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Sore throatBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/sore-throat/DS00526
A sore throat is pain, scratchiness or irritation of the throat that often worsens when you swallow.
A sore throat is the primary symptom of pharyngitis — inflammation of the throat (pharynx). But the terms "sore throat" and "pharyngitis" are often used interchangeably.
The most common cause of a sore throat is a viral infection, such as a cold or the flu. A sore throat caused by a virus resolves on its own with at-home care. Strep throat (streptococcal infection), a less common type of sore throat caused by bacteria, requires additional treatment with antibiotic drugs to prevent complications.
Other less common causes of sore throat may require more complex treatment.
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Symptoms of a sore throat may vary depending on the cause. Signs and symptoms may include:
- Pain or a scratchy sensation in the throat
- Pain that worsens with swallowing or talking
- Difficulty swallowing
- Dry throat
- Sore, swollen glands in your neck or jaw
- Swollen, red tonsils
- White patches or pus on your tonsils
- Hoarse or muffled voice
Common infections causing a sore throat may result in other signs and symptoms, as well. They may include:
- Runny nose
- Body aches
- Nausea or vomiting
When to see a doctor
Take your child to a doctor if your child's sore throat doesn't go away with the first drink in the morning, recommends the American Academy of Pediatrics.
Get immediate care if your child has severe signs such as:
- Difficulty breathing
- Difficulty swallowing
- Unusual drooling, which may indicate an inability to swallow
If you're an adult, see your doctor if you have a sore throat and any of the following associated problems occur, according to the American Academy of Otolaryngology:
- A sore throat that is severe or lasts longer than a week
- Difficulty swallowing
- Difficulty breathing
- Difficulty opening your mouth
- Joint pain
- Fever higher than 101 F (38.3 C)
- Blood in saliva or phlegm
- Frequently recurring sore throats
- A lump in your neck
- Hoarseness lasting more than two weeks
Most sore throats are caused by viruses that cause the common cold and flu (influenza). Less often, sore throats are due to bacterial infections.
Viral illnesses that cause a sore throat include:
- Common cold
- Flu (influenza)
- Mononucleosis (mono)
- Croup — a common childhood illness characterized by a harsh, barking cough
Bacterial infections that can cause a sore throat include:
- Strep throat, which is caused by a bacterium known as Streptococcus pyogenes, or group A streptococcus
- Whooping cough, a highly contagious respiratory tract infection
- Diphtheria, a serious respiratory illness that's rare in industrialized nations, but is more common in developing countries
Other causes of sore throat include:
- Allergies. Allergies to pet dander, molds, dust and pollen can cause a sore throat. The problem may be complicated by postnasal drip, which can irritate and inflame the throat.
- Dryness. Dry indoor air, especially in winter when buildings are heated, can make your throat feel rough and scratchy, particularly in the morning when you first wake up. Breathing through your mouth — often because of chronic nasal congestion — also can cause a dry, sore throat.
- Irritants. Outdoor air pollution can cause ongoing throat irritation. Indoor pollution — tobacco smoke or chemicals — also can cause chronic sore throat. Chewing tobacco, drinking alcohol and eating spicy foods also can irritate your throat.
- Muscle strain. You can strain muscles in your throat just as you can strain them in your arms or legs. Yelling at a sporting event, trying to talk to someone in a noisy environment or talking for long periods without rest can result in a sore throat and hoarseness.
- Gastroesophageal reflux disease (GERD). GERD is a digestive system disorder in which stomach acids or other contents of the stomach back up in the food pipe (esophagus). Other signs or symptoms may include heartburn, hoarseness, regurgitation of stomach contents and the sensation of a lump in your throat.
- HIV infection. A sore throat and other flu-like symptoms sometimes appear early after someone is infected with HIV. Also, a person who is HIV-positive may have a chronic or recurring sore throat due to a secondary infection. Common problems include a fungal infection called oral thrush and cytomegalovirus infection, a common viral infection that can be serious in people with compromised immune systems.
