Pharyngitis (Sore Throat)

Pharyngitis: Description

The term pharyngitis actually stands for inflammation of the pharyngeal mucosa: the mucous membrane lining the throat is inflamed. Doctors distinguish between two forms of the disease – acute pharyngitis and chronic pharyngitis:

  • Acute pharyngitis: An acutely inflamed pharynx is very common and usually accompanies a cold or flu infection.

Pharyngitis: Symptoms

The symptoms of acute and chronic pharyngitis are similar to some extent, but there are also differences:

Acute pharyngitis: symptoms

If the pharyngitis is caused by the typical pathogens of acute respiratory diseases, other complaints are often added. Rhinitis and other cold symptoms such as hoarseness or cough, and possibly also increased body temperature are then typical.

Bacterial superinfection

In addition, the mucous membrane in the throat is then highly red in color, the tonsils are swollen and bear whitish-yellow coatings (tonsillitis, angina tonsillaris). If the patient no longer has tonsils, the lateral cords are often bright red and swollen instead (lateral gangrene, angina lateralis). These lateral cords are lymphatic channels that run downward from the upper posterior pharyngeal wall on both sides.

Chronic pharyngitis: symptoms

The other symptoms depend on what form of chronic pharyngitis it is:

  • Atrophic form (pharyngitis sicca): Most common form of chronic pharyngitis. The pharyngeal mucosa is dry, pale, particularly tender and thin (atrophic), shiny like firn and covered with some viscous mucus.

Pharyngitis: Causes and Risk Factors

Acute and chronic pharyngitis have very different causes:

Acute pharyngitis: causes

Occasionally, the viral triggers of systemic diseases (diseases of the whole body) also additionally lead to acute pharyngitis. These include cytomegaloviruses, Epstein-Barr viruses (causative agent of Pfeiffer’s glandular fever), measles and rubella viruses. Only rarely are other viruses to blame for acute pharyngitis, for example the herpes simplex virus.

Because it is caused by pathogens, acute pharyngitis is contagious.

Chronic pharyngitis

Chronic pharyngitis, unlike acute pharyngitis, is not caused by viruses or bacteria and is therefore not infectious. Instead, chronic pharyngitis is caused by persistent irritation of the mucous membrane. This can have very different causes:

  • excessive consumption of tobacco or alcohol
  • dry indoor air in overheated rooms
  • frequent inhalation of chemical vapors or dust at the workplace
  • obstructed nasal breathing (e.g. due to a curvature of the nasal septum or severely enlarged pharyngeal tonsils)
  • repeated sinusitis (inflammation of the sinuses)
  • radiotherapy in the head or neck region
  • hormonal changes during menopause
  • excessive or incorrect use of the voice (such as constant throat clearing and coughing)

Pharyngitis: examinations and diagnosis

The first step is a detailed doctor-patient consultation: the doctor will ask you about your exact symptoms, for example, how long you have had a sore throat and whether there are any other complaints. In the case of chronic pharyngitis, he will ask about possible triggers such as tobacco or alcohol abuse or chemical exposure.

If the doctor discovers whitish plaques on the throat wall (suspected bacterial superinfection), he or she may take a swab to perform a rapid strep test.

If there is ear pain, the doctor will also perform an ear exam. It may just be radiating pain from the pharyngitis, or it may be a middle ear infection.

Pharyngitis: Treatment

How to treat pharyngitis depends on whether it is an acute or chronic inflammation and whether additional bacteria have settled.

Acute pharyngitis: therapy

In addition, the doctor prescribes antibiotics for pharyngitis if additional bacteria have settled in the throat or caused the infection. In most cases, the germs are streptococci, which is why the doctor generally prescribes penicillin – an antibiotic that works well against these bacteria.

Chronic pharyngitis: therapy

Once the cause of the irritation has been eliminated, the inflammation often heals on its own within a few weeks. This healing process can be supported, for example with:

  • anti-inflammatory medications (ibuprofen, diclofenac, etc.)
  • Inhalations and gargles (with salt water or ointment solution)
  • lozenges (with sage, salt, hyaluronic acid or Iceland moss)

Surgery is sometimes necessary when obstructed nasal breathing is the cause of chronic pharyngitis. For example, the surgeon can straighten a curved nasal septum or enlarge the openings of the sinuses.

Surgical intervention also helps with so-called pharyngitis lateralis: the proliferating, excess (hypertrophic) tissue of the lateral cords is either cauterized or removed with a laser.

Pharyngitis: Home remedies

To get rid of the discomfort quickly, many patients with acute pharyngitis use home remedies.

Teas against pharyngitis

Many patients find warm tea very pleasant for pharyngitis. The following medicinal plants are especially good home remedies for pharyngitis because of their anti-inflammatory properties:

  • Chamomile
  • Thyme
  • Sage
  • Ginger
  • Blackberry (blackberry leaves)
  • Blueberries
  • Marigold
  • Marshmallow
  • Mallow
  • Ribwort
  • Iceland moss
  • Mullein

When fever sets in, it’s best to reach for medicinal herbal teas that boost sweat production:

  • Linden blossoms
  • Elderflower

Read more about the effect and the correct preparation of the teas in the respective medicinal plant articles.

Gargle

You can also use cooled medicinal herbal teas for gargling. Take a sip and rinse your mouth and throat with it.

Alternatively, you can make a special gargle solution: To do so, dissolve one of the following ingredients in a glass of lukewarm water:

  • two tablespoons of apple cider vinegar or
  • one tablespoon of lemon juice or
  • one teaspoon of sea salt

Stir well and gargle with the solution several times a day.

Throat compress and compresses

Prießnitz neck wrap: Place a cloth in cold water (10 to 18 degrees), wring out and place around the neck. Avoid the spine. Cover with a dry cloth and leave for 30 minutes to several hours. After removing the wrap, protect the neck from the cold.

Healing clay overlay: Mix the desired amount of healing clay with a little cold water to form a spreadable paste and apply directly to the neck in a thickness of approx. 0.5 to 2 cm. Cover with a cloth and fix with another cloth. Leave the overlay to work for one to two hours until the healing clay is dry. Then cleanse, dry and oil the skin. Use once or twice a day.

Tips for everyday life

The following tips help to protect the mucous membranes in the event of pharyngitis:

Avoid irritating substances: Mucous membrane-irritating factors such as nicotine, alcohol and hot spices should be avoided in the case of pharyngitis – especially in the case of chronic pharyngitis.

Eat garlic: The bulb has a mild anti-inflammatory effect. If you suffer from chronic pharyngitis, feel free to cook or season with garlic more often.

Pharyngitis: course of the disease and prognosis

Acute pharyngitis is generally harmless and heals on its own within a few days. Supportive measures include bed rest, home remedies and, if necessary, painkillers from the pharmacy.

Complications of acute pharyngitis

Sometimes acute pharyngitis spreads to the larynx or vocal cords (laryngitis). The patient then becomes hoarse or has no voice at all. The most important tips for laryngitis are: Do not talk or whisper, but drink plenty of fluids (warm drinks!).

Chronic pharyngitis