Don’t Stress Over Strep – Associates in Family Medicine

Oh, the wonders of winter. Snowball fights, skiing, hot cocoa, and… strep throat?

Yes, the season of fun-filled pastimes and sparkling snow can also be marked by sickness. And this winter, our providers at Associates in Family Medicine are seeing higher-than-usual cases of strep throat.

While this bacterial bane on the winter season is familiar to most of us, our team of providers has noticed a number of misconceptions around strep throat. We talked to AFM physician and urgent care director Dr. Shelley Moore to get clarity on common strep throat symptoms, treatment options, spread, and more.

What are the most common strep throat symptoms?

The telltale signs of strep throat are – you guessed it – a very sore throat that is most often paired with a fever. “In general, people with strep don’t exhibit generic cold symptoms like coughs, runny noses, nasal congestion, or sneezing,” says Moore. “If you are experiencing these types of symptoms with the absence of a fever, chances are you have a viral infection, and you don’t need to be tested for strep.”

While throat pain and fever are the most common and notable symptoms of strep throat, other signs of this bacterial infection may include:

• Body aches
• Fatigue
• Red, swollen tonsils (possibly with white patches or streaks of pus)
• Tiny red spots on the back portion of the roof of the mouth
• Swollen, tender lymph nodes in the neck
• Headache
• Nausea or vomiting (particularly in younger children)
• Rash

When should I get tested for strep throat?

If you have a sore throat that’s accompanied by a fever and/or some of the other symptoms described above (especially if these symptoms persist longer than 48 hours), it’s a good idea to see a doctor.

“With strep throat, it’s better to be seen earlier rather than later,” says Moore. “The quicker you get treated, the quicker you can be sure you don’t spread the infection to others. Also, if you get to the point where your pain is not well controlled and you have trouble drinking fluids, you run the risk of getting dehydrated and weak.”

Does strep throat require antibiotic treatment?

The short answer is yes. “Unlike ear infections, which can be bacterial or viral in nature, strep throat is always caused by bacteria (group A streptococcus),” Moore clarifies. “Therefore, best practice is to prescribe antibiotics to prevent future problems and stop the spread of the infection.

“While there are times when strep could go away without antibiotics, the problem is that some of those cases could have negative outcomes, especially for very young or elderly patients,” says Moore. “Complications can include abscesses inside the throat or on the tonsils, rheumatic fever, and even post-streptococcal glomerulonephritis, which is a rare inflammation of the kidneys.”

How can I avoid getting (or spreading) strep throat?

To steer clear of strep throat and its unpleasant symptoms, follow a couple of simple yet effective practices in your day-to-day life. First and foremost, wash your hands regularly. “It doesn’t need to be antibacterial soap,” says Moore. “Regular soap and water can wash away all the potential germs responsible for spreading strep throat.” Moore also encourages people to avoid sharing drinks or foods with one another, even among family members.

If you already have strep throat symptoms or have been diagnosed with strep throat, keep in mind that you are typically most contagious when you have a fever. “Once you have started taking antibiotics, the general rule of thumb is 24 hours – or two doses of antibiotics for most prescriptions – before you are no longer contagious,” says Moore. As is the case when trying to escape strep throat, handwashing and avoiding close contact with other people are key to be sure you don’t spread your strep infection.

Where can I go for convenient, affordable strep throat treatment and care?

Because an official strep throat diagnosis cannot be made over the phone, Moore encourages people with strep symptoms to visit their primary care provider if they are able to be seen within 24 hours.

“If you can’t get in to your primary provider in a timely manner, the next step would definitely be to visit one of our urgent care locations, especially on the weekends,” says Moore. “We have access to rapid strep tests – which are easy, fast, and painless and take less than 10 minutes in the clinic setting.”

But what about the costs? “Thankfully, a rapid strep test is one of the least expensive point-of-care tests,” confirms Moore. “At several of our AFM urgent care and primary care locations, we also have most antibiotics available onsite – making the prescriptions much more affordable to patients with and without insurance.” Additionally, a visit to one of AFM’s urgent care locations will save you big bucks over an unnecessary trip to the ER. But it’s always a good idea to check with your insurance about what is and isn’t covered in your plan.

The top things to remember about strep throat

While there’s a lot of information out there on strep throat, here are the important things to keep in mind at this time of year and always:

• If you have generic cold symptoms with a sore throat, you probably don’t need a strep test – a virus is the more likely culprit.
• If you have throat pain, a fever, and not much else, go ahead and get tested.
• Strep tests are easy, fast, inexpensive, and painless.
• Strep throat is easily treated with affordable antibiotics.
• Keep washing those hands!
• Don’t depend on the internet for your diagnosis – count on experienced urgent care and primary care providers for a convenient, personalized diagnosis you can trust.

Strep Throat | HealthLink BC

Topic Overview

What is strep throat?

Strep throat is a bacterial infection in the throat and the tonsils. The throat gets irritated and inflamed, causing a sudden, severe sore throat.

What causes strep throat?

Strep throat is caused by streptococcal (strep) bacteria. There are many different types of strep bacteria. Some cause more serious illness than others.

Although some people are quick to think that any painful sore throat is strep, sore throats are usually caused by a viral infection and not strep bacteria. A sore throat caused by a virus can be just as painful as strep throat. But if you have cold symptoms such as coughing, sneezing, or a runny or stuffy nose, you probably do not have strep throat.

What are the symptoms?

The most common symptoms of strep throat are:

• A sudden, severe sore throat.
• Pain when you swallow.
• Fever over38.3°C (101°F).
• Swollen tonsils and lymph nodes.
• White or yellow spots on the back of a bright red throat.

You may also have a headache and belly pain. Less common symptoms are a red skin rash, vomiting, not feeling hungry, and body aches.

Strep throat can be passed from person to person. When a person who has strep throat breathes, coughs, or sneezes, tiny droplets with the strep bacteria go into the air. These droplets can be breathed in by other people. If you come into contact with strep, it will take 2 to 5 days before you start to have symptoms.

How is strep throat diagnosed?

Your doctor will do a physical examination, ask you about your symptoms and past health, and do a lab test such as a throat culture or rapid strep test.

