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Sore Throat
Soothing advice that's easy to swallow
Did you wake up this morning with a cold? A slight cough? Maybe a fever? When you tried to swallow, did your throat hurt? When you looked in the mirror, was the back of your throat red and inflamed? Did you see greenish or yellowish phlegm? If so, you've got the classic symptoms of a sore throat.
Synonyms
- Pharyngitis
How Common Is Sore Throat?
Virtually everyone -- from infants to seniors -- is susceptible to a sore throat at one time or another.
Possible Underlying Causes
What causes the soreness in a sore throat? Most sore throats are caused by viral infections such as colds and flus, with postnasal drip that can irritate your throat. Pneumonia or mononucleosis can also cause inflammation. Sometimes the soreness results from a dry throat brought on by breathing through your mouth instead of your nose.
If you have a severe sore throat for more than four days, it could be a bacterial infection such as strep throat or tonsillitis. If so, a visit to your doctor may be necessary. Left unchecked, these bacterial infections can lead to kidney problems and even rheumatic fever, which can cause heart inflammation or arthritis.
Other causes of a sore throat include cigarette smoking, shouting, seasonal allergies, oral-genital sexually transmitted diseases, and such infectious diseases as chickenpox, mumps, and diphtheria.
Triggers of Sore Throat
- A cold or flu
- Postnasal drip
- Swollen neck (lymph) glands
- Swollen tonsils and/or a rash
- Smoking
Diagnosing the Underlying Cause
While a sore throat is common and usually nothing to worry about, in rare instances it may be a symptom of an underlying condition, disease or disorder. Some of these disorders have certain characteristic symptoms in addition to a fever of 101F and higher, extremely painful swallowing, and/or blood in your phlegm.
The following conditions may include sore throat among their symptoms, but a sore throat should not lead you to conclude that you have a more serious disorder. You should not attempt to diagnose yourself with a medical condition, even if your symptoms match those characteristics of a certain disorder. If your symptoms concern you, the best thing to do is to seek medical advice. In order to understand your symptoms and reach a diagnosis, your health care provider will consider your medical history, your symptoms, and the results of a physical examination and laboratory tests.
- Viral infections such as a common cold, flu, or herpes
- Tonsillitis (inflammation of the tonsils)
- Laryngitis (inflammation of the voice box)
- Vocal cord polyps, nodules, or ulcers
- Mumps (an infectious viral disease)
- Viral pneumonia
- Mononucleosis (an infectious disease caused by the Epstein-Barr virus)
- Cancer of the tonsils or voice box
- Strep throat (a bacterial infection)
- Gonorrhea (from oral sex) or syphilis
- Fungi, such as candida
Diagnostic Procedures
In order to diagnose the underlying cause of your sore throat, your physician will ask you about other symptoms you might have. He or she will perform a physical exam, feel for swollen glands and visually examine the back of the throat and vocal cords. He or she might swab a sample from your throat and have it analyzed for any infectious organisms.
Goals of Treatment
It's estimated that sore throats annually send 40 million Americans to their doctors. For most people, the goal of treatment is to reduce pain and swelling. Treatment will depend on a sore throat's underlying cause. For mild cases, or for a sore throat caused by a viral infection, drugs that relieve symptoms may be enough. For bacterial infections, antibiotics may be recommended.
Treatment Options
Fortunately, most of us can get quick relief for the pain of a sore throat through a variety of home remedies, over-the-counter medicines, and prescription drugs. These include gargling with salt and warm water, drinking more fluids, and taking aspirin to relieve pain.
Other options include an over-the-counter throat spray with phenol as the active ingredient (consult your health care practitioner before administering it to your kids), and taking over-the-counter drugs to lower your temperature or reduce swelling aspirin, acetaminophen, or ibuprofen).
If you have a fever but no other associated symptoms (such as runny nose), you may have a bacterial infection. If so, an antibiotic will probably be prescribed by your doctor for seven to 10 days. Even if the soreness dissipates within a few days, you should continue your medication until you take all the pills. This can help prevent a reoccurrence. If you have difficulty swallowing, make sure to see a doctor.
