Anyone knows what a sore throat is from school: a disgusting hissing sensation that prevents swallowing, a burning sensation in the nasopharynx, and other charms that precede the advent of one of the common cold.
In the view of an average person without special medical training, a sore throat is always associated with a cold, ARVI. In fact, the "root of evil" may lie in the reasons far from infectious defeat.
The mechanisms of sore throat
Like any other kind of pain, the pain in the throat is a discomfort, obsessive sensation, localized in the area of the pharynx, larynx, and the initial sections of the trachea. At the subjective level, the patient is unlikely to be able to independently distinguish which of the organs of the upper respiratory tract is affected.
Both the larynx, the trachea, and the pharyngeal mucosa are provided with a huge number of small blood vessels, the purpose of which is to heat the inhaled air and enhance local immunity.
Obviously, with a rich blood supply, the degree of innervation of these structures is also very high, so even the smallest cause can cause intense pain in the throat.
Sore throat: causes
Sore throat is not an independent pathology. The symptom indicates the presence of a wide variety of diseases, from a common cold to the oncological process. If your throat hurts badly, the causes can be very different.
A very important marker of etiology is the presence or absence of hyperthermia (increase in body temperature). For diagnostic purposes, this is one of the most important factors.
Body temperature increased
1) Pharyngitis. Sore throat hurts to swallow - one of the most frequent complaints of patients with pharyngitis. However, the pain is not localized in the pharynx and soft palate. Patients feel discomfort in the area of the protrusion of the larynx (Kadyk). Symptoms of pharyngitis include a number of typical manifestations:
- Increase in body temperature (hyperthermia) to subfebrile marks: 37.2-38.0 degrees Celsius.
- A feeling of dryness in the throat, in the area of the soft palate. Burning in the nasopharynx, sore throat.
- Dry cough.
- Manifestations of intoxication: headache, weakness, lethargy and fast fatigue, "aching" joints and eyeballs, etc.
- arching pains in the neck area (on the sides), under the tongue (this can be an increase in the nearby lymph nodes).
- In advanced cases - purulent discharge in sputum, severe swelling of the palate, and, as a consequence, difficulty breathing.
In about 40% of cases, if a sore throat is severe, the reason is pharyngitis. Pharyngitis in most cases (more than 95%) is an infectious disease. However, the term "infectious" is very broad.
So, there are the following types of infectious pharyngitis:
- Viral pharyngitis: rhinovirus caused by coronoviruses, etc.
- Caused by bacteria: streptococci, staphylococci, etc.
- Pharyngitis of fungal etiology: caused by Candida fungi.
In addition, in some cases, pharyngitis may have a non-infectious nature:
- Allergic. The cause of pharyngitis can be an allergy. In this case, the duration of the disease is usually shorter.
- Radiation pharyngitis. Develops in patients with cancer, undergoing radiation therapy. The reason is exposure to radiation (ionizing radiation).
As they say, “out of the blue” pharyngitis, of course, does not develop, even if a person has been in contact with staphylococcus, streptococcus or other infectious agents. Every day, each of us comes into contact with billions of various infectious agents, including such scary ones as the Koch wand. But after such a meeting, tuberculosis develops in thousandths. The same goes for pharyngitis.
Why is that?
The fact is that infection requires a combination of factors.
Firstly, contact with the pathogen.
Secondly - the weakening of immunity against the backdrop of a rigid diet, hypothermia, exacerbation of chronic diseases, taking specific drugs that suppress the functions of immunity.
It is important to note that much, including the symptoms of pharyngitis, depends on the characteristics of the body of a particular patient. It often happens that a sore throat hurts to swallow, but hyperthermia is not observed. This may indicate a weak immune system, and may indicate a non-infectious nature of pharyngitis.
2) Tonsillitis. Tonsillitis is an inflammation of the tonsils. The disease almost always has an infectious etiology and can affect both one and both tonsils.
Under normal conditions, tonsils act as a special organ of the immune system that delays infectious agents. With repeated prolonged or single, but extremely intense effects on the tonsils, inflammation develops.
At the household level, acute tonsillitis also has the name of tonsillitis. The main symptom is a sore throat. Not always the source of the disease is external factors. The source can be chronic infectious and inflammatory foci in the body: for sinus, caries, etc.
The most frequent pathogens of acute tonsillitis are staphylococcus (greening, golden staphylococcus).
Complicated forms of tonsillitis (sore throats) may be accompanied by purulent rashes (abscesses), severe edema.
With inadequate treatment or its absence, tonsillitis becomes chronic.
3) Pharyngomycosis. It is a fungal infection. In general, the picture of pharyngomycosis is similar to the picture of pharyngitis. The intensity of the symptoms is somewhat different.
- With infectious pharyngitis, pain is more intense. Simply put, a sore throat. Pharyngomycosis is characterized by moderate pains, the main complaint is uncomfortable sensation in the pharynx area: burning, "hissing", etc.
- With pharyngomycosis, acute intoxication develops.
- A plaque (white or yellow) is characteristic of a fungal infection.