To do a throat culture, the doctor will swab a sample of cells from the back of your throat. The sample will go into a special cup (culture) where the strep bacteria can grow over time. If strep bacteria grow, the doctor knows that you have strep. If the doctor does a rapid test and the test says that you don’t have strep (the test is negative) but your symptoms suggest that you do, your doctor may want to do a throat culture to be sure. This is because rapid strep tests are not always accurate.

If the rapid strep test is positive and says that you do have strep, there’s no need to do the throat culture.

How is it treated?

Doctors usually treat strep throat with antibiotics. Antibiotics shorten the time you are able to spread the disease to others (are contagious) and lower the risk of spreading the infection to other parts of your body. Antibiotics also may help you feel better faster.

You are contagious while you still have symptoms. Most people stop being contagious 24 hours after they start antibiotics. If you don’t take antibiotics, you may be contagious for 2 to 3 weeks, even if your symptoms go away.

Your doctor may also advise you to take an over-the-counter medicine like acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) to help with pain and lower your fever. Acetaminophen and ibuprofen are different products with different dosing recommendations. Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine. Studies have not shown any added benefit from alternating these medicines. Be safe with medicines. Read and follow all instructions on the label. Do not give aspirin to anyone younger than 18. It has been linked to Reye syndrome, a serious illness.

How do you prevent strep throat?

To avoid getting strep throat, it is a good idea to avoid contact with anyone who has a strep infection. If you are around someone who has strep, wash your hands often. Don’t drink from the same glass or use the same eating utensils. And don’t share toothbrushes.

Bacteria can live for a short time on doorknobs, water faucets, and other objects. It’s a good idea to wash your hands regularly.

If you have a strep infection, there are things you can do to avoid spreading it to others. Use tissues you can throw away instead of handkerchiefs, wash your hands often, and do not sneeze or cough on others. Antibiotics can shorten the time that you are contagious. It is a good idea to stay home from work or school until 24 hours after you have started antibiotics.

Cause

Strep throat is caused by streptococcal (strep) bacteria, most often by group A beta-hemolytic streptococcus (GABS). Other types of strep that can sometimes infect the throat are groups C and G strep bacteria.

A strep infection causes the throat (pharynx) and the tonsils or adenoids to become irritated, inflamed, and painful.

Sore throats are most commonly caused by viral infections or other irritants such as smoke, allergies, dry air, or a throat injury, and not by a strep infection.

How the strep infection is spread

Strep throat can be passed from person to person. When a person infected with strep throat breathes, coughs, or sneezes, tiny droplets containing the strep bacteria are released into the air and are breathed in by other people.

Symptoms

Common symptoms of strep throat in children and adults include:

• Severe and sudden sore throat without coughing, sneezing, or other cold symptoms.
• Pain or difficulty with swallowing.
• Fever over 38.3°C (101°F). Lower fevers may point to a viral infection and not strep.
• Swollen lymph nodes in the neck.
• White or yellow spots or coating on the throat and tonsils.
• Bright red throat or dark red spots on the roof of the mouth at the back near the throat.
• Swollen tonsils, although this symptom may also be caused by a viral infection.

In teenagers, mononucleosis can cause a severe sore throat that looks like and has symptoms similar to those of strep throat. For more information, see the topic Mononucleosis (Mono).

It is easy to tell when you have a sore throat or a cold. It is harder to know when you have strep throat. Typically, sore throats are caused by a viral infection and not strep bacteria. Strep throat usually does not occur with cold symptoms such as coughing, sneezing, or a runny or stuffy nose. The more cold symptoms you have, the less likely it is that your sore throat is a strep infection.

In some cases of strep infection, a skin rash develops and spreads over the neck and chest and eventually over the whole body. The rash feels rough like sandpaper. This condition is called scarlet fever. Scarlet fever is treated with antibiotics. This usually leads to a quick recovery. Scarlet fever is not dangerous if treated.

What Happens

Symptoms of strep throat usually begin within 2 to 5 days after you come in contact with someone who has a strep infection. Strep throat usually goes away in 3 to 7 days with or without antibiotic treatment. In contrast, if allergies or irritants are the cause of your sore throat, it will usually last longer unless the cause is eliminated.

If strep throat isn’t treated with antibiotics, you will continue to be contagious for 2 to 3 weeks even if your symptoms go away. You are much less contagious within 24 hours after you start antibiotics and are less likely to develop complications of the strep infection.

Complications of strep throat

Complications of strep throat are rare but can occur, especially if your throat infection isn’t properly treated with antibiotics. Complications can occur when the strep infection spreads to other parts of the body and causes other infections, such as an ear or sinus infection or an abscess near the tonsils (peritonsillar abscess). Complications can also result in your immune system attacking itself and causing serious conditions such as rheumatic fever.

Treating strep throat can greatly reduce your risk for rheumatic fever and its complications. It is not clear whether treating the strep infection with antibiotics reduces your risk for inflammation of the kidneys (acute glomerulonephritis).

What Increases Your Risk

Your risk of getting strep throat increases if you come in close contact with others, especially children, who have a strep infection.

The size of a child’s tonsils isn’t a risk factor for throat infections. Children or adults who have had their tonsils removed can still get strep throat.

When should you call your doctor?

Call your doctor today if you have:

Call a doctor if the following symptoms develop 1 to 2 weeks or longer after a strep throat infection. These symptoms may indicate rheumatic fever.

• Weakness
• Shortness of breath
• Joint pain
• Raised red rash or lumps under the skin
• Uncontrolled, jerking movements of the arms or legs

Call your doctor if your symptoms do not improve after 2 days of treatment with an antibiotic.

Watchful waiting

Watchful waiting is appropriate if your sore throat occurs with symptoms like those of a cold, such as sneezing, coughing, and a runny or stuffy nose. In general, the more of these symptoms you have, the less likely it is that your sore throat is caused by a strep infection. You can try home treatment if your sore throat is not severe and you have other symptoms of a cold.

Who to see

Your family doctor or general practitioner can evaluate a sore throat, do throat cultures or quick tests, and prescribe antibiotic treatment if needed. You may be referred to a specialist, such as a pediatrician for your child, or an otolaryngologist (ear, nose, and throat specialist).

