Sore throats

What is the throat?

Your throat runs from the back of your mouth to the top of your respiratory and digestive tracts, it comprises the tonsils, larynx and pharynx. Your throat has an important function - it helps to filter out potentially harmful bacteria, which can lead to infection.

A = Pharynx B = Uvula C = Tongue D = Tonsils

What is a sore throat?

No matter what age you are, everybody at some time has experienced a sore throat. Inflammation of the tissues in the larynx, pharynx and tonsils cause the symptoms we associate with sore throats.
Uncomplicated sore throats usually last up to 3 days and are commonly linked with the flu and colds. Coughing, which is a symptom of both infections can aggravate the throat and make it feel worse.

A severe sore throat, that lasts over 3 days could be a symptom of a more serious condition like tonsillitis (see below) or laryngitis and you should see your doctor. Sore throats also accompany many viral infections such as measles, mumps, chicken pox, glandular fever and whooping cough. All these conditions are highly contagious and can cause epidemics, especially during the winter months.

What causes a sore throat?

Sore throats are normally caused by either a viral or bacterial infection. The most important difference between a virus and bacteria is that bacteria respond well to antibiotic treatment and viruses do not. A sore throat is commonly spread by: sharing drinks, kissing, coughing, nose blowing, and sneezing.

Viral sore throats

The majority of sore throats are caused by a viral infection, like those which cause colds and flu. These are most common in the winter, when we spend more time indoors in contact with other people, enabling germs to spread rapidly. A viral infection can lead to a more serious bacterial infection once the immune system has been weakened. When your sore throat is caused by a viral infection there is no immediate treatment. Fortunately, viral infections usually only last a few days as the body is normally able to fight off the infection by itself.

Bacterial sore throats

Bacteria can cause more serious sore throats, that can lead to conditions such as tonsillitis or ear infections. Bacteria can cause the throat to become very inflamed and sore. In most cases antibiotic treatment prescribed from your doctor will be the only successful treatment to help reduce the symptoms.

The bacteria that causes the majority of sore throats, is called streptococcus group A (strep A). Somebody who has a strep sore throat might have a sore throat with a fever that starts suddenly, without a cough or cold symptoms. Strep throat is very common in children.

What is tonsillitis?

Tonsillitis is an infection of the lumpy tissue (tonsils) either side of the throat towards the back of the tongue. The tonsils and the back of the throat may look red, swollen and dotted with white/yellow specks of pus. When the tonsils become infected you may also experience a high temperature, headache and feel generally unwell. Tonsillitis may be caused by either a virus or bacteria but the symptoms will be the same no matter which germ causes the infection. When bacteria cause tonsillitis it is nearly always from strep A bacteria.

Other reasons for a sore throat include:

• Pollution - contaminates the air we breathe and can irritate the throat.
• Allergy - hay fever and allergy sufferers may get an irritated throat during an allergy attack.
• Cigarette smoke - is a major irritant of the airways and makes both viral and bacterial infection more likely.
• Changes in temperature - such as going from warm centrally heated rooms to the icy outdoors can affect the throat.
• Overuse of the vocal cords - through singing or shouting, can lead to inflammation.

Symptoms

Symptoms of a sore throat caused by bacteria or a virus can include:

• Painful red throat.
• Swollen tonsils.
• Difficulty in swallowing.
• Fever.
• Headache.
• Swollen lymph glands and neck stiffness.

Treatments

It is almost impossible to predict from the look of the throat, or the severity of the pain whether the cause is bacteria or a virus and a throat swab will usually need to be taken to confirm a diagnosis.

Most viruses subside in a few days and treatment is not necessary, antibiotics are not given to relieve throat pain in general, and usually the best advice would be to let nature take its course.

People with a sore throat caused by bacteria can be treated very easily with a course of antibiotics prescribed by a doctor. Treatment is essential with bacteria infection to prevent more serious conditions developing.

What can I do to make my sore throat better?

Whether your sore throat is due to bacteria or a virus, the following will help to relieve your symptoms:

• Drink plenty of non-alcoholic fluids.
• Gargle with warm salty water.
• If you have a temperature take paracetamol to reduce it.
• Adults may try gargling with soluble aspirin before swallowing it.
• Suck throat lozenges (available from chemists and some supermarkets).
• Use throat sprays (available from chemists and some supermarkets).
• Do not smoke.
• Avoid alcohol.

When do I need to see a doctor?

• You are finding it difficult and almost impossible to swallow.
• Symptoms persist for more than 4 days.
• The glands in your neck are swollen.
• You have a persistent fever over 38.3 °C (101°F).
• You have pus on your tonsils.
• You have any difficulty in breathing.
• You have a stiff neck and severe headache.
• You have an earache.
• If a rash develops.
• There is blood in saliva or phlegm.
• You have mouth ulcers lasting for over 2 weeks.
• If the phlegm you have coughed up is either green or yellow.