What are the common causes of a persistent sore throat. How can you identify the underlying conditions leading to chronic throat pain. When should you consult a doctor for a sore throat that won’t go away.

Understanding the Causes of Chronic Sore Throat

A chronic or persistent sore throat can be a troublesome condition that affects many individuals. Unlike acute sore throats that typically resolve within a few days, chronic sore throats persist for weeks or even months, significantly impacting one’s quality of life. Understanding the various causes of this condition is crucial for effective management and treatment.

Smoking and Its Impact on Throat Health

One of the primary culprits behind chronic sore throats is smoking. The act of inhaling tobacco smoke irritates the sensitive tissues lining the throat, leading to persistent discomfort. This irritation stems from exposure to hot, dry air and the toxic chemicals present in cigarette smoke. Regular smokers often experience a sore throat that refuses to subside, and they’re also more susceptible to other health conditions that can exacerbate throat pain.

How does smoking affect the immune system and increase the risk of throat-related issues? Smoking weakens the immune system’s functioning, making individuals more prone to colds, flu, and respiratory tract infections. Moreover, it significantly elevates the risk of developing throat cancer, with a persistent sore throat being a potential symptom of this serious condition.

Environmental Factors: Air Pollution and Allergens

Environmental factors play a significant role in the development of chronic sore throats. Air pollution, particularly prevalent in large cities and industrial areas, can have similar health consequences to inhaling cigarette smoke. Breathing in smog or polluted air, especially on hot days, can lead to various symptoms, including throat pain, chest discomfort, and coughing.

Allergens are another environmental factor that can contribute to persistent throat irritation. These substances, which can include pollen, food particles, or chemicals in cleaning products and cosmetics, trigger allergic reactions in sensitive individuals. People with seasonal allergies may notice prolonged throat discomfort during periods of high pollen count.

The Role of Postnasal Drip in Chronic Sore Throat

Postnasal drip is a common condition that can lead to a persistent, raw sore throat. It occurs when excess mucus drains down the back of the nasal passage into the throat. This condition is often associated with allergies but can also be triggered by colds, flu, reactions to certain medications, and specific weather conditions.

Symptoms Associated with Postnasal Drip

• Itchy eyes
• Runny nose
• Coughing and sneezing
• Watery eyes
• Persistent throat irritation

Can postnasal drip be managed effectively? While it can be challenging, there are several strategies to manage postnasal drip and alleviate associated throat discomfort. These may include staying hydrated, using saline nasal sprays, and avoiding known allergens. In some cases, over-the-counter or prescription medications may be necessary to control symptoms.

Mouth Breathing and Its Effects on Throat Health

Breathing through the mouth for extended periods, particularly during sleep, can lead to a chronic sore throat. This issue often manifests as a dry mouth upon waking, which typically improves after drinking or eating. Mouth breathing can occur due to various factors, including nasal obstructions from enlarged tonsils or excess mucus.

Why does mouth breathing cause throat irritation? When we breathe through our mouths, the air bypasses the natural filtering and humidifying processes that occur in the nasal passages. This can lead to dryness and irritation in the throat, especially over prolonged periods such as during sleep.

Lingering Infections and Their Impact on Throat Health

Persistent infections, whether viral or bacterial, can cause prolonged throat pain. Colds and flu, which are viral infections, are among the most common causes of sore throats. While these infections typically resolve on their own, they can sometimes lead to throat discomfort that lasts for weeks after the main symptoms have subsided.

Bacterial Infections and Chronic Sore Throat

In some cases, a bacterial infection such as strep throat may be the underlying cause of a persistent sore throat. Unlike viral infections, bacterial infections can often be treated effectively with antibiotics. It’s important to distinguish between viral and bacterial infections to ensure appropriate treatment.

How can you differentiate between viral and bacterial throat infections? While it can be challenging to distinguish between the two based on symptoms alone, some signs may point towards a bacterial infection. These can include severe throat pain, fever, and the presence of white or yellow spots on the tonsils. However, a definitive diagnosis typically requires a medical examination and possibly a throat culture.