If surgery to remove chronically enlarged or infected tonsils or adenoids is suggested, you may be referred to an otolaryngologist.

Examinations and Tests

Strep throat is diagnosed from your medical history, a physical examination of your throat, and a lab test, such as a throat culture. Sometimes a rapid strep test is used to check for strep. Your doctor may confirm the results of the rapid strep test with a throat culture.

Current treatment guidelines recommend that your doctor confirm strep throat with a lab test, such as a throat culture, and not just diagnose strep throat from your symptoms. But your doctor may begin treatment for strep throat before the result of your throat culture is back if you have three or four of the following symptoms:

• A recent fever of 38.3°C (101°F) or higher
• White or yellow spots or coating on the throat or tonsils
• Swollen or tender lymph nodes on the neck
• Absence of signs of a cold or upper respiratory infection, such as coughing or sneezing

One or both of the following tests are used to confirm that you have strep throat.

• Throat culture is a test to find germs (such as strep bacteria) that can cause an infection. A sample of cells from the back of your throat is added to a substance that promotes the growth of bacteria. If no bacteria grow, the culture is negative. If strep bacteria grow, the culture is positive.
• Rapid strep test analyzes the bacteria in your throat to see if strep is the cause of your sore throat. The doctor uses a cotton swab to gather cells from the back of your throat for testing. The rapid strep test is not used in many parts of Canada.

If symptoms of strep throat are present, it is important to be tested for strep infection. Prompt treatment will reduce the spread of strep throat and may reduce the risk of complications, such as the infection spreading to other parts of your body causing ear or sinus infections or an abscess behind or around your tonsils (peritonsillar abscess).

The rapid strep test is not used in many parts of Canada. If you need to be tested for strep throat and the rapid strep test is available, it may help to discuss with your doctor the advantages and disadvantages of each test. For instance, results from a rapid strep test are available within 10 to 15 minutes, and results from a throat culture may take 1 to 2 days. A throat culture is more accurate.

• A negative rapid strep test result can mean there are no strep bacteria present. But the rapid strep test can give negative results even when strep bacteria are present (false-negative test results). If the rapid strep test result is negative but strep throat is still suspected, your doctor may order a throat culture to verify the results.
• If the rapid strep test result is positive, a throat culture isn’t needed. Antibiotic treatment can be started right away. Antibiotics may not make you well faster. But they shorten the time you are able to spread the disease to others. Antibiotics also lower the risk of spreading the infection to other parts of your body.

Testing is not needed:

• After antibiotic treatment, unless you still have symptoms. Testing may be done if symptoms return or you have had rheumatic fever and are at risk for it coming back.
• For a person who was exposed to strep but has no symptoms. For instance, family members of a person who has strep throat do not need to be tested unless they start to have symptoms.

It is possible for a person to carry the strep bacteria and not have any symptoms. If a number of infections occur in the same family, or if there have been severe complications such as rheumatic fever or toxic shock syndrome, it may be helpful to test family members to learn whether they are carriers of strep infection. But it is unusual for a person to catch strep throat from a carrier.

Treatment Overview

Antibiotics such as amoxicillin, cephalexin, or penicillin are used to treat strep throat. Antibiotics work only against bacterial infections such as strep throat. They will not help sore throats caused by allergies or viral infections such as colds.

Antibiotics are commonly used to:

• Kill the bacteria and shorten the time you are contagious. You are typically no longer contagious 24 hours after you start antibiotics.
• Prevent rare complications. Although uncommon, strep bacteria can spread to other parts of your body, causing ear or sinus infections or an abscess behind or around the tonsils (peritonsillar abscess). Antibiotics may also prevent the infection from triggering your immune system to attack itself and cause serious conditions such as rheumatic fever.
• Relieve discomfort and speed healing to some degree.

Antibiotic treatment can begin immediately if a strep infection is confirmed by a rapid strep test. But there is no harm in waiting for the results of a throat culture to confirm strep throat before starting antibiotic treatment. In fact, it is better to wait until strep throat has been confirmed so that antibiotics are not used unnecessarily. Overuse of antibiotics can make them ineffective.

Although waiting to treat strep throat may prolong the time you have the illness, delaying treatment for a few days doesn’t increase the risk of rheumatic fever or other complications.

Your doctor also may recommend non-prescription medicines such as acetaminophen or anesthetic throat sprays to help relieve the pain and discomfort caused by strep throat. Acetaminophen will also reduce fever.  Be safe with medicines. Read and follow all instructions on the label. Acetaminophen and ibuprofen are different products with different dosing recommendations. Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine. Studies have not shown any added benefit from alternating these medicines.

For more information, see:

Prevention

To avoid getting strep throat, it is a good idea to avoid contact with anyone who has a strep infection.

Wash your hands often when you are around people with colds or viral or bacterial illnesses. Do not share toothbrushes or eating and drinking utensils.

• Bacteria are almost always transmitted by contact with tiny droplets from an infected person. Strep throat is passed from one person to another by contact with the tiny droplets of an infected person’s cough, sneeze, or breath.
• Bacteria can also live for a short time on doorknobs, water faucets, and other objects. If you touch an infected object and then touch your eyes, nose, or mouth, you can become infected with the bacteria or virus.
• Bacteria can also be carried on food.

Keep up your body’s resistance to infection with a good diet, plenty of sleep, and regular exercise. Managing stress can also strengthen your body’s ability to fight off illness, such as strep throat.

Humidify your home during the dry winter months or year-round if you live in a dry climate. Moisture in the air (humidity) helps keep your mucous membranes moist and more resistant to bacteria. You can use a humidifier in the bedroom while you sleep. But use care if a person in the home has asthma or allergies, because mould or other particles that collect in the humidifier can make these conditions worse. Clean humidifiers on a regular basis.

Stop smoking, and avoid breathing others’ smoke. Smoke irritates the throat tissues and may make you more likely to get infection.

Home Treatment

Your doctor may have prescribed an antibiotic for strep throat. Take all of the antibiotic exactly as prescribed. This will help prevent the infection from coming back and will prevent complications of infection that could occur if you do not take the medicine as prescribed.