Drugs most commonly used
- Chloraseptic (Benzocaine topical sprays)
- Cepacol (Phenol lozenges)
- Antibiotics such as penicillin or erythromycin
Special Diets
The following fluids may help to soothe a sore or irritated throat:
- Herbal teas
- Fruit juices
- Clear soups or broths
Considerations for Children
Consult a physician before giving aspirin to your child. It can cause Reye's syndrome, a potentially fatal condition for children. You may safely give acetaminophen (Tylenol) or ibuprofen (Advil).
Gargle a mixture of a one-quarter teaspoon salt per four ounces of warm water, every other hour. For the majority of sore throats, this therapy may be enough to end the pain. Drinking more fluids (broths, teas and herbal teas, fruit juices) or using throat lozenges (eucalyptus, lemon, or honey) may also help.
Supplements
Certain vitamins and minerals may strengthen the body's immune system, reducing the severity of your sore throat, especially if it comes from a cold.
- Vitamin C: Try taking vitamin C (500 mg four times a day). Finnish researchers analyzed 21 vitamin C studies and found that the vitamin reduced average symptom scores 23%. [1]
- Zinc: Suck on zinc lozenges. Several studies show that they may significantly shorten the duration of a cold.[2][3]
Herbs
A variety of herbs can help relieve a sore throat, including:
- Echinacea: if your sore throat is due to any upper respiratory infection, try echinacea, which stimulates the immune system. Take one teaspoon of tincture in juice three times a day. [4]
- Goldenseal: is said to dry secretions, fight infections, and reduce swelling.
- Licorice: add a pinch of powdered licorice root to any beverage tea. It helps to soothe a sore throat.
[1] Hemila, "Does Vitamin C Alleviate Symptoms of the Common Cold?" Scandinavian Journal of Infectious Diseases 26:1, 1994.
[2] Eby, G., et al. "Reduction in Duration of Common Colds by Zinc Gluconate Lozenges: A Double-Blind Study." Antimicrobial Agents and Chemotherapy 25:20, 1984.
[3] Godfrey, J.C. "Zinc Gluconate and the Common Cold: A Controlled Clinical Study," Journal of International Medical Research 20:234, 1992.
[4] Hoheisel. O., et al. "Echinagard Treatment Shortens The Course of the Common Cold: A Double-Blind, Placebo-Controlled Clinical Trial," European Journal of Clinical Research 9:261, 1997.
Preventing Sore Throats
No matter what preventive measures you take, it is unlikely that you can prevent sore throats altogether. However, there are still steps you can take to minimize the frequency or severity of sore throats. If you have frequent bouts of tonsillitis, your health care provider may suggest you have your tonsils removed.
Self-Care Measures
- Don't smoke -- it's a major throat and lung irritant.
- Avoid other respiratory irritants, including dust, chemical fumes, and any fine particulates.
- Suck on throat lozenges or hard candies, which have a soothing effect.
- Drink plenty of hot liquids -- they also soothe a sore throat.
- Gargle with warm water. Some people prefer warm salt water (one-quarter teaspoon per four ounces of water).
- Vitamin C and echinacea may also be helpful. Learn more in Sore Throat: Alternative Care.
When to Call the Doctor
You may want to see a physician if any of the following symptoms accompany your sore throat:
- A fever of 101F or greater for three or more days
- Blood in your phlegm
- Swollen neck glands
- Inflamed tonsils
- Extremely painful swallowing or difficulty swallowing
- Labored breathing
- Skin rash
Websites & Organizations
American Academy of Otolaryngology -- Head and Neck Surgery
One Prince Street
Alexandria, VA 22314-3357
Phone: 703-836-4444
American Institute of Preventive Medicine
30445 Northwestern Hwy., Suite 350
Farmington Hills, MI 48334
Phone: 800-345-2476
Children's Virtual Hospital
Dr. Grossan's Ear, Nose and Throat Consultant
KidsHealth.org
National Health Information Center
P.O. Box 1133
Washington, DC 20013-1133
Phone: 301-565-4167 or 800-336-4797
Fax: 301-984-4256
Email: nhicinfo@health.org
National Institute of Allergy and Infectious Diseases
National Institutes of Health
Bethesda, MD 20892
Oral Health Education Foundation, Inc.