Tonsillitis and Its Role in Chronic Throat Pain

Tonsillitis, an infection that causes inflammation of the tonsils, can be a significant contributor to chronic sore throats. This condition can affect individuals of any age, although it’s more common in children. Both viruses and bacteria can cause tonsillitis, and the treatment approach depends on the underlying cause.

Recognizing the Symptoms of Tonsillitis

1. Red or swollen tonsils
2. Fever and chills
3. Difficulty swallowing
4. Hoarse or scratchy voice
5. Severe sore throat
6. Yellow or white spots on the tonsils
7. Bad breath

Is tonsillitis always a cause for concern? While many cases of tonsillitis resolve on their own or with appropriate treatment, recurrent or chronic tonsillitis may require more aggressive management. In some cases, surgical removal of the tonsils (tonsillectomy) may be recommended, particularly if the condition significantly impacts quality of life or leads to complications.

Mononucleosis: A Prolonged Cause of Sore Throat

Mononucleosis, commonly known as “mono,” is an infection that can cause symptoms lasting up to two months. One of the hallmark symptoms of mono is a severe sore throat, which in some cases can persist for the duration of the infection. This condition, often referred to as the “kissing disease,” is most common among teenagers and young adults.

Distinguishing Mono from Other Throat Infections

How can you differentiate mono from other throat infections? While mono shares many symptoms with other viral infections, there are some distinguishing features. These may include extreme fatigue, swollen lymph nodes, and an enlarged spleen. Additionally, the duration of symptoms is typically longer in mono compared to other viral throat infections.

Is there a specific treatment for mononucleosis? Unfortunately, there is no specific cure for mono, as it’s caused by a virus. Treatment typically focuses on managing symptoms and may include rest, hydration, and over-the-counter pain relievers. In severe cases, corticosteroids may be prescribed to reduce throat and tonsil swelling.

Peritonsillar Abscess: A Serious Complication of Tonsillitis

A peritonsillar abscess is a potentially serious condition that can develop as a complication of tonsillitis. This condition occurs when a bacterial infection in the tonsil spreads to the surrounding tissue, forming a pus-filled bump. Peritonsillar abscesses can cause severe symptoms and require prompt medical attention.

Recognizing the Signs of a Peritonsillar Abscess

What are the key symptoms of a peritonsillar abscess? While the symptoms are similar to those of tonsillitis, they are often more severe. Key indicators may include:

• Intense throat pain, often worse on one side
• Difficulty opening the mouth
• Difficulty swallowing or speaking
• Fever and chills
• Swelling of the neck or jaw
• Earache on the affected side

How is a peritonsillar abscess treated? Treatment typically involves draining the abscess, often through a procedure called aspiration or incision and drainage. Antibiotics are also usually prescribed to clear the underlying infection. In some cases, hospitalization may be necessary for more intensive treatment and monitoring.

When to Seek Medical Attention for a Chronic Sore Throat

While many cases of sore throat resolve on their own, persistent or severe symptoms may warrant medical attention. It’s generally recommended to consult a healthcare provider if a sore throat lasts longer than 5-10 days, or if it’s accompanied by other concerning symptoms.

Red Flags That Require Immediate Medical Attention

What symptoms should prompt immediate medical evaluation? While not an exhaustive list, the following symptoms in conjunction with a persistent sore throat should be evaluated promptly:

• Difficulty breathing or swallowing
• Severe pain that doesn’t respond to over-the-counter pain relievers
• High fever (above 101°F or 38.3°C)
• Blood in saliva or phlegm
• A lump in the neck
• Hoarseness lasting more than two weeks
• Ear pain

Is a chronic sore throat always a sign of a serious condition? While many cases of persistent sore throat are due to benign causes, it’s important not to ignore prolonged symptoms. Chronic throat pain can sometimes be a symptom of more serious conditions, including throat cancer. Therefore, it’s crucial to have unexplained persistent symptoms evaluated by a healthcare professional.

