Index
Questions and answers
What is pharyngitis
What we commonly call a sore throat, in medical terms is actually called pharyngitis, and is the inflammation of the mucosa that lines the pharynx, the organ that connects the nasal cavity, the esophagus, the larynx and the middle ear. The pharynx is that part of the oral cavity that we can see by opening our mouth and looking in the mirror, and which usually when pharyngitis appears, we notice is red.
The larynx is divided into three portions:
- Nasopharynx (the back part of the nasal airways);
- Oropharynx (the actual throat);
- Laryngopharynx (the lower part).
Pharyngitis, which occurs more often during the winter, is usually the beginning of an upper respiratory infection. It is often associated with tonsillitis, i.e. inflammation of the tonsils, and is called pharyngotonsillitis. It usually appears suddenly, i.e. in acute form, and lasts a few days, since in most cases it resolves on its own, unless it is due to streptococci and then antibiotic treatment is necessary.
Since it is a viral or bacterial infection, pharyngitis is contagious, especially if streptococcus is the culprit.
Pharyngitis not due to a pathogen can also persist over time and become chronic.
Symptoms of pharyngitisThe most common symptoms that should make us think of the onset of acute pharyngitis are:
- Difficulty swallowing;
- Sensation of having a foreign body in the throat;
- Sensation of dry mouth;
- Itching sensation;
- Local redness of the mucosa and/or presence of vesicles or white plaques (just open your mouth and look in the mirror);
- Cough;
- Fever (rarely);
- Lack of voice (aphonia);
- Inflammation of the lymph nodes in the neck;
- Ear pain (otalgia, otitis).
In the case of chronic pharyngitis, it also manifests itself with frequent hoarseness and catarrh.
What causes pharyngitis
Acute pharyngitis is very common, both in adults and children. The causes of pharyngitis are usually infections, which can be bacterial (such as strep) or viral. The infection can also start from infections present in the nose or larynx area.
Cold and temperature changes trigger the infection. For example, in summer, going from outside to places with very strong air conditioning or in winter from hot rooms to the cold outside, favors a sore throat. There are two reasons why this happens. First of all, viruses find more fertile ground in cold contexts. Furthermore, when it is cold, or after a sharp change in temperature, the cilia in our respiratory system which help us protect it from pathogens, struggle to move and carry out their function.
Chronic pharyngitis
Sometimes pharyngitis doesn’t go away. It can be simplified by saying that if the pharyngitis lasts for more than 6 hours a day, for more than two weeks a month, for more than three months, it is called chronic pharyngitis. It can be a consequence of various factors, such as ulcers, inflammation of the lymphatic glands. Reflux pharyngitis is especially common, due to the persistence of gastroesophageal reflux. In this case, treatment under medical supervision is necessary to resolve or alleviate the reflux problem, which often requires time to understand what the triggering cause is.
Chronic pharyngitis is often catarrhal, that is, it sees the presence of nasal congestion with consequent production of mucus and phlegm.
Chronic hypertrophic pharyngitis (chronic granular pharyngitis) is rather common, which is characterized by a bright red pharyngeal mucosa, thickened (hypertrophic) by enlarged lymphatic follicles.
Then there is gonococcal pharyngitis (pharyngeal gonorrhea), a gonorrhea infection that can affect people who have had oral sexual contact with an infected individual; it is asymptomatic in most cases, although it sometimes causes a sore throat and plaques on the tonsils. Gonorrhea (also called blenorrhagia) originates from the bacterium Neisseria gonorrhoeae, also known as gonococcus. Warning: gonorrhea is transmitted through any type of sexual intercourse, including vaginal and anal, including deep kisses and any contact with the genital area of the infected person.
It is important to diagnose gonorrhea immediately to avoid infecting other people (as soon as the diagnosis has been made, it is necessary to proceed with the curative antibiotic therapy on medical prescription before having further sexual intercourse).