There are many ways that you can make yourself feel better while you are waiting for the strep infection to go away.

• Drink plenty of fluids and increase humidity (moisture in the air) in your home to help keep your throat moist. Herbal teas formulated for colds may help relieve symptoms.
• Get plenty of rest. Stay home the first day of antibiotic treatment. You are still contagious and might pass the infection to others. Rest in bed if you feel very sick. Bedrest is not required if you feel fine.
• Take non-prescription medicines to relieve a painful sore throat and reduce fever. Be safe with medicines. Read and follow all instructions on the label.
• Try an over-the-counter anesthetic throat spray or throat lozenges, which may help relieve throat pain. Do not offer throat lozenges to young children as they are a choking hazard. If your child is younger than age 2, ask your doctor if you can give your child numbing medicines.

For more information on non-prescription medicines and other ways to relieve sore throat symptoms, see the topic Strep Throat: Home Treatment.

For the first 24 hours after you start taking an antibiotic, you are still contagious. You can avoid passing the strep throat infection to others and reinfecting yourself by:

• Avoiding sneezing or coughing on others.
• Washing your hands often.
• Using tissues you can throw away, not handkerchiefs.
• Using a new toothbrush as soon as you feel sick. Replace it again when you are well. You can also clean your toothbrush well before using it again. Bacteria can collect on the bristles and reinfect you.

Medications

Antibiotics are the treatment of choice for a confirmed strep throat infection.

• Antibiotics will reduce the time you are contagious. You are usually not contagious 24 hours after starting antibiotics.
• Antibiotic treatment for strep throat can also help prevent some of the rare complications related either to the strep infection itself or to the body’s immune response to the infection. Complications of strep throat are rare but can occur, especially if strep throat is not properly treated.
• Antibiotics may shorten the time you are sick by about one day.

When antibiotics may be used

Antibiotics may be used in the following situations:

• You have had a positive rapid strep test or positive throat culture.
• You have three or more of the following signs or symptoms:
  • A recent fever
  • White or yellow spots or coating on the throat or tonsils
  • Swollen or tender lymph nodes on the neck
  • Absence of signs of a cold or other upper respiratory illness, such as coughing or sneezing
• You have recently had rheumatic fever and have been exposed to strep. Preventive antibiotics may be given in some cases.
• Several family members are having repeated strep infections as confirmed by positive throat cultures.

It is possible for you to carry the strep bacteria in the throat and not have any symptoms. Antibiotics for the carrier state are usually not needed unless you have a history of rheumatic fever or frequent infections or infections are occurring frequently in the family.

For more information, see:

Medicine choices

Antibiotics such as amoxicillin, cephalexin, or penicillin are used to treat strep throat infection.

What to think about

Immediate treatment with an antibiotic after a positive rapid strep test may not make you well faster. But it will shorten the time you are able to spread the disease to others. Antibiotics also lower the risk of the infection spreading to other parts of your body. But there is no harm in delaying medicine treatment 1 to 2 days to wait for the results of a throat culture. Antibiotics will prevent rheumatic fever even if it is started up to 9 days after symptoms begin.

Surgery

If strep throat continues to recur, you and your doctor may decide that you need surgery to remove the tonsils (tonsillectomy). Surgery is considered when you:

• Have recurring episodes of strep throat or tonsillitis in a single year despite antibiotic treatment.
• Have abscesses around the tonsils that do not respond to drainage, or if an abscess is present in addition to other signs that you may need tonsillectomy.
• Have persistent bad odour or taste in the mouth, which is caused by tonsillitis that does not respond to antibiotics.
• Need a biopsy to evaluate a suspected tumour of the tonsil.

Large tonsils are not an indication for tonsillectomy unless they are causing one of the above problems or they are blocking the upper airway, which can cause sleep apnea or problems with eating.

Surgery choices

Tonsillectomy may be done in some cases of strep throat.

An abscess around the tonsils (peritonsillar abscess) may be treated with a simple procedure in which a small incision is made to drain the abscess, although removing the tonsils is appropriate in some of these cases.

What to think about

Tonsillectomy is no longer routine for children who have frequent sore throats. Surgery has been shown to reduce the number of throat infections for 2 years. But over time many children who did not have surgery also had fewer throat infections.^{footnote 1}

When you are trying to decide whether to have your or your child’s tonsils removed, consider:

• How much time you or your child is missing from work or school because of throat infections.
• How much stress and inconvenience the illness places on the family.

The risks of surgery must also be weighed against the risks of leaving the tonsils in. In some cases of persistent strep throat infections, especially if there are other complications, surgery may be the best choice.

References

Citations

1. Baugh RF, et al. (2011). Clinical practice guideline: Tonsillectomy in children. Otolaryngology–Head and Neck Surgery, 144(IS): S1–S30.

Other Works Consulted

• American Academy of Pediatrics (2015). Group A streptococcal infections. In LK Pickering et al., eds., Red Book: 2015 Report of the Committee on Infectious Diseases, 28th ed., pp. 616–628. Elk Grove Village, IL: American Academy of Pediatrics.
• American Heart Association (2009). Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis: A scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on the Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics. Circulation, 119(11): 1541–1551.
• Kenealy T (2014). Sore throat. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/pdf/clinical-evidence/en-gb/systematic-review/1509.pdf. Accessed March 21, 2014.
• Wessels MR (2011). Streptococcal pharyngitis. New England Journal of Medicine, 364(7): 648–655.
• Wessels MR (2015). Streptococcal infections. In DL Kasper et al., eds., Harrison’s Principles of Internal Medicine, 19th ed., vol. 2, pp. 963–971. New York: McGraw-Hill Education.

Credits

Adaptation Date: 7/24/2020

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

Strep Throat Treatment: Do You Need an Antibiotic?

Exposure to too many antibiotics can lead to antibiotic resistance, a problem that causes 23,000 deaths each year, according to the Centers for Disease Control and Prevention (CDC). Resistance is when bacterial growth can no longer be controlled or killed by an antibiotic.

“People should hope that their doctor does not prescribe an antibiotic,” says Aaron Glatt, MD, the chairman of medicine at South Nassau Communities Hospital in Hewlett, New York, and a spokesperson for the Infectious Disease Society of America. “They also shouldn’t expect a prescription every time they visit their doctor.”