Diagnostic Approaches for Chronic Sore Throat

How do doctors diagnose the cause of a chronic sore throat? The diagnostic process typically begins with a thorough medical history and physical examination. Depending on the suspected cause, additional tests may be ordered, such as:

1. Throat culture: To identify bacterial infections
2. Blood tests: To check for infections or other systemic conditions
3. Imaging studies: Such as X-rays or CT scans to visualize the throat and surrounding structures
4. Laryngoscopy: A procedure that allows direct visualization of the throat and voice box
5. Allergy testing: If an allergic cause is suspected

Can lifestyle changes help prevent chronic sore throats? In many cases, yes. Simple measures such as staying hydrated, avoiding irritants like smoke and pollution, practicing good hand hygiene to prevent infections, and managing allergies can all contribute to reducing the risk of chronic throat irritation. However, if symptoms persist despite these measures, it’s important to seek professional medical advice for proper diagnosis and treatment.

Causes and when to see a doctor

A chronic or persistent sore throat can result from smoking, allergies, infections, mouth breathing, and other causes. It can also stem from an underlying condition, such as gastroesophageal reflux disease (GERD) or cancer.

Chronic throat pain often results from lingering throat infections, irritants or allergens in the air, or dry air conditions. People with allergies or asthma may be especially sensitive to these triggers.

Some causes of a chronic sore throat require medical treatment. See a doctor if a sore throat lasts longer than 5–10 days.

In this article, we look at common reasons why a chronic sore throat develops.

Share on PinterestPossible causes of a chronic sore throat include smoking, air pollution, and allergic reactions.

Inhaling smoke irritates the sensitive tissues lining the throat. This irritation results from inhaling the hot, dry air and toxic chemicals in tobacco smoke. People who smoke regularly may experience a sore throat that does not go away.

Smoking also makes a person more susceptible to health conditions that can cause a sore throat, including a cold, the flu, and respiratory tract infections. This is because smoking weakens the functioning of the immune system. It also increases a person’s risk of throat cancer, and a lasting sore throat can be a symptom of the disease.

If a person smokes and develops a sore throat that does not go away or comes and goes regularly, they should see their healthcare provider. A doctor can also provide assistance to anyone who wants to quit.

Smog and air pollution are common in larger cities and in areas near industrial factories or power plants. Breathing in smog or air pollution has similar health consequences to inhaling smoke from a cigarette. Inhaling smog on hot days can be particularly harmful.

People who breathe in polluted air may experience symptoms such as:

• pain in the chest
• a sore throat
• coughing
• other asthma symptoms

Allergens are substances that cause an allergic reaction. Allergens can include foods, pollen, and chemicals in cleaning products or cosmetics, for example.

People with seasonal allergies may notice lasting throat irritation during warm months and other times when the pollen count is high.

Allergies can cause postnasal drip, which involves excess mucus draining down the back of the nasal passage into the throat. Postnasal drip can lead to a persistent, raw sore throat.

Colds and the flu, reactions to medication, and certain weather conditions can also trigger postnasal drip.

A person allergic to an airborne substance such as pollen, grass, or mildew may experience any of the following symptoms when exposed to the allergen:

• itchy eyes
• a runny nose
• coughing and sneezing
• watery eyes
• postnasal drip

A person can develop a sore throat from breathing through their mouth for a long period. This is most likely to occur while a person sleeps.

A person may be breathing through their mouth overnight if they wake up with a dry mouth that goes away after drinking or eating.

Obstructions to the nasal passage — from enlarged tonsils or excess mucus, for example — can cause a person to breathe through their mouth while asleep.

Anyone who consistently wakes up with a sore throat should consult a healthcare provider.

A lingering cold or flu can cause pain in the throat for weeks after the main infection has begun to subside.

Colds and the flu are caused by viruses, and viral infections are the most common cause of sore throats. They usually go away on their own with time.

Otherwise, a bacterial infection — such as strep throat — may be the underlying issue. Antibiotics can treat bacterial infections, but they will not treat infections caused by viruses.

Share on PinterestSymptoms of tonsillitis include swollen tonsils, a fever, and difficulty swallowing.