- Tumors. Cancerous tumors 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.
Rarely, an infected area of tissue (abscess) in the throat causes a sore throat. Another rare cause of a sore throat is a condition that occurs when the small cartilage "lid" that covers the windpipe swells, blocking airflow (epiglottitis). Both causes can block the airway, creating a medical emergency.
Although anyone can get a sore throat, some factors make you more susceptible. These factors include:
- Being a child or teenager. Children and teens are most likely to develop sore throats. Children are also more likely to have strep throat, the most common bacterial infection associated with a sore throat.
- Being exposed to tobacco smoke. Smoking and secondhand smoke can irritate the throat. The use of tobacco products also increases the risk of cancers of the mouth, throat and voice box.
- Having allergies. If you have seasonal allergies or ongoing allergic reactions to dust, molds or pet dander, you're more likely to develop a sore throat than are people who don't have allergies.
- Being exposed to chemical irritants. Particulate matter in the air from the burning of fossil fuels, as well as common household chemicals, can cause throat irritation.
- Having chronic or frequent sinus infections. Chronic or frequent sinus infections increase the risk of sore throat because 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 — child care centers, classrooms, offices, prisons and military installations.
- Having decreased immunity. You're more susceptible to infections in general if your resistance is low. Common causes of lowered immunity include HIV, diabetes, treatment with steroids or chemotherapy drugs, stress, fatigue, and poor diet.
Preparing for your appointment
If you or your child has a sore throat, make an appointment with your family doctor or your child's pediatrician. In some cases, you may be referred to a specialist in ear, nose and throat (ENT) disorders or an allergy specialist (allergist).
Here's some information to help you get ready for your appointment.
What you can do
- Write down any symptoms you or your child has had, and for how long.
- Note any recent, possible sources of infection, such as a friend or family member with a sore throat or a cold.
- Write down key medical information, including any other health problems and the names of any medications you or your child is taking.
- Write down questions for the doctor.
Preparing a list of questions will help you make the most of your time with your doctor. For sore throat, some basic questions to ask your doctor include:
- What is the most likely cause of these signs and symptoms?
- Are there any other possible causes?
- What tests are needed?
- What treatment do you recommend?
- How soon do you expect symptoms to improve with treatment?
- How long will this be contagious? When is it safe to return to school or work?
- What self-care steps might help?
- Is there a generic alternative to the medicine you're prescribing?
- How can other health conditions best be managed with sore throat?
Don't hesitate to ask other questions as they occur to you.
What to expect from your doctor
Your doctor is likely to ask a number of questions about you or your child. Your doctor may ask:
- What symptoms have you had besides a sore throat?
- When did these symptoms begin?
- Have these symptoms included a fever? How high?
- Have you had trouble breathing?
- Does anything worsen your sore throat, such as swallowing?
- Does anything seem to make the symptoms better
- Is a sore throat a recurring problem?
- Do you smoke? Are you or your child regularly exposed to secondhand smoke?
- Do you have allergies? Do you take allergy medication?
- Do you have any drug allergies?
What you can do in the meantime
If you or your child has a sore throat, try these steps.
- Keep your hands clean, cover your mouth when you cough or sneeze, and don't share personal items.
- Gargle with 1 teaspoon (5 grams) of table salt in 8 ounces (237 milliliters) of warm water also may help.
- Rest, drink fluids, eat soft foods and take pain relievers such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) to help ease symptoms. Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.
Tests and diagnosis
Your doctor will start with a physical exam that is generally the same for children and adults. The exam will include:
- Using a lighted instrument to look at your throat, and likely your ears and nasal passages
- Gently feeling (palpating) your neck to check for swollen glands (lymph nodes)
- Listening to your breathing with a stethoscope
With this simple test, the doctor rubs a sterile swab over the back of your throat to get a sample of secretions. The sample will be checked in a lab for streptococcal bacteria, the cause of strep throat. Many clinics are equipped with a lab that can get a test result within a few minutes. However, a second more reliable test is usually sent out to a lab that can return results within 24 to 48 hours.