- With pharyngomycosis, pain radiates. Sore throat and ear.
4) Other infectious diseases. Sore throat, for example, may be the first symptom of tetanus. But since this disease today is rather exotic, it is necessary to suspect tetanus in a very limited number of cases.
Body temperature is normal
1) Pharyngitis of non-infectious nature. Non-infectious pharyngitis can develop due to nutritional causes, toxic, radiation, allergic lesions.
In general, the symptoms of non-infectious pharyngitis are similar to the manifestations of an infectious form. The main difference is the absence of hyperthermia.
Even non-infectious pharyngitis is characterized by inflammation, so pain can have a radiating character. Usually sore throat and ear.
2) Chemical, thermal and mechanical causes. If the throat hurts, there is no temperature and before the onset of discomfort, a person somehow damaged the throat (ate solid, rough food, drank an aggressive chemical composition, such as carbonated water, etc.), it makes sense to look for reasons in nutritional factors.
3) Tumors. If there is often no sore throat, there is a risk of developing tumors. Benign neoplasms, as a rule, do not contribute to the development of intense pain. Benign adenoma tumors reaching large sizes can cause discomfort when swallowing. However, the most characteristic pain in malignant neoplasms.
Malignant tumors of the throat:
- Epitheliomas - tumors that develop during the degeneration of epithelial tissue of the pharynx. It begins with the growth of the lesion in the form of a tubercle in 1-3 cm. The tubercle ulcerates, after which changes occur in the nearby lymph nodes (lymphadenitis). The pains, as the process progresses, increase, often radiating to the ears and head (sore throat and head).
- Lymphosarcoma.
- Often, pain can provoke thyroid cancer (papillary, follicular). In malignant tumors of the thyroid gland, there are radiating "false" sore throats.
Sore throat on the background of neurological diseases and pathologies of the musculoskeletal system
1) Osteochondrosis. Osteochondrosis of the neck causes pathological changes in the vertebrae and intervertebral discs. These changes provoke compression of the nerve roots and the development of specific syndromes. So, with cervical osteochondrosis, there is often a feeling of a foreign object in the throat, pain syndrome. In addition, often the symptoms characteristic of osteochondrosis are combined with the above-mentioned neurological symptoms. As a result, the patient feels that he has a sore throat and head, a false clinical picture arises, which can lead to the appointment of the wrong treatment.
2) Nervous system disorders, neurotic disorders. Depressive states, panic attacks cause spasm of the muscles of the larynx. Muscle spasm provokes a rather intense pain syndrome and foreign body sensation (coma) in the throat.
Venereal diseases
Persons who prefer exotic types of close relationships are at risk of contracting STDs. Most common are syphilis and gonorrhea.
1) Gonorrhea. The clinical picture is identical to acute purulent tonsillitis (sore throat). The difference in the pathogen. It is noteworthy that newborns can become ill with this form of gonorrhea if the mother is infected.
2) Syphilis. The clinical picture is characteristic of syphilis as a whole. A solid chancre is formed, then numerous ulcerations occur, etc.
Laryngeal changes
Pathologies of the larynx may be accompanied by fever and pain in the throat.
Sore throat: diagnosis
Diagnostic measures include both instrumental and laboratory methods, due to which it is not a problem to identify the exact cause of sore throat for a competent specialist. As a rule, two specialists deal with sore throat treatment: an ENT (otolaryngologist) and, to a lesser extent, a general practitioner.
Diagnostics includes:
History taking
It is an oral questioning of a patient in person. The doctor hears the patient's complaints, ascertains the circumstances preceding the occurrence of a sore throat, the intensity of the manifestations and other factors. When collecting history, the doctor makes an approximate clinical picture and prepares a diagnostic strategy.
Primary inspection. The tasks of the initial examination include determining the state of the pharyngeal mucosa. In 99% of cases, the doctor reveals typical signs of tonsillitis or pharyngitis (of various origins).
A typical pharyngitis picture includes:
• Swelling of the pharyngeal ring.
• Redness of the posterior pharyngeal wall.
• Granular structure, uneven inflammation.
• Mucus or purulent discharge on the back wall.
• Hypertrophic follicles form on the surface of the pharyngeal wall.
This picture is also typical of a number of other diseases: purulent (catarrhal) tonsillitis, diphtheria.
Unlike catarrhal sore throat, follicles are small and do not form stable foci. For purulent tonsillitis, numerous whitish or yellow rashes in the form of spots are characteristic.
The same sign of pharyngitis differs from a fungal infection of the pharynx (pharyngomycosis).
With diphtheria is not so simple. A visual assessment of the pharynx is not enough. In order to conduct a competent differentiated diagnosis and to distinguish pharyngitis from diphtheria and pharyngomycosis, it is necessary to take a smear from the pharynx and nose for plantings to detect Lefler sticks (BL).
During the examination, the attending specialist should be kept in mind. If manifestations are observed for a long time: several days (for example, a sore throat for a week), the picture can be "blurred" due to the immune response. In addition, it cannot be excluded that the patient took certain drugs, rinsed her throat with herbs and resorted to other "grandmother's advice."