Tonsillitis is a throat infection that causes inflammation. Both viruses and bacteria can cause tonsillitis.

Children are more prone to tonsillitis, but it can affect people of any age. The treatment will depend on whether the infection is bacterial or viral.

Some additional symptoms of tonsillitis include:

• red or swollen tonsils
• a fever
• chills
• difficulty swallowing
• a hoarse or scratchy voice
• a severe sore throat
• yellow or white spots on the tonsils
• bad breath

Mononucleosis — typically referred to as mono — can last for up to 2 months. Mono often causes flu-like symptoms, which can include a sore throat.

In some cases, the sore throat lasts for the duration of the infection.

A peritonsillar abscess results from a bacterial infection in the tonsil.

A peritonsillar abscess can develop when tonsillitis does not fully heal. The abscess forms as a pus-filled bump on one tonsil, and the infection then spreads to surrounding tissue.

Symptoms of a peritonsillar abscess are very similar to those of tonsillitis, but they are often much more severe. If a person receives treatment for tonsillitis, but the infection does not appear to go away, they should consult a doctor.

Gonorrhea is a very common sexually transmitted infection in the United States. The Neisseria gonorrhoeae bacterium causes it.

In addition to affecting the genitals, gonorrhea can also develop in the throat, after oral sex.

Acid reflux occurs when a muscle at the top of the stomach weakens and leaks acid into the esophagus, which is the tube that connects the mouth and stomach.

This causes a painful burning sensation known as heartburn.

Acid reflux can cause a sore throat. Anyone who suspects that they have acid reflux should speak to their doctor about treatments. Over time, it can damage the esophagus and cause further health problems.

Learn more about sore throats and acid reflux.

A person with a weakened immune system is more likely to experience a chronic sore throat. This is because their body is less able to fight off infections when bacteria and viruses enter the body.

If a person has any of the following, they may have weakened immune system function:

• rheumatoid arthritis
• lupus
• HIV
• AIDS
• cancer and other conditions that require chemotherapy

Throat cancer, which is also called laryngeal cancer, can cause a chronic sore throat.

Some other symptoms of laryngeal cancer include:

• hoarseness or voice changes
• constant coughing
• difficulty or pain when swallowing
• trouble breathing
• weight loss
• a lump or mass in the neck

If cancer starts developing above the voice box, people may not notice hoarseness or voice changes.

The American Cancer Society recommend seeing a doctor if hoarseness or other voice changes last for more than 2 weeks.

Share on PinterestIf a sore throat lasts longer than 5–10 days, a person should consider seeing a doctor.

A person should see a doctor if a sore throat lasts longer than 5–10 days, according to the American Academy of Otolaryngology – Head and Neck Surgery.

Sore throats are often easy to diagnose and treat. However, seek immediate medical attention if any of the following occurs:

• a high fever
• difficulty turning the head
• swelling in the throat that impairs breathing, talking, or swallowing
• severe pain on one side of the throat and swollen glands
• a lump or obstruction in the throat

People can often relieve the pain of a sore throat using over-the-counter treatments and home remedies.

Read about 15 natural remedies for a sore throat.

Sore throats are common and can result from a variety of conditions and illnesses.

If sore throats occur frequently or become persistent — lasting longer than 5–10 days — speak to a doctor.

A healthcare provider can determine the cause and suggest effective treatments.

Causes and when to see a doctor

A chronic or persistent sore throat can result from smoking, allergies, infections, mouth breathing, and other causes. It can also stem from an underlying condition, such as gastroesophageal reflux disease (GERD) or cancer.

Chronic throat pain often results from lingering throat infections, irritants or allergens in the air, or dry air conditions. People with allergies or asthma may be especially sensitive to these triggers.

Some causes of a chronic sore throat require medical treatment. See a doctor if a sore throat lasts longer than 5–10 days.

In this article, we look at common reasons why a chronic sore throat develops.

Share on PinterestPossible causes of a chronic sore throat include smoking, air pollution, and allergic reactions.

