailed visualization. In some cases, a radioisotope scan of the thyroid gland is performed.
Laboratory tests. Patients who feel a sore throat are prescribed a standard clinical and biochemical blood test, and the fasting glucose concentration is measured. To exclude chronic diseases, liver tests are performed according to indications, acute phase parameters and the level of certain enzymes are determined.
To identify endocrine pathology as the leading cause of pain, a blood test for thyroid hormones and adrenal cortex is necessary. Serological reactions (RIF, ELISA, PCR) are needed to identify pathogenic microorganisms. Additionally, they can do radiography and CT of the cervical spine. In the presence of dyspeptic disorders, FGDS and intraesophageal pH-metry are used. Patients who have a sore throat should be examined by a dentist for the presence of inflammatory processes of teeth and periodontitis.
Throat examination
Throat examination
Treatment
Help before diagnosis
To reduce sore throat, it is recommended to drink plenty of warm drinks (teas, herbal decoctions), while it is advisable to exclude drinks with milk. You can rinse the oropharynx with calendula tincture, take tablets for resorption. Doctors advise to avoid pungent odors, limit the use of household chemicals, which can irritate the mucous membrane. With intense pain, you need to take warm, chemically and mechanically sparing food — soups, porridges. If the throat is very sore or the pain is accompanied by fever, weakness, it is necessary to consult a doctor as soon as possible.
Conservative therapy
Medical tactics depend on the cause of sore throat. Etiotropic therapy is the most effective. A combination of medical treatment with physiotherapeutic methods that are aimed at eliminating the main cause of the disorder and individual painful manifestations helps to quickly reduce sore throat. In addition to rinsing, inhalations with essential oils and medicinal solutions are often used. UHF is performed on the pharyngeal region, magneto- and laser therapy. Treatment regimens include:
Antibiotics. If the throat hurts due to an infectious process, antibacterial agents are used that selectively act on pathogens of respiratory infections. With candidiasis, the administration of specific antifungal drugs is prescribed.
Anti-inflammatory drugs. Medications from the NSAID group allow to relieve sore throat. Medications effectively reduce the level of inflammatory mediators and cytokines, have powerful antipyretic and analgesic effects.
Antiseptics. Bactericidal agents (chlorhexidine, etc.) are shown to inhibit the growth of bacterial flora in the pharynx and respiratory tract. To relieve sore throats, the throat is additionally rinsed with mint, eucalyptus, and other natural products several times a day.
Antihistamines. When the throat begins to ache after contact with allergens, oral administration of specific drugs — histamine receptor blockers is necessary. In severe situations, aerosols with topical corticosteroids are effective.
Vitamins. Sore throat can occur due to a severe lack of vitamins, therefore, after passing specific tests, it is necessary to take vitamin preparations taking into account the immediate cause of vitamin deficiency. Most often, medicines based on cyanocobalamin, riboflavin are recommended.
Infusion formulations. With extensive purulent processes, the pain felt in the throat is accompanied by massive intoxication of the body, which is eliminated by crystalloid and colloidal solutions administered intravenously through a dropper.
Antisecretory drugs. Sore throat caused by gastroesophageal reflux requires taking medications that reduce acidity. The drugs of choice are proton pump inhibitors, which have minimal side effects.
Surgical treatment
Sore throat, which has developed as a result of purulent processes (pharyngeal or paratonsillar abscess, suppuration of the cyst), requires surgery to eliminate the leading cause. The abscess is incised and drained, it is washed with antibacterial and antiseptic solutions. With benign neoplasia, an economical resection of the pharynx is performed. Malignant formations in which complaints of sore throat are presented require hemilaryngectomy with the formation of a tracheostomy. In the long-term period, laryngoplasty is performed, if possible.
