Sore throat

A sore throat means that your throat hurts, feels irritated, or scratchy. You may experience mild discomfort or burning pain in the throat, and sometimes even difficulty swallowing or talking. Your throat might become red. In some cases, white patches can be seen in your throat (mostly on the tonsils), which are common in the case of strep throat (a bacterial infection). In addition to a sore throat, you may also experience other symptoms such as:

• Fever
• Nasal congestion
• Runny nose
• Sneezing
• Cough
• Chills
• Body ache
• Headache
• Loss of appetite
• Red and swollen tonsils

Note: The symptoms may vary based on the causes of the sore throat.

Some of the common causes of sore throat are:

1. Viral infections:
   • Common cold
   • Flu or influenza
   • Infectious mononucleosis or glandular fever
   • Measles
   • Chickenpox
   • Mumps
   • Herpangina
   • Hand, foot and mouth disease (HFMD)
   • Croup
   • COVID-19
2. Bacterial infections:
   • Streptococcus pyogenes (group A streptococcus) which causes strep throat.
   • Arcanobacterium haemolyticum causes sore throat mainly in adolescents and is sometimes accompanied by a red rash.
   • Less common causes of bacterial sore throat include chlamydia, gonorrhea, and corynebacterium.
3. Allergies:

   Allergies to pet fur, skin shed by animals, molds, pollen, grass, and dust can also cause sore throat.

4. Dry air:

   Dry indoor air can reduce moisture in the mouth and make the throat feel rough and scratchy. Indoor air is mostly dry in the winter due to the use of heaters.

5. Irritants:

   Air pollution, cigarette or tobacco smoke, secondhand smoke, cleaning products and other chemicals, spicy foods, and hot liquids can also irritate the throat.

6. Sinusitis:

   Sinus infections can cause post-nasal drip in which mucus runs down the back of the throat. This infected mucus can cause a sore throat.

7. Injury:

   Injuries such as a hit or cut to the neck can cause pain in the throat. A piece of food or some external particle stuck in the throat can also irritate it.

8. Overexertion:

   Repeated use of vocal cords can strain the throat muscles. Yelling, talking loudly, or talking or singing for long periods without a break can cause sore throat.

9. Gastroesophageal reflux disease (GERD):

   This condition occurs when stomach acids move back up into the food pipe. When the acid reaches the throat, it can irritate it and cause a sore throat.

10. Medications:

    Certain antibiotics, chemotherapy, or other immune-compromising medications can cause sore throat due to the growth of the yeast candida.

11. Throat cancer:

    In rare cases, cancerous tumors of the throat, tongue, or voice box can also cause a sore throat.

Although anyone can suffer from a sore throat, the following risk factors increase the chances of infection:

• Children and adolescents are more susceptible to developing a sore throat.
• Close contact with someone who is sick, especially due to respiratory infections.
• Viral and bacterial infections spread faster in close quarters, such as child care centers, classrooms, offices, or airplanes.
• Cold and flu seasons.
• Regular exposure to cold environments.
• Chronic respiratory illness.
• Allergies.
• Exposure to any irritants at home or in the workplace.
• Professions requiring overuse of the voice, such as teachers and fitness instructors.
• Drugs such as angiotensin-converting enzyme (ACE) inhibitors, chemotherapy drugs, and long-term use of steroids.
• Habit of snoring.
• Smoking or exposure to secondhand smoke.
• Weakened immunity due to poor diet, stress, or conditions such as human immunodeficiency virus (HIV) infection and diabetes.

Your doctor will ask you a few questions about your symptoms, followed by a physical examination of your throat. He or she might check the back of your throat for redness, swelling, and white patches. Your doctor may also feel the sides of your throat to check for the presence of swollen glands.

If your doctor suspects strep throat, a bacterial infection, then a throat swab or culture will be advised for diagnosis. In some cases, your doctor might also recommend additional tests to determine the exact cause of the sore throat.

• Throat swab: A sterile swab is rubbed over the back of the throat to obtain a sample of secretions, which is then sent to the lab for testing. Rapid antigen tests, although not highly sensitive, can quickly detect strep bacteria.
• Throat culture: If the antigen test comes back negative, your doctor may send a throat culture to a lab to test for strep throat.

A sore throat can be prevented by following some simple and effective steps.

1. Practice good hand hygiene
   Wash your hands properly with clean water and soap. Scrub your hands for at least 20 seconds, ensuring to clean the back, front, between your fingers, and under your nails. Wash your hands thoroughly when you:
   • Touch your eyes, mouth, and nose
   • Are near a person with an infection
   • Use toilets and bathrooms
   • Cough, sneeze, or clean your nose
   • Eat food
2. Avoid close contact with sick people
   Since viral infections are common causes of sore throats, it is advisable to stay away from individuals suffering from sore throats, colds, or other upper respiratory infections. Do not share food, drinks, or utensils. Wearing a mask can also help prevent the spread of respiratory infections.
3. Avoid smoking and exposure to secondhand smoke/irritants
   Numerous health complications are associated with smoking, including sore throats. If you are a smoker, it is wise to quit. Consider nicotine replacement therapy available in patches and gums. Additionally, avoid exposure to secondhand smoke, which can increase the risk of sore throat.
4. Eat healthy food
   Maintain a healthy diet rich in vitamins, minerals, and antioxidants. Prefer home-cooked meals and avoid oily, spicy, and salty foods. Stay hydrated by drinking plenty of fluids such as buttermilk, fruit juices, coconut water, or plain water. Drinking lukewarm or boiled water can help keep your throat clean and healthy.
5. Boost your immunity
   A strong immune system is essential for preventing infections. In addition to staying hydrated and eating a healthy diet, incorporate fresh fruits and vegetables into your meals to provide essential nutrients. Consider dietary nutritional supplements to further boost your immunity.
6. Exercise
   Regular exercise or light workouts can help you stay fit, increase your immunity, and combat sore throat.
7. Get adequate sleep
   Insufficient sleep can weaken the immune system, leading to more frequent occurrences or slower recovery from sore throat.