Glatt says that people need to change the way they think about doctor visits. They should go to a doctor for a diagnosis and a recommendation on how to treat an illness, not to always walk away with a prescription in hand.

It’s also important to remember that antibiotics can have side effects, and patients may even have allergic reactions to them. Antibiotics can also be expensive, especially if you do not have insurance and have to pay with cash, says Dr. Glatt.

“It has to be the right person, the right time, and the right drug,” said Glatt.

“There’s a lot of overdiagnosis for strep throat that leads to overtreatment,” says Stanford Shulman, MD, one of the authors of the 2012 guidelines for strep throat diagnosis and treatment by the Infectious Diseases Society of America (IDSA).

Dr. Shulman, a doctor at the Ann and Robert H. Lurie Children’s Hospital and a professor at Northwestern University’s Feinberg School of Medicine in Chicago, says there’s some confusion over the diagnosis of group A strep throat. Often, a large number of people who are carriers of the bacteria don’t need to be treated. And a sore throat doesn’t automatically mean you have a strep infection.

A patient may come in with a sore throat along with cold symptoms, such as a cough, runny nose, pink eye, or a raspy or strained voice. With those symptoms, it’s more likely he or she has a viral infection, for which an antibiotic would be useless.

How to Know When Antibiotics Are Necessary

Strep throat is common in children because it’s easily spread through a sneeze, cough, or sharing food, among other ways. Watch out for these symptoms:

• A fever
• Sore throat that causes pain when swallowing
• Swollen tonsils with pus
• Absence of cough
• Swollen lymph nodes

Some children may feel nauseated, have a headache or a stomachache, or vomit. A number of children with these symptoms may have scarlet fever, a fever accompanied by a rash.

Doctors have to be selective about testing for strep throat, says Shulman. Strep throat is not diagnosed just by symptoms: There are two tests used to confirm it. The doctor or medical professional takes a throat swab, called a rapid strep test, or a throat culture. If the test comes back positive for the bacteria, then the doctor will usually prescribe an antibiotic.

But strep throat is a self-limited disease that will go away on its own, says Shulman. Antibiotics are not prescribed to treat strep itself, but to prevent serious complications, such as rheumatic fever. Also, after the initial 24 hours of taking antibiotics, people can go back to work or school because they’re not considered contagious anymore, though their symptoms may take a little longer to subside.

“Patients should actually ask if they really need to take an antibiotic,” says Waldetoft. “Over here [in Sweden] we are very concerned with antibiotic resistance and try to use narrow spectrum antibiotics whenever we can.”

Narrow spectrum antibiotics, which the authors of the review recommend for treating certain cases of strep throat, are limited in the number of bacteria targeted and will not affect as many of the normal bacteria in the body. The IDSA guidelines recommend narrow spectrum antibiotics such as penicillin. Penicillin is the treatment of choice, and strep bacteria hasn’t been found to be resistant to it. (Waldetoft shared that his research did find that penicillin isn’t effective in urinary tract infections because of bacterial resistance.) Amoxicillin is considered to be a broader spectrum antibiotic, so it will kill more bacteria than penicillin.

Right now, total elimination of antibiotics for treatment of strep throat is not an option, because there are no real replacements. But it is well worth considering alternatives, because there are other consequences of antibiotic overuse for people down the line, says Waldetoft.

In the meantime, we wait for government agencies and pharmaceutical companies to develop alternative therapeutics. The World Health Organization (WHO) has a number of programs that address antibiotic resistance. By 2023, it aims to develop new treatments through the enhancement of existing antibiotics and development of new antibiotic drugs.

If someone feels ill he or she should definitely consult a doctor. The important thing is not to expect or demand an antibiotic every time you get a sniffle — and never, ever, try to self-medicate with antibiotics.

“Antibiotics are wonderful when they are needed,” says Shulman. “We don’t want to overuse them.”

How long does strep throat last? Duration and treatment.

Once a person has contracted the group A Streptococcus bacteria, they can become ill after roughly 2–5 days. A person will begin to feel better after taking antibiotics for 1–2 days.

According to the Centers for Disease Control and Prevention (CDC), if a person is not feeling better after taking antibiotics for 48 hours, they should see a doctor.

This article discusses the most important information about strep throat, including how long it lasts and how long someone is contagious.

We also discuss treatments, symptoms, causes, diagnosis, ways to prevent it, and when to see a doctor.

Share on PinterestAfter 1–2 days of taking antibiotics, a person with strep throat should start to feel better.

The incubation period for strep throat is 2–5 days. In this time, a person could pass the bacteria on.

The CDC recommend that people with strep throat should stay home until they are fever-free for at least 24 hours and have been taking antibiotics for at least 1 day.

People who do not receive treatment can remain contagious until they are better. However, most people require antibiotics to recover.

People with strep throat require medical treatment to get better and reduce the risk of serious complications. However, the CDC state that those who do not test positive for strep throat do not need to take medication.

It typically takes a day or two for someone with strep throat to start feeling better after starting antibiotic treatment.

Call a doctor if symptoms do not begin to lessen 48 hours after starting antibiotics.

A doctor will typically prescribe antibiotics to treat strep throat, usually penicillin or amoxicillin.

The CDC state that in most cases taking antibiotics reduces:

• the length of time someone is sick
• symptom severity
• the chance of spreading it to others
• the chance of complications

Even though someone may start to feel better within a day or two of starting antibiotic treatment, always take antibiotics exactly as prescribed.

Do not stop taking antibiotics early, as doing so might lead to more severe infections or complications.

Several at-home remedies may also help soothe a sore throat, most of which focus on keeping the mouth or throat moist and avoiding irritants. According to the National Institutes of Health News In Health, remedies include:

• drinking plenty of clear fluids
• sucking on hard candies or throat lozenges
• eating a popsicle or other frozen treats or cold liquids
• over-the-counter (OTC) medicated throat sprays with numbing or cooling compounds
• OTC pain medications, such as ibuprofen or acetaminophen
• avoiding food or drinks that are too warm or spicy
• avoiding smoking or inhaling secondhand smoke

The CDC indicate that the most common symptoms of strep throat are a painful sore throat that can come on very quickly and red, swollen tonsils.

