What Causes Sore Throats?

What is the difference between a sore throat, tonsillitis, strep throat, bacterial and viral infections?

Tonsillitis: When tonsils are infected with bacteria, they will usually get large, turn somewhat red, and may have some yellowish-white debris of the surface.  This will cause a sore throat.

There are some viruses, which can cause tonsillitis (as in infectious mononucleosis).  The only way to be sure whether you have a bacterial or a viral infection is by doing a throat culture, although there are other tests, which may suggest a bacterial infection.

Obstruction of the airway by enlarged tonsils can lead to difficulties in breathing, snoring and disturbed sleep that leads to daytime sleepiness in adults and behavioral problems in children.  Some orthodontists believe chronic mouth breathing from large tonsils and adenoids causes malformations of the face and improper alignment of the teeth.

Sore Throat: It can be caused by a number of problems.  A sore throat is usually the result of a virus infecting the upper respiratory tract (mouth, nose and throat) such as the flu, the common cold or mononucleosis. Less commonly, it can be caused by a bacterial infection such as strep, mycoplasma, or hemophilus.   Bacterial infections responds very well to antibiotic treatment.  However, viral infections do not respond to antibiotic treatment.

Infections in the nose and sinuses can cause sore throats because mucus from the nose drains down into the throat (post-nasal drip).

The most dangerous throat infection is epiglottitis, caused by bacteria that infects a portion of the larynx (voice box) and causes swelling that closes the airway. This infection is an emergency condition that requires prompt medical attention. Symptoms include extreme pain when swallowing (causing drooling), muffled speech and difficulty breathing.

Strep Throat: This is an infection by one particular type of bacteria - Streptococcus pyogenes.  Although other bacteria can cause throat infections, most doctors will try to specifically diagnose the "strep" bacteria so that antibiotic treatment can be given. In rare cases, strep infections can also damage the heart valves (rheumatic fever) and kidneys (nephritis), cause scarlet fever, tonsillitis, pneumonia, sinusitis, and ear infections.  Because of these possible complications, a strep throat should be treated with an antibiotic.

Severe and chronic cases of tonsillitis or tonsillar abscess may be culture negative.  Negative cultures are seen with diphtheria, and infections from oral sexual contacts will escape detection by strep culture tests.

Viral Infections: Most viral sore throats accompany flu or colds.  Usually patients have a stuffy, runny nose, sneezing, and generalized aches and pains.  They are highly contagious and spread quickly, especially in winter.  The body builds antibodies that destroy the virus, a process that takes about a week.

Sore throats accompany other viral infections such as:

·         Measles

·         Chicken pox

·         Whooping cough

·         Croup

Infectious mononucleosis, or "mono”: Mono is a viral infection that takes much longer than a week to be cured. This virus lodges in the lymph system, causing massive enlargement of the tonsils with white patches on their surface and swollen glands in the neck, armpits, and groin.

Transmitted primarily through saliva, it has been nicknamed the "kissing disease," but it can also be transmitted from mouth-to-hand or by sharing of food or beverages and even your towels.  It creates a severe sore throat and, sometimes, serious breathing difficulties.  It can affect the liver, leading to jaundice— yellow skin and eyes.  It also causes extreme fatigue that can last six weeks or more.  In some patients, treatment with steroids (e.g. cortisone) is sometimes helpful.  

What are the other causes of sore throat?
Allergies:

·         Pollens and molds

·         Cat and dog dander

·         House dust  

Irritation:
Dry heat, during the cold winter months, may create a recurring, mild sore throat with a parched feeling, especially in the mornings. This often responds to humidification of bedroom air and increased liquid intake. Patients with a chronic stuffy nose, causing mouth breathing, also suffer with a dry throat. They need an examination and treatment of the nose.  Pollutants and chemicals in the air can irritate the nose and throat.  The most common air pollutant is tobacco smoke.  Other irritants include smokeless tobacco, alcoholic beverages and spicy foods.

A person who strains his or her voice (yelling at a sports event, for example) gets a sore throat not only from muscle strain but also from the rough treatment of his or her throat membranes.

Reflux:
An occasional cause of a morning sore throat is regurgitation of stomach acids up into the back of the throat.  To avoid reflux, Place extra pillows under your head or tilt your bed frame so that the head is elevated four-to-six- inches higher than the foot of the bed.

Antacids can be helpful and avoid eating within three hours of bedtime, and eliminate caffeine and alcohol.  An evaluation by a physician is recommended if these tips failed.

Tumors:
Tumors of the throat, tongue, and larynx (voice box) are usually (but not always) associated with long-time use of tobacco and alcohol.  Sore throat and difficulty swallowing—sometimes with pain radiating to the ear—may be symptoms of such a tumor.  More often the sore throat is so mild or so chronic that it is hardly noticed.  Important symptoms include:

·         Hoarseness

·         Lump in the neck

·         Unexplained weight loss

·         Spitting up blood in the saliva or phlegm

How Do I Manage My Sore Throat?

When Should I See a Doctor?
The following signs and symptoms should alert you to seek medical treatment:

·         Severe and prolonged sore throat

·         Difficulty breathing

·         Difficulty swallowing

·         Difficulty opening the mouth

·         Joint pain

·         Earache

·         Rash

·         Fever (over 101°)

·         Blood in saliva or phlegm

·         Frequently recurring sore throat

·         Lump in neck

·         Hoarseness lasting over two weeks

How Can I Treat My Sore Throat?
A mild sore throat associated with cold or flu symptoms can be made more comfortable with the following remedies:

·         Increase your liquid intake

·         Warm tea with honey is a favorite home remedy

·         Use a steamer or humidifier in your bedroom

·         Gargle with warm salted water several times daily: ¼ tsp. salt to ½ cup water.

·         Take over-the-counter pain relievers such as acetaminophen (Tylenol Sore Throat^®) or ibuprofen (Motrin IB^®, Advil^®).

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