If the rapid, in-clinic test comes back positive, then you almost certainly have a bacterial infection. If the test comes back negative, then you likely have a viral infection. Your doctor will wait, however, for the more reliable, out-of-clinic lab test to determine the cause of the infection.
- Complete blood count (CBC). Your doctor may order a CBC with a small sample of your blood. The result of this test, which can often be completed in a clinic, produces a count of the different types of blood cells. The profile of what's elevated, what's normal or what's below normal can indicate whether an infection is more likely caused by a bacterial or viral agent.
- Allergy tests. If your doctor suspects your sore throat is related to an allergy, you may be referred to an allergist for additional tests.
You may be referred to an ENT doctor or other specialist if you have chronic or frequent sore throat or if there are any signs or symptoms that suggest a serious condition other than a common viral or bacterial infection.
Treatments and drugs
A sore throat caused by viral infection — the most common cause — usually lasts five to seven days and doesn't require medical treatment.
Treating bacterial infections
If your sore throat is caused by a bacterial infection, your doctor will prescribe a course of antibiotics. Penicillin taken by mouth for 10 days is the most common antibiotic treatment prescribed for infections such as strep throat. If you're allergic to penicillin, your doctor will prescribe an alternative antibiotic.
You must take the full course of antibiotics as prescribed even if the symptoms go away completely. Failure to take all of the medication as directed may result in the infection worsening or spreading to other parts of the body. Not completing the full course of antibiotics to treat strep throat can, in particular, increase a child's risk of rheumatic fever and serious kidney inflammation.
Talk to your doctor or pharmacist about what to do if you forget to take a dose.
If a sore throat is a symptom of a condition other than a viral or bacterial infection, other treatments will likely be considered depending on the diagnosis.
Lifestyle and home remedies
Regardless of the cause of your sore throat, at-home care strategies usually provide temporary relief. Try these strategies:
- Rest. Get plenty of sleep and rest your voice.
- Drink fluids. Drink plenty of water to keep the throat moist and prevent dehydration.
- Try comforting foods and beverage. Warm liquids — broth, caffeine-free tea or warm water with honey — and cold treats such as ice pops can soothe a sore throat.
- Gargle saltwater. A saltwater gargle of 1 teaspoon (5 grams) of table salt to 8 ounces (237 milliliters) of warm water can help soothe a sore throat. Gargle the solution and then spit it out.
- 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.
- Consider lozenges. Lozenges can soothe a sore throat. Because lozenges are a choking hazard for young children, don't give them to children age 4 and younger.
- Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat.
- Treat pain and fever. Ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) may minimize throat pain. Aspirin has been linked with Reye's syndrome, so use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns.
Although a number of alternative treatments are commonly used to treat sore throat, evidence is limited about what works and what doesn't. Check with your doctor before using any herbal remedies, as they can interact with prescription medications and may not be safe for children, pregnant women and people with certain health conditions.
Herbal or alternative products for sore throat are often packaged as teas, sprays or lozenges. Common alternative remedies include:
- Slippery elm
- Licorice root
- Marshmallow root
- Honeysuckle flower and other Chinese medicine herbs
The germs that cause viral and bacterial infections are contagious. Therefore, the best prevention is to practice good hygiene. Follow these tips and teach your child to do the same:
- 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.
- Cough or sneeze into a tissue and throw it away. When necessary, sneeze into your elbow.
- Use alcohol-based hand sanitizers as an alternative to hand-washing when soap and water aren't available.
- Avoid touching public phones or drinking fountains with your mouth.
- Regularly clean telephones, TV remotes and computer keyboards with sanitizing cleanser. When you travel, clean phones and remotes in your hotel room.
- Avoid close contact with people who are sick.
Other tips to avoid sore throat include the following:
- Stay indoors as much as possible on high-pollution days.
- 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 breaking a smoking habit.
- Avoid exposure to secondhand smoke.
- Humidify your home if the air is dry.
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