Sore Throat

With the return of cooler temperatures to Central Virginia come rises in many of the common respiratory illnesses.  Complaints such as pharyngitis, or sore throat, are intensified by autumn’s swings in temperature, environmental contributors such as weeds, leaves and molds, and exposure to sick classmates or co-workers.  Many ailments will come and go so quickly that no treatment is necessary.  Others will need medical treatment.  But not every sore throat is a “strep throat.”

About half of sore throats will have no identifiable cause.  These are called idiopathic.  In other words, we don’t know what is causing it.  These sore throats may be from weather changes, allergies, mouth breathing, dry air, breathing pollution, smoking or any number of other nonspecific causes.  

Another large portion of sore throats are caused by viruses.  The same viruses that give us the common cold can cause persistent sore throats.  The virus that causes mono is often associated with a severe sore throat.  Other viruses can cause painful ulcers on the tongue, the roof of the mouth, and the pharynx.

Bacteria cause less than 10 percent of sore throats.  The most well-known is infection of the pharynx with streptococcus or “strep throat.”  Streptococcal pharyngitis is most common in children aged five to 12 years.  It’s seen most often in the winter and spring.  It can be transmitted from person to person through saliva, airborne droplets or nasal secretions.

Strep throat is usually associated with a high fever, swollen neck glands and a red, painful throat.  The tonsils are usually enlarged and red and may have whitish spots.  As a general rule, a cough and runny nose do not usually accompany strep throat.  These are much more common with colds and viral infections.

Children with strep throat can get pain in their stomach and/or a rash on the skin.  This occurs much less often in adults with strep.  Other symptoms may include general body aches, headache and vomiting.

Viral infections and other causes of sore throat do not respond to treatment with antibiotics.  Instead, the body’s defenses will fight off the infection, or the cause is otherwise treated accordingly.  For example, treatment of allergies can resolve soreness related to allergic drainage.  

On the other hand, infections caused by bacteria are treated with antibiotics.  Penicillin and its derivatives are most commonly prescribed for strep pharyngitis.  Untreated strep pharyngitis can lead to complications in the heart valves (rheumatic fever) and the kidneys (glomerulonephritis).  These complications have become rare since the introduction of modern antibiotics.  However, strep that have developed a resistance to the usual antibiotics are on the rise due to the overuse of antibiotics.   

Severe and persistent sore throats should prompt a visit to your doctor.  Milder symptoms can initially be treated conservatively with home remedies.  These include pain relievers/fever reducers such as acetaminophen, ibuprofen or naproxen.  Rest and plenty of liquids are encouraged.  

Salt water gargles may help.  Use a mixture of one-fourth teaspoon of salt in one cup (eight oz.) of warm water, gargle and spit.  Throat lozenges provide temporary relief.  A humidifier may be beneficial if the air is particularly dry.  Avoid catching or passing diseases by regular hand-washing and covering your mouth and nose when coughing or sneezing.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.

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