Other common signs of strep throat include:

• a fever
• tiny, red spots on the roof of the mouth, often with white patches or pus streaks
• pain during swallowing
• swollen lymph nodes, often in the front of the neck
• stomach pain
• nausea or vomiting
• a headache
• skin rashes associated with scarlet fever

Strep throat is a bacterial infection that occurs due to a bacteria called Streptococcus pyogenes (S. pyogenes).

S. pyogenes belongs to a group of bacteria that grow in chains of spherical cells called group A Streptococcus.

According to a 2020 article, strep throat causes approximately 5–15% of sore throats in adults and 20–30% of cases involving children.

The CDC state that group A strep bacteria typically live in the throat and nose and spread through tiny droplets of infected mucus or moisture.

Even people who are not experiencing symptoms can spread the bacteria.

Most people become exposed to infectious mucus droplets by:

• breathing them in
• touching things contaminated with them and then touching the nose or mouth
• touching skin sores caused by other group A bacteria
• drinking from the same glass or straw, eating from the same plate or sharing food, using the same utensils

To diagnose strep throat, a doctor will examine someone’s mouth, throat, neck, and nose and ask them about their symptoms.

A doctor will probably ask if someone has come into contact with others with strep throat.

But the only way to definitively diagnose strep throat is to run a rapid strep test. This test involves a doctor running a swab along someone’s throat and then testing the sample using methods that detect strep bacteria within minutes.

In some cases, a doctor may also perform a throat culture, which involves culturing throat samples from a swab for a day or two.

According to the CDC, strep throat is more common in children, typically aged 5–15 years old.

Although it is more common in children, adults who may be more likely to contract the bacteria are parents of children who go to school or are in contact with children.

The best way to reduce the risk of getting strep throat is to avoid exposure to infected droplets.

According to the CDC, common prevention methods include:

• washing the hands frequently for at least 20 seconds or use an alcohol-based sanitizer
• avoiding touching the nose, mouth, or face
• avoiding contact with people who have contagious infections
• washing glasses, plates, utensils, and other items after someone with strep throat has used them or come into contact with them

People with strep throat can also reduce the risk of spreading it to others by:

• taking antibiotics
• washing their hands frequently, especially after coughing or sneezing or before preparing or eating food
• coughing or sneezing into a tissue of the upper elbow or shirt sleeve, not the hands
• placing used tissues into the trash can or garbage
• staying home when symptomatic
• avoiding sharing food and drinks, plates, utensils, or glasses with others

Complications are uncommon. However, if the bacteria spread to other parts of the body, a person can develop:

If a person develops symptoms or they know that they have come into contact with the bacteria, they should talk to a doctor as soon as possible.

Also, talk to a doctor about severe sore throats, or those that do not get better after a few days.

People should also talk to a doctor when swollen lymph nodes or a high fever accompany a sore throat.

The CDC state that most people with a sore throat have a viral infection, although strep throat accounts for 5–15% of sore throats in adults and 20–30% of sore throats in children.

Most people with strep infections start to feel better a few days after starting antibiotics. And many people with strep throat are contagious as long as they are sick, though taking antibiotics typically lowers this risk significantly within 24–48 hours.

People who think they have strep throat should talk with a doctor as soon as possible to get proper treatment and prevent complications.

Home Remedies for Strep Throat Symptoms

The scratchy, burning pain of a sore throat can make life miserable. From sipping water to answering the phone, everyday tasks are suddenly painful challenges.

While it’s common to think you may have strep throat, the bacterial infection can only be diagnosed by a throat swab test.

If you test positive for strep, it’s important to take any prescribed medications, including antibiotics, as not doing so can lead to serious health complications such as rheumatic fever or heart murmurs.

It usually takes only a day or two after starting antibiotics to feel better, but in the meantime, there are some things you can do to help ease the symptoms, including some quick and easy home remedies for strep throat.

What Causes Strep Throat

Strep throat, also known as streptococcal pharyngitis, is caused by bacteria called group Astreptococcus, or Streptococcus pyogenes, which can seed the nose and throat.

You can get the infection from someone who is sick with strep, as it spreads through close contact with saliva.

Symptoms, which include fever, sore throat, red tonsils, and enlarged lymph nodes in the neck, typically begin one to three days after exposure and last seven to 10 days.

How to Test for Strep Throat at Home

The only way to know definitively if you have strep throat is through a rapid strep test administered by your doctor or at your nearest GoHealth Urgent Care. And while home strep tests are available, they aren’t 100 percent accurate and can produce false negative results.

You can examine your throat for signs of infection by looking in the mirror and saying, “Ahhh.” If you see white dots or patches in the back of your throat, or your tonsils are red and swollen, you may have strep throat and should see your doctor or go to your local GoHealth Urgent Care.

Home Remedies for Strep Throat

Sore throat is not the same as strep throat, as strep is a bacterial infection, yet many sore throat remedies can also help ease the symptoms of strep throat.

In addition to getting plenty of rest and drinking lots of water, you can try the following home remedies, which are aimed at killing the bacteria that causes strep throat. Keep in mind, however, the only way to cure strep throat is with antibiotics.

Supplements

• Elderberry has antibacterial and antiviral effects and has shown to protect against the risk of upper respiratory disorders and virus- and bacteria-induced respiratory infections on flights. Elderberry is available as a tea, and in capsule, powder, or liquid form.
• Echinacea is best known for its ability to prevent the common cold, but research suggests it may also stop the spread of bacterial conditions like strep throat. Echinacea’s anti-inflammatory properties can also help relieve pain related to strep throat. Take echinacea in liquid form, as a tea, or in capsule form as soon as symptoms appear.
• Vitamin C can boost your immune system as well as kill infections already in your body. If you have strep throat, boost your vitamin C consumption by taking a supplement and eating foods rich in vitamin C like oranges, kale, strawberries, grapefruit, and kiwi.
• Vitamin D deficiency has been linked to respiratory infections, and research has shown it plays an important role in the immune system.