Inhaling smoke irritates the sensitive tissues lining the throat. This irritation results from inhaling the hot, dry air and toxic chemicals in tobacco smoke. People who smoke regularly may experience a sore throat that does not go away.

Smoking also makes a person more susceptible to health conditions that can cause a sore throat, including a cold, the flu, and respiratory tract infections. This is because smoking weakens the functioning of the immune system. It also increases a person’s risk of throat cancer, and a lasting sore throat can be a symptom of the disease.

If a person smokes and develops a sore throat that does not go away or comes and goes regularly, they should see their healthcare provider. A doctor can also provide assistance to anyone who wants to quit.

Smog and air pollution are common in larger cities and in areas near industrial factories or power plants. Breathing in smog or air pollution has similar health consequences to inhaling smoke from a cigarette. Inhaling smog on hot days can be particularly harmful.

People who breathe in polluted air may experience symptoms such as:

• pain in the chest
• a sore throat
• coughing
• other asthma symptoms

Allergens are substances that cause an allergic reaction. Allergens can include foods, pollen, and chemicals in cleaning products or cosmetics, for example.

People with seasonal allergies may notice lasting throat irritation during warm months and other times when the pollen count is high.

Allergies can cause postnasal drip, which involves excess mucus draining down the back of the nasal passage into the throat. Postnasal drip can lead to a persistent, raw sore throat.

Colds and the flu, reactions to medication, and certain weather conditions can also trigger postnasal drip.

A person allergic to an airborne substance such as pollen, grass, or mildew may experience any of the following symptoms when exposed to the allergen:

• itchy eyes
• a runny nose
• coughing and sneezing
• watery eyes
• postnasal drip

A person can develop a sore throat from breathing through their mouth for a long period. This is most likely to occur while a person sleeps.

A person may be breathing through their mouth overnight if they wake up with a dry mouth that goes away after drinking or eating.

Obstructions to the nasal passage — from enlarged tonsils or excess mucus, for example — can cause a person to breathe through their mouth while asleep.

Anyone who consistently wakes up with a sore throat should consult a healthcare provider.

A lingering cold or flu can cause pain in the throat for weeks after the main infection has begun to subside.

Colds and the flu are caused by viruses, and viral infections are the most common cause of sore throats. They usually go away on their own with time.

Otherwise, a bacterial infection — such as strep throat — may be the underlying issue. Antibiotics can treat bacterial infections, but they will not treat infections caused by viruses.

Share on PinterestSymptoms of tonsillitis include swollen tonsils, a fever, and difficulty swallowing.

Tonsillitis is a throat infection that causes inflammation. Both viruses and bacteria can cause tonsillitis.

Children are more prone to tonsillitis, but it can affect people of any age. The treatment will depend on whether the infection is bacterial or viral.

Some additional symptoms of tonsillitis include:

• red or swollen tonsils
• a fever
• chills
• difficulty swallowing
• a hoarse or scratchy voice
• a severe sore throat
• yellow or white spots on the tonsils
• bad breath

Mononucleosis — typically referred to as mono — can last for up to 2 months. Mono often causes flu-like symptoms, which can include a sore throat.

In some cases, the sore throat lasts for the duration of the infection.

A peritonsillar abscess results from a bacterial infection in the tonsil.

A peritonsillar abscess can develop when tonsillitis does not fully heal. The abscess forms as a pus-filled bump on one tonsil, and the infection then spreads to surrounding tissue.

Symptoms of a peritonsillar abscess are very similar to those of tonsillitis, but they are often much more severe. If a person receives treatment for tonsillitis, but the infection does not appear to go away, they should consult a doctor.

Gonorrhea is a very common sexually transmitted infection in the United States. The Neisseria gonorrhoeae bacterium causes it.

In addition to affecting the genitals, gonorrhea can also develop in the throat, after oral sex.

Acid reflux occurs when a muscle at the top of the stomach weakens and leaks acid into the esophagus, which is the tube that connects the mouth and stomach.

This causes a painful burning sensation known as heartburn.