Treatment and remedies
If the sore throat persists, it is a good idea to go to the doctor, who during the visit will check if the throat is red, swollen, if there are plaques and whitish secretions visible on the mucosa and if the lymph nodes in the neck are swollen. In the presence of these symptoms, since the pharyngitis is due to some pathogen (virus or bacterium), if it is suspected that streptococcus is responsible, the doctor can perform a rapid test (RADT) to search for antigens or a swab throat test with culture and antibiogram.
If the nature of acute pharyngitis is viral, the inflammation usually goes away on its own within a few days. If the cause is streptococcus, an antibiotic treatment is required which must be prescribed by the doctor and which must be followed scrupulously.
To treat chronic pharyngitis, you must first identify its triggering cause.
In the meantime, in both cases, to relieve the discomfort, if excessive, we can still take anti-inflammatories such as ibuprofen or paracetamol. Furthermore, it is a good idea to drink plenty of liquids for a few days, avoiding smoking, alcohol and hot drinks, all substances that can irritate the throat, slowing down healing. It is also recommended to use mouthwashes that help disinfection.
Pharyngitis and Covid-19
It is not easy to understand at the first signs of a cough or cold whether it is banal pharyngitis, flu, allergies or the beginning of a COVID-19 illness.
We can broadly say that the main differences concern:
Fever: frequent in the case of COVID-19 and flu, rare in the case of pharyngitis or allergies;
Sore throat: only sometimes present in those who are positive for COVID-19, always present in the case of pharyngitis and colds.
But since each patient expresses the disease differently, the best thing to do if the sore throat does not go away in a couple of days, and if other symptoms appear such as fatigue, soreness, fever, is to contact your doctor who will evaluate whether to undergo swab.
BIBLIOGRAPHICAL REFERENCES
https://www.issalute.it/index.php/la-salute-dalla-a-alla-z-menu/m/mal-di-gola
https://www.editorebambinogesu.it/nuovo-coronavirus-quali-sono-i-primi-sintomi-96933/
https://www.health.gov.au/sites/default/files/documents/2020/11/coronavirus-covid-19-identificare-i-sintomi-identifying-the-symptoms.pdf
https://www.siams.info/gonorrhea/
Questions and answers
How to cure throat pharyngitis?
If the nature of acute pharyngitis is viral, the inflammation usually goes away on its own within a few days. If streptococcus is behind it, an antibiotic treatment is necessary which must be prescribed by the doctor and which must be followed scrupulously.
To relieve the discomfort, if excessive, we can still take anti-inflammatories such as ibuprofen and paracetamol.
Furthermore, it is a good idea to drink plenty of liquids for a few days, avoiding smoking, alcohol and hot drinks which can irritate the throat. It is also recommended to use mouthwashes that help disinfection.
Why doesn’t my pharyngitis go away?
Pharyngitis can only be diagnosed by a doctor. The causes of pharyngitis are infections, which can be bacterial or viral and depending on the responsible pathogen, antibiotic therapy may also be necessary, as with streptococcus. Reflux pharyngitis is also quite common, due to the persistence of gastro-esophageal reflux. In this case, treatment under medical supervision is necessary to resolve or alleviate the reflux problem.
How to understand if a sore throat is viral or bacterial?
During the visit, the doctor will check if the throat is red, swollen, if there are whitish secretions visible on the mucosa and if the lymph nodes in the neck are swollen. In the presence of these symptoms, since the pharyngitis is due to some pathogen (virus or bacterium), if it is suspected that streptococcus is responsible, the doctor can perform a rapid test (RADT) to search for antigens or a swab throat test with culture and antibiogram.
How is chronic pharyngitis treated?
To treat chronic pharyngitis, you must first identify its triggering cause. One of the most common is gastroesophageal reflux. In the meantime, to relieve the discomfort, if excessive, we can still take anti-inflammatories such as ibuprofen and paracetamol. Furthermore, it is a good idea to drink plenty of liquids for a few days, avoiding smoking, alcohol and hot drinks which can irritate the throat. It is also recommended to use mouthwashes that help disinfection.