Foods

• Raw honey raises antioxidant levels in the body, which helps boost the immune system, and its consistency has long been used to ease sore throats. Studies have found that medical-grade honey can fight some of the bacteria that cause infections.
• Bone broth can keep you hydrated when a sore throat makes it difficult to swallow other foods. It also provides minerals that boost the immune system and help reduce swelling and pain. Drinking warm bone broth made from protein powder throughout the day can help ease the symptoms of strep throat.
• Herbal tea for strep throat can help ease pain and treat inflammation. Chamomile tea has antioxidants that help reduce pain, congestion, swelling, and redness, while dandelion tea may help fight infection while boosting your immune system.
• Apple cider vinegar has powerful healing compounds such as acetic acid, which can kill harmful bacteria while promoting the growth of beneficial bacteria.
• Warm comforting drinks also help soothe symptoms while being gentle on sore throats.

Essential Oils

• Peppermint oil can reduce swelling in the throat, while its naturally occurring menthol provides a cooling and calming sensation. Mix 1 to 2 drops of peppermint oil in a glass of water and drink it or apply 1 to 2 drops to the skin around your throat, chest, and temples.
• Lemon oil has antibacterial properties and has been shown to limit the growth of antibiotic-resistant bacterial strains. Add 1 to 2 drops to a glass of water or herbal tea.
• Thyme oil is a common home remedy for strep throat symptoms. Research has shown it’s effective in killing bacteria taken from patients with oral and respiratory infections. Add 1 to 2 drops of thyme oil to a glass of water and gargle or add thyme oil to your bath for relief of body aches.  

Other Things to Try

• Gargling with Himalayan salt can soothe a sore throat, reduce painful swelling, and kill bacteria present in your mouth. The salt’s antibacterial properties are also known to improve respiratory conditions. Mix 1/4 teaspoon (1.42 grams) of table salt in 8 ounces (237 milliliters) of warm water. Be sure to spit out the liquid after gargling.
• Oil pulling has been shown to reduce the presence of strep bacteria and other toxin in the mouth. Swish 1 to 2 tablespoons of coconut oil in your mouth for at least 10 minutes, then spit it out, rinse your mouth, and brush your teeth.

Will Strep Throat Go Away on Its Own?

Strep throat typically goes away in three to seven days with or without antibiotic treatment. However, if you don’t take antibiotics, you can remain contagious for two to three weeks and are at a higher risk for complications, such as rheumatic fever.

What’s more, complications resulting from the bacterial infection can lead to increased susceptibility to other viral infections like influenza which can be fatal.

If you have been diagnosed with strep throat, you can help prevent repeat infections by changing your and your families’ toothbrushes and thoroughly disinfecting all surfaces that may have been in contact with the strep virus.

If these at-home remedies don’t help alleviate your sore throat symptoms after 48 hours, you can book an appointment online with us; the widget below will help you find the GoHealth Urgent Care center nearest you.

See our prices on co-pays and same-day visits, with and without insurance.

GoHealth Urgent Care partners with these regional healthcare providers:

Strep Throat (Bacterial): Symptoms, Diagnosis and Treatment

There are two different germs that cause sore throats: viruses and bacteria. Most sore throats are caused by viruses. The one that comes on suddenly is caused by bacteria (germs) called “strep,” short for streptococci (strep toe KAW ki). If untreated, it can lead to complications and be spread to others.

Strep throat is contagious (can be spread to others). The strep bacteria hang out in the nose and throat. When the infected person coughs, sneezes or talks, the germs go into the air. The germs are then breathed in or caught by touching something that the germs are on (contaminated). Strep throat is most common in school age children but anyone can be infected with strep.

Antibiotic medicine must be given as soon as possible to prevent the strep germs from spreading in the body. The bacteria can cause damage to the kidneys or to the heart (Rheumatic fever). Rheumatic fever can cause painful and swollen joints, a specific type of rash, or harm the heart.

There are some people with strep who should not be given antibiotics. Strep bacteria can sometimes live on children’s throats without causing illness. As many as 1 in 5 children are “strep carriers.” This means that they have no symptoms, they are not contagious and their throat strep test stays positive even after taking antibiotics. If your child gets a sore throat and you know that he or she is a strep carrier, the doctor will treat it like a virus.

Symptoms

A child with strep throat, may have some or all of these symptoms:

• Sore throat, especially when swallowing
• Bright red, swollen tonsils, sometimes with white patches or streaks of pus
• “Strawberry” look to the tongue or tiny red spots on the back roof of the mouth
• Fever
• Swollen, tender glands in the neck
• Headache, irritability or fussiness
• Sleeping more than usual
• Poor appetite, nausea or vomiting, especially in younger children
• Pain in the abdomen (tummy)
• A red rash on the body that “feels like sandpaper.” It may appear 12 to 48 hours after the first symptoms. This is known as scarlet fever or scarlatina.

When a child has a cough, hoarseness, red eyes and runny nose, it may be due to a virus, the flu or a different illness rather than strep.

Diagnosis

The health provider will examine your child, check for signs and symptoms and do a strep test.

A sample will be taken from the throat and tested. Two cotton-tipped swabs will be swiped over the back of the throat and tonsils. This should not hurt but may cause your child to gag. The lab will do one or more tests on the sample.

• Rapid strep test screen (rapid antigen test): The test usually takes up to half an hour. You will be asked to wait until the test results are read. A “positive” test means your child has strep throat caused by bacteria. If the rapid strep test screen is negative and the doctor still suspects strep, a follow-up test will be done.
• Second test to confirm the rapid strep test: Your child will not need another throat swab done for a follow-up test. The same sample will be tested in a different way to confirm the result of the rapid strep test. If the second test is positive, you will be notified the next day so that your child can be treated with antibiotics. A negative test means the sore throat is likely caused by a virus and does not need antibiotics.

Strep carriers do not need to have repeated strep tests done. Doing throat swabs on children who are strep carriers may cause them to take antibiotics that they do not need.

Treatment with Antibiotics

A positive strep test must be treated with antibiotic medicine within a few days to prevent the germs from causing problems. Antibiotics are not given to strep carriers or to treat viruses because and they will not be effective. Antibiotics can have side effects such as diarrhea and rash.