Acid reflux can cause a sore throat. Anyone who suspects that they have acid reflux should speak to their doctor about treatments. Over time, it can damage the esophagus and cause further health problems.

Learn more about sore throats and acid reflux.

A person with a weakened immune system is more likely to experience a chronic sore throat. This is because their body is less able to fight off infections when bacteria and viruses enter the body.

If a person has any of the following, they may have weakened immune system function:

• rheumatoid arthritis
• lupus
• HIV
• AIDS
• cancer and other conditions that require chemotherapy

Throat cancer, which is also called laryngeal cancer, can cause a chronic sore throat.

Some other symptoms of laryngeal cancer include:

• hoarseness or voice changes
• constant coughing
• difficulty or pain when swallowing
• trouble breathing
• weight loss
• a lump or mass in the neck

If cancer starts developing above the voice box, people may not notice hoarseness or voice changes.

The American Cancer Society recommend seeing a doctor if hoarseness or other voice changes last for more than 2 weeks.

Share on PinterestIf a sore throat lasts longer than 5–10 days, a person should consider seeing a doctor.

A person should see a doctor if a sore throat lasts longer than 5–10 days, according to the American Academy of Otolaryngology – Head and Neck Surgery.

Sore throats are often easy to diagnose and treat. However, seek immediate medical attention if any of the following occurs:

• a high fever
• difficulty turning the head
• swelling in the throat that impairs breathing, talking, or swallowing
• severe pain on one side of the throat and swollen glands
• a lump or obstruction in the throat

People can often relieve the pain of a sore throat using over-the-counter treatments and home remedies.

Read about 15 natural remedies for a sore throat.

Sore throats are common and can result from a variety of conditions and illnesses.

If sore throats occur frequently or become persistent — lasting longer than 5–10 days — speak to a doctor.

A healthcare provider can determine the cause and suggest effective treatments.

Constant pain and itching in the throat

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Contents

• Causes of constant sore throat

Patients with chronic sore throat come to our clinic every day. However, diseases of the pharynx are the most complex and polyetiological in otorhinolaryngology. In order to make a correct diagnosis, it is necessary to carry out a number of diagnostic measures.

Clinical manifestations of persistent sore throat are approximately the same: the phenomena of chronic tonsillitis and/or chronic pharyngitis. However, the same clinical manifestations can cause different causes. Not a single good eye specialist can tell what nature this inflammation is. And drugs prescribed without knowledge of the etiology of the disease are often ineffective.

1. Bacterial infections. The most dangerous bacterial causative agent of sore throat is B-hemolytic streptococcus group A. It can cause complications, such as frequent exacerbations of sore throat, paratonsillar abscesses, nephritis, arthritis, myocarditis (complications can occur after 20-30 years from an acute process) . In order to exclude the presence of streptococcal infection on the surface of the tonsils, there is Streptatest (express diagnostics for hemolytic streptococcus), performed in the clinic in 5 minutes. To assess the general condition and streptococcal intoxication, it is necessary to conduct a biochemical blood test (Antistreptolysin O, Rheumatoid factor, C-reactive protein). To exclude concomitant pathogenic flora, it is necessary to carry out sowing from the pharynx for flora and sensitivity to antibiotics and phages. Often found the presence of Staphiloccocus aureus, Pseudomonas aeruginosa. Knowing the pathogen and its sensitivity, it is possible to treat with phage preparations without resorting to systemic antibiotic therapy.
2. Viral infections. There are a number of chronic persistent viral infections that can cause persistent sore throat , such as chronic persistent herpes infections (Cytomegalvirus, Epstein-Barr virus, HSV type 6). By adulthood, almost every one of us has met with these infections and had been ill. The disease is acute once (often disguised as SARS), the virus remains in the body for life. But with a decrease in immunity, a replica of the virus (reproduction) is possible. How to find out? PCR studies of saliva are often not informative (70-80% reliability), the most informative for assessing the persistence of blood ELISA (determination of antibodies). To the Epstein-Barr virus, our body produces antibodies Ig M (capsid) in the acute phase of primary inflammation (infectious mononucleosis), Ig G capsid – antibodies to surface antigens, can be slightly increased throughout life, and Ig G nuclear (nuclear) – its increase indicates active viral replication and speaks of chronic persistent Epstein-Barr virus infection of unknown date of infection. There are also Ig M and G antibodies to Cytomegalvirus, an increase in the titer of Ig G antibodies to CMV by tens and hundreds of times indicates a persistent infection. Less common are Ig G antibodies to HSV type 6.
3. Fungal infections. Such infections are more likely to occur in people after a long-term illness, after several courses of antibiotic therapy, patients with immunosuppression (taking cytostatics, hormones, chemotherapy, tuberculosis, HIV infection, etc.). To diagnose and verify the pathogen, you can take culture from the pharynx for fungi and sensitivity to antimycotics.