P.O. Box 396
Fairburn, GA 30213
Sources & Further Reading
Books
Balch, James F. and Balch, Phyllis A. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing, 1997.
Bennett, J. Claude and Plum, Fred. Cecil Textbook of Medicine, eds. Philadelphia: W. B. Saunders, 1996.
Fauci, Anthony J., et al. Harrison's Principles of Internal Medicine, eds. New York: McGraw-Hill, 1998.
Hardman, Joel G. and Limbird, Lee E. Goodman and Gilman's The Pharmacological Basis of Therapeutics eds. New York: McGraw Hill, 1996.
Hurst, J. Willis. Medicine for the Practicing Physician eds. Stamford, CT: Appleton & Lange 1996.
Murray, Michael T. Encyclopedia of Natural Medicine. Prima, 1998.
Noble, John. Primary Care Medicine ed. St. Louis: Mosby, 1996.
Physicians' Desk Reference. Montvale, NJ: Medical Economics Co., 1998.
Rakel, Robert E. Conn's Current Therapy eds. Philadelphia: W.B. Saunders, 1998.
Taylor, Robert B. Family Medicine: Principles and Practice. New York: Springer-Verlag, 1998.
Tierney, LM, McPhee, SJ, and Papadakis, MA. Current Medical Diagnosis and Treatment eds. Stamford, CT: Appleton & Lange, 1998.
Articles
De Meyere, M, Mervielde, Y, Verschraegen, G, Bogaert, M. "Effect of Penicillin on the Clinical Course of Streptococcal Pharyngitis in General Practice." Eur J Clin Pharmacol. 43(6):581-5. 1992.
Del Mar, C. "Managing Sore Throat: A Literature Review. I. Making the Diagnosis." Med J Aust. 156(8):572-5. Apr 1992.
Del Mar ,C. "Managing Sore Throat: A Literature Review. II. Do Antibiotics Confer Benefit?" Med J Aust. 156(9):644-9. May 4, 1992.
Eby, G. et al. "Reduction in Duration of Common Colds by Zinc Gluconate Lozenges: A Double-Blind Study. Antimicrobial Agents and Chemotherapy, 25:20, 1984.
Godfrey, J.C. "Zinc Gluconate and the Common Cold: A Controlled Clinical Study," Journal of International Medical Research, 20:234, 1992.
Hemila, "Does Vitamin C Alleviate Symptoms of the Common Cold?" Scandinavian Journal of Infectious Diseases, 26:1, 1994.
Hoheisel. O. et al. "Echinagard Treatment Shortens The Course of the Common Cold: A Double-Blind, Placebo-Controlled Clinical Trial," Europ. J. of Clinical Research, 9:261, 1997.
Lang, SD, Singh, K. "The Sore Throat. When to Investigate and When to Prescribe." Drugs. 40(6):854-62. Dec 1990.
Little, P, Gould, C, Williamson, I, Warner, G, Gantley, M, Kinmonth, AL. "Reattendance and Complications in a Randomised Trial of Prescribing Strategies for Sore Throat: The Medicalising Effect of Prescribing Antibiotics." BMJ. 315(7104):350-2. Aug 9, 1997.
Little, P, Williamson, I, Warner, G, Gould, C, Gantley, M, Kinmonth, AL. "Open Randomised Trial of Prescribing Strategies in Managing Sore Throat." BMJ. 314(7082):722-7. Mar 8, 1997.
Little, P, Williamson, I. "Sore Throat Management in General Practice." Fam Pract. 13(3):317-21. Jun 1996.
Muhrer, JC. "Diagnostic Considerations in the Evaluation and Treatment of Sore Throat." Nurse Pract. 16(9):33-8, 41, 45. Sep 1991.
Perkins, A. "An Approach to Diagnosing the Acute Sore Throat." Am Fam Physician. 55(1):131-8, 141-2. Jan 1997.
Pichichero, ME. "Sore Throat after Sore Throat after Sore Throat. Are You Asking the Critical Questions?" Postgrad Med. 101(1):205-6, 209-12, 215-8, passim. Jan 1997.