Throat infections are quite common in children. Here are a few tips to prevent it.

While sore throat caused by viruses is usually self-limiting and does not require antibiotic treatment, a bacterial cause may necessitate prompt medical care.

Treatment Options for Sore Throat

1. Analgesics or Pain Relief Medications

You can take over-the-counter (OTC) medications to relieve pain. These include:

• Paracetamol
• Ibuprofen
• Aspirin

Note: Never give aspirin to children as it can lead to Reye’s syndrome, a rare but very serious illness in kids that affects the liver and brain.

2. Cough Syrups

In some cases, the use of throat lozenges and cough syrups is also known to provide relief from sore throat.

3. Other Drugs

If your sore throat is caused by an underlying stomach problem such as gastrointestinal reflux disease (GERD), the following medications may be recommended:

• Antacids such as aluminum hydroxide, magnesium hydroxide, and calcium carbonate
• Proton pump inhibitors: omeprazole, pantoprazole, and rabeprazole
• H2 blockers: famotidine and ranitidine

Antibiotics for Sore Throat: Yes or No?

Mostly, a sore throat resolves within a week without the need for antibiotics. However, if your sore throat lasts longer than 1-2 weeks, or you have a temperature higher than 100.4 °F or any other unusual symptom, you may need an antibiotic. Your doctor may prescribe antibiotics if you or your child tests positive for the bacteria Streptococcus pyogenes.

Typically, antibiotics begin to show their effects within 24 to 48 hours of administration. It is crucial to complete the course of antibiotics, which may last for 2 weeks. You should continue the medications even if symptoms disappear to ensure the antibiotic course is finished.

Antibiotics are intended for treating bacterial infections. Since most sore throats are viral, using antibiotics will not cure the condition. Taking antibiotics for viral infections can be costly and may lead to unwanted side effects such as diarrhea and vomiting. The misuse and overuse of antibiotics contribute to antibiotic resistance, a phenomenon that reduces or eliminates the effectiveness of these medications.

Here are some simple ways to help relieve a sore throat:

• Avoid foods that are salty, spicy, acidic (like orange juice), or sharp (like potato chips) as they can irritate your child's throat.
• Stick with bland and soft foods to make it easier for food to pass through the throat without irritation.
• Use a humidifier at home or work to help keep the throat moist.
• Try steam inhalation to relieve congestion.
• Suck on cough drops (lozenges) to lubricate and soothe irritated throat tissues.
• Stay hydrated with plenty of fluids, as higher liquid intake will keep you hydrated and moisten your throat, making it easier to swallow.
• Include comforting foods such as warm soup and soft vegetables in your diet, as they are easier to swallow.
• Sip on warm liquids like warm water, lukewarm lemon water, or herbal tea to soothe the throat and lessen irritation.
• Get proper rest, as it is essential for regaining strength when sick.
• To relieve pain from a sore throat, consider over-the-counter medications such as paracetamol or throat lozenges.
• If your child has a sore throat, avoid sending them to school for one to two days to prevent spreading the infection to other children.
• If you experience a persistent cough, try a cough syrup suited to the type of cough you have.

Sore throat caused by bacteria (strep throat) can lead to various health complications if left untreated. Although not common, strep throat can result in serious complications if the bacteria spreads to other parts of the body. Some of the potential complications include:

• Sinusitis (infection of the sinuses)
• Ear infection
• Abscesses or pockets of pus around the tonsils
• Swollen lymph nodes in the neck
• Chest infection
• Rheumatic fever (a heart disease)
• Post-streptococcal glomerulonephritis (infection of the kidneys)

You can try some home remedies to soothe pain and irritation caused by a sore throat. Some common home remedies include:

• Ginger (Adrak): Ginger has anti-inflammatory and antimicrobial properties. It also boosts immunity to help fight infections that cause sore throats. You can consume it in the form of raw ginger root, ginger candy or lozenge, ginger tea, or ginger supplement pills and capsules.
• Honey (Sehad): Mix 2 teaspoons of honey with an equal quantity of ginger juice. Add this to a glass of warm water and drink it every morning. This concoction helps to expel mucus, thereby providing relief for cough and sore throat. Note: Don't give honey to children younger than one year of age.
• Garlic (Lehsun): Garlic has natural antibacterial properties. It contains allicin, known for its ability to fight off infections. Suck on a clove of garlic to soothe your sore throat or consume it along with ginger in the form of tea. Taking a garlic supplement regularly can also help to prevent sore throat.
• Turmeric (Haldi): Turmeric is an excellent remedy for sore throat. You can mix half a teaspoon of turmeric and half a teaspoon of salt into a cup of hot water and gargle with it. You can also add half a teaspoon of turmeric to a cup of milk to combat sore throat. It is advised to warm the milk mixed with turmeric slowly over the flame and consume this drink once a day.
• Chamomile (Babunah ke phul) tea: Infuse the tea bag into a cup of boiling water, let it steep for five minutes, and consume as is. You can add a small quantity of honey or sugar for improved taste.
• Licorice (Mulethi) tea: Drink tea made from one teaspoon crushed licorice (mulethi) and one teaspoon jaggery powder steeped in one cup of boiling water for 3-5 minutes. You can also gargle with licorice water to fight sore throat and cough.