In conclusion, I would like to give you a clinical case:

In February 2018, patient A, 18 years old, came to our clinic with complaints of discomfort in the throat, a feeling of a foreign body in the throat, which appeared in August 2017. She was repeatedly consulted by an otorhinolaryngologist, local therapy was prescribed (gargling with antiseptics, antiseptic absorbable lozenges), with a temporary effect. The diagnosis is also suspected: pharyngoneurosis, consultation of a neurologist is recommended.

Objective data during endoscopic ENT examination of the pharynx: the oral mucosa is pink, clean, there is hyperemia of the anterior palatine arches. Tonsils 2 tbsp, soldered, cicatricially changed, in lacunae caseous masses. The back wall is pink, dry.

Diagnosed:
chronic tonsillitis, chronic pharyngitis.

Examination carried out. According to the results of the analyzes, the presence of Streptococcus puogenus in the throat, an increase in the titer of antistreptolysin O-350 and C-reactive protein – 6.4, an increase in nuclear Ig G to the Epstein-Barr virus – 500. Thus, the causative agents of the disease were verified, streptococcal infection and chronic persistent Epstein-Barr virus infection.

The patient was prescribed etiotropic treatment, a course of washing the lacunae of the tonsils No. 5, physiotherapy (K-laser nose/pharynx No. 10) with a pronounced positive effect.

Thus it becomes clear why self-treatment does not lead to a positive effect.

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Sore throat – causes

What can sore throat signal? About SARS? Angina? Tonsillitis? As it turns out, there could be many more reasons.

What can a sore throat signal? About SARS? Angina? Tonsillitis? As it turns out, there could be many more reasons.

Emelyanova Alexandra Nikolaevna, our permanent consultant, Candidate of Medical Sciences, otolaryngologist at LLC “Expert Clinic Kursk” told us about this and many other things.

－ Alexandra Nikolaevna, everyone has experienced a sore throat at least once in their life. What disease accompanies this symptom?

There are many. Pathologies of the pharynx itself: its injuries and wounds, foreign bodies, burns, inflammatory processes, fungal infections, tuberculosis and syphilis, purulent lesions (including palatine tonsils, cellular spaces of the pharynx), neoplasms.

In addition, soreness in the throat can appear with infectious mononucleosis, agranulocytosis, leukemia.

Sore throat can also occur with pathologies of organs adjacent to the pharynx – for example, with foreign bodies, inflammation and neoplasms of the larynx, diseases of the esophagus.

Sometimes the cause is associated with diseases of the nervous system, namely with neuralgia of some nerves (for example, vidian, glossopharyngeal, stellate and geniculate). Despite this, the patient can often first turn to an ENT doctor, and only then will be redirected to another specialist.

－ What could be the causes of a persistent sore throat?

These are the neurological syndromes that I mentioned earlier, the stylohyoid muscle syndrome, tumors in fairly advanced stages, as well as such a disease of the gastrointestinal tract as gastroesophageal reflux disease.

－ What is the difference between tonsillitis and tonsillitis?

If we are talking specifically about acute tonsillitis, then he and tonsillitis are one and the same. At the same time, otolaryngologists, for the convenience of classification, are in favor of retaining the term “acute tonsillitis” and the abolition of tonsillitis. Both definitions are in use today.