Hence the advice to patients. To facilitate the work of a specialist should not take any therapeutic action to visit the attending physician.
Instrumental diagnostic methods. The main diagnostic method for pain of unknown origin is laryngoscopy. If during the initial examination no serious changes in the pharynx are detected, the ENT doctor is obliged to exclude laryngeal pathologies. Moreover, they can be the most diverse: from relatively innocuous laryngitis to malignant neoplasms.
To exclude diseases of the larynx, an endoscopic examination method is used - laryngoscopy. Laryngoscopy allows you to assess the condition of the larynx using a probe and a miniature video camera.
If it is determined that the pain is not related to changes in the organs of the upper respiratory tract, then you should contact other specialists: a neurologist and an orthopedist.
The next step in the diagnosis and correct diagnosis is a radiography of the cervical and thoracic spine and MRI diagnostics.
Laboratory diagnostic methods. The main laboratory method is a general blood test, as well as taking smears from the nose and throat.
Complete blood count, in most cases, will indicate an inflammatory process: increased ESR, leukocytosis, etc. If the pharyngitis is allergic in nature, eosinophilia will be informative.
Throat and throat swabs will help establish the composition of microflora and identify pathogens that could be the causative agents of the disease and cause discomfort in the throat.
Sore throat: treatment
The treatment of sore throat is symptomatic. The answer to the question of what to do if a sore throat is ambiguous. By itself, a sore throat is not a disease and you need to fight with the original source.
It often happens that the throat begins to "sad", but the person does not pay attention to it, counting on "maybe." But then, a throat hurts for a week, and only then the patient runs to the attending physician. In no case should this be allowed.
As soon as discomfort occurs in the throat and nose, it makes sense to try to eliminate the discomfort yourself. If the method does not work within 1-2 days, symptoms of intoxication increase and the general condition worsens, you should immediately go to a specialist.
Method 1. Rinse.
Answering the question if you have a sore throat than to treat at home, you can advise rinsing. The easiest way to resort to the following:
To a glass of warm water, dilute 3-5 teaspoons of salt to form a concentrated and saturated solution. Rinse 3-4 times a day.
If the patient is absolutely not allergic to iodine, herbs, you can try the following recipes:
Dilute 10-15 ml of hydrogen peroxide, half a teaspoon of iodine solution into a glass of warm water. Rinse 3-4 times a day.
Prepare a strong solution of chamomile or sage. Rinse 3-4 times a day.
Method 2. Lubrication.
With the guaranteed absence of allergy to iodine, you can resort to self-lubrication of the pharynx and tonsils with iodinol or a silver solution. Miramistin solution is relatively safe for self-treatment.
Allergic pharyngitis can be tried to alleviate the use of antihistamines.
In all other cases, you should consult a doctor and begin a specific treatment. This is an unequivocal answer to the question of what to do if a sore throat.
For the treatment of pharyngitis, tonsillitis, catarrhal angina, complex medical therapy is used, including anti-inflammatory, antibacterial drugs, immunomodulators. If a specific causative agent of the disease is detected during diagnostic measures, bacteriophage solutions are prescribed.
In case of thermal, mechanical and chemical damages, the essence of therapy consists in disinfecting the damaged area (so that the traumatic injuries do not become the gate of infection) and to soften the injured area. Therapy consists in the use of special sprays, aerosols and rinses.
Allergic-induced lesions of the pharynx are eliminated by specific therapy, including antipruritic, antihistamine and other drugs.
In some cases, resort to surgical treatment. So, in chronic tonsillitis with frequent exacerbations, resorted to the removal of the tonsils. In severe catarrhal tonsillitis, tonsillectomy is also indicated. If malignant neoplasms or overgrown benign tumors that threaten the patient's life are detected, surgical treatment is indicated.
Fortunately, in most cases it is possible to get by with "little blood", in the literal sense of the word. The main thing is to consult a doctor in time and begin treatment.
To answer the question, if you have a sore throat than to treat at home, you can definitely: in the absence of contraindications to herbal medicine and iodine, you can try to eliminate the unpleasant symptom with your own rinsing and lubrication. In all other cases - do not self-medicate.
Sore throat: prevention
Prevention guidelines are standard:
- Prevent hypothermia, dress warmer and deal with drafts in the house;
- strengthen immunity, to do this, adjust your diet. In winter, take vitamins complexes;
- take drugs that have an immunosuppressive effect carefully, under the supervision of a doctor;
- minimize contact with infectious patients;
- observe oral hygiene;
- chew food thoroughly, do not drink large amounts of carbonated drinks, do not consume too hot food.
- regularly attend preventive examinations at the ENT doctor. At the slightest suspicion of oncology, go to a specialist.
Thus, a sore throat symptom is extremely variable, indicating many diseases and pathologies.
A completely healthy person will never have a sore throat. This must be borne in mind, and at the first manifestation, immediately go to the hospital for examination.
A competent specialist will make the correct diagnosis and prescribe an effective treatment. Only in this case, the sore throat will recede.