－ How often does acute tonsillitis become chronic?

Accurate statistics are hard to come by, but in practice this happens quite often.

－ Is chronic tonsillitis somehow coded in ICD-10?

Yes, its code for this classification is J35. 0.

－ What are the symptoms of chronic tonsillitis?

Discomfort, as well as recurrent sore throat, some fever (intermittent or constant), bad breath. In the lacunae of the tonsils there may be pus, their edges are reddened, the size may be increased. The lymph nodes of the neck are enlarged.

－ On what principles are clinical guidelines for the treatment of acute tonsillitis based?

Standardized clinical guidelines do not yet exist for the treatment of tonsillitis.

If the bacterial nature of the disease is proven, it is necessary to carry out general antibiotic therapy, prescribe anti-inflammatory drugs (systemically and locally), desensitizing drugs, and local use of antiseptics.

In the acute stage, washing of the tonsils should not be used, it is undesirable to lubricate them with drugs. With fever, physiotherapy is contraindicated.

－ Alexandra Nikolaevna, what methods are effective in the treatment of patients with chronic tonsillitis?

Here the range of treatment possibilities is wider, and the best treatment of chronic tonsillitis, as in many pathologies, is complex. Antibiotics may be used as indicated. Washing and lubrication of the palatine tonsils with drugs are used, the introduction of drugs into them using phono- and electrophoresis. It is extremely rare that antibiotics are injected into the tonsils and paratonsillarly. Sometimes bacteriophages are used topically.

General tonic preparations, vitamins, adaptogens, physiotherapy, hardening, spa treatment are shown.

－ Does chronic tonsillitis always involve removal of the tonsils? Or does this method have its pros and cons?

Not always. A few decades ago, this operation was carried out more often than at present. The issue of removing the tonsils is decided on an individual basis, taking into account the effectiveness of the treatment, the number of exacerbations of tonsillitis over a certain period of time, the threat of development or an existing complication of the disease, and some others.

A number of scientists are of the opinion that the removal of the tonsils is not a prevention of the development of possible complications of tonsillitis. It is believed that after tonsillectomy, inflammatory pathologies of various parts of the respiratory tract develop more often.

Despite this, as well as a wide range of non-surgical treatments, indications for surgery still exist today. Among them: the lack of effect of conservative therapy with a simple form of chronic tonsillitis or a toxic-allergic form of the first degree after 2-3 courses of therapy; toxic-allergic form of the second degree; the presence of paratonsillar abscess, parapharyngitis, acute and chronic tonsillar sepsis, rheumatism, suspicion of a malignant neoplasm of the tonsil and a number of others.

－ Is there a difference in the treatment of chronic tonsillitis in adults and children?

The principles are the same, however, in young children there are limitations in terms of manipulation interventions in the form of washing, lubricating, irrigation of the tonsils, physiotherapy.

－ Why is tonsillitis dangerous and what will happen if it is not treated?

Complications may develop – both local (for example, paratonsillar abscess, parapharyngeal or deep phlegmon of the neck, tonsillogenic sepsis), and remote (for example, various infectious lesions of organs associated with group A beta-hemolytic streptococcus, and some others). 0003

－ What is the prognosis for chronic tonsillitis?

It depends, among other things, on the form of the disease, the general reactivity of the body, the patient’s adherence to the prescribed treatment.

－ What is the prevention of exacerbations in chronic tonsillitis?

Medications, physiotherapy, various types of hardening, phytoadaptogens, immunomodulators according to indications are used. These courses are held twice a year. Even in the absence of an exacerbation, it is necessary to see an ENT doctor at least once a year.

－ If you often have a sore throat, which doctor should you consult?

In practice, the first doctor you should consult is an otolaryngologist. But since we already know that sore throats can also be associated with other ailments, after excluding “their” diseases, the patient can be referred for a consultation with an infectious disease specialist, hematologist, gastroenterologist, neurologist, endocrinologist.