Antibiotic medicine is usually taken by mouth but may be given by injection. Your child should start feeling better within a day or two.

It is very important to take all the medicine for ten days, as ordered, even after starting to feel better (Picture 1). When antibiotics are not used correctly (such as taking too much, missing doses or not finishing a prescription), some bacteria can develop resistance. Resistance can make infections very hard to treat. Sometimes they cannot be treated at all.

If your child is allergic to penicillin, be sure to tell the doctor. Another medicine will be prescribed.

Comfort and Care

• If your child has a fever or throat pain, give acetaminophen (such as Tylenol®) or ibuprofen (Advil®, Motrin®) as directed. Read the label to know the right dose for your child. Do not give aspirin or products that contain aspirin.
• Give your child lots of liquids, such as water, Pedialyte®, apple juice or popsicles. Give small amounts of liquid often.
• Give soft foods that are easy to swallow, such as applesauce, mashed potatoes, hot cereal or eggs. Your child may not want to eat much if it hurts to swallow.
• To soothe a sore throat offer:
  • For children over age 1, warm fluids such as chicken broth or apple juice
  • For children over age 4, throat or cough lozenges or throat sprays. Read the label to know the right dose for your child. Do not use throat sprays that contain benzocaine, as this could cause a drug reaction.
  • For children over age 6 who are able to gargle without swallowing, a mixture of ½ teaspoon of table salt in 8 ounces of warm water. Swish and gargle the mixture 2 to 3 times a day for the next few days. Do not let your child swallow the salt water; have him spit it out.

How to Protect Others

• Everyone should wash hands often with soap or hand sanitizer. Good handwashing prevents the spread of infection.
• Cover the mouth when coughing or sneezing. Give your child a paper bag and have him put his used tissues in the bag. Moisture from the child’s nose and mouth is contagious.
• Do not share drinking cups or eating utensils.
• Throw away your child’s toothbrush and buy a new one as soon as the illness is over. (Strep throat germs may still be on your child’s toothbrush.)
• Keep your child away from others for 24 hours after the medicine is started and until he has no fever.
• Tell the school nurse and your child’s teacher that your child has strep throat. It is important for school personnel to know so that other parents can be told to watch for symptoms in their children.
• If anyone in the family gets a sore throat, he should be checked by a doctor to see if medical treatment is needed.

When to Call the Doctor

Your child:

• Has a fever more than 102˚F that lasts more than 2 days after taking an antibiotic
• Has a sore throat that lasts more than 3 days after taking an antibiotic
• Develops a rash or diarrhea after taking antibiotics
• Starts drooling, cannot talk or voice becomes muffled

When to Return to School or Daycare

Your child should stay home from school or childcare until he has taken antibiotic medicine for 24 hours and has no fever.

Strep Throat – Bacterial (PDF)

HH-I-122 11/89, Revised 10/17 Copyright 1989, Nationwide Children’s Hospital

Strep Throat

Bacterial Throat Infection

Pharyngitis is an inflammation of the pharynx, the area in the back of the throat. This inflammation causes the symptom of a sore throat. Although most infectious causes of sore throat are due to viruses, about 5% to 10% of pharyngitis cases result from a bacterial infection. Since the bacteria most often responsible for bacterial pharyngitis is a strain of Streptococcus bacteria, bacterial throat infections are referred to as strep throat. Strep throat is most common in young children between ages 3 and 15, but it can occur in anyone. Strep throat bacteria are spread easily from person to person in close-contact settings, such as schools, households, or day care centers. Classic symptoms of a step throat include a painful sore throat, difficulty swallowing, fever, swollen neck glands, nausea, and headache. Upon examination, a strep throat appears red, often with white or yellow dots or streaks, tiny red dots on the upper palate, and swollen tonsils. Since a definitive diagnosis cannot be made by symptoms and examination alone, a swab of the throat area is used to detect a bacterial infection using a rapid strep test, followed by a culture if the rapid test is negative.

If the throat swab test or culture is positive, an antibiotic is prescribed to stop the infection from spreading and to prevent complications. Although unusual, an untreated strep throat can lead to a sinus or ear infection, abscess of the tonsils, scarlet fever, or more serious complications, such as kidney disease (glomerulonephritis) or heart disease (rheumatic fever). After 24 hours of antibiotic therapy, patients with strep throat are no longer considered contagious and can return to school or work if they have no fever. Most cases of strep throat respond quickly to antibiotic therapy, but patients must finish the entire course of medication to avoid the bacteria from returning. If a strep throat returns after appropriate treatment, the source of Streptococcus may be a close contact (who may or may not have symptoms), or the antibiotic was not effective.

Most Infections Respond Quickly to Antibiotics

The symptoms of strep throat include a severe sore throat, especially when swallowing, along with a fever, swollen glands in the neck, headache, and nausea. Sore throats accompanied by cold or flu-like symptoms, such as nasal congestion and cough, are typically caused by a virus, and antibiotics are not effective to kill viruses. To avoid the unnecessary use of antibiotics and development of resistance to antibiotics, the diagnosis of a bacterial infection should be made before antibiotics are prescribed. This diagnosis is based on a history of symptoms, a physical examination, and a positive laboratory test or culture for Streptococcus bacteria.

Treating Strep Throat:

Antibiotics are the appropriate treatment for strep throat since they stop the further spread of bacteria, reduce the risk of spreading the infection to other areas of the body, and help prevent serious complications. There are many antibiotics used in the treatment of strep throat, including oral penicillin VK or injectable penicillin G, amoxicillin or amoxicillin-clavulanate, cephalosporins, and macrolides. Factors to consider in the choice of antibiotic include the sensitivity of the bacteria to the antibiotic, patient allergies, how often the antibiotic must be taken, taste, and cost. Antibiotics that must be taken three or four times daily for seven to 10 days are more complicated to take correctly than those taken less often for a shorter period. The taste may also have a big impact on how likely the patient is to finish an oral liquid antibiotic. The cost of the prescription may be an important consideration for some families. Even the side effects, such as the risk of diarrhea, can be a big factor in choosing the best antibiotic for a particular patient.

Acetaminophen or ibuprofen is appropriate to treat a fever, but aspirin should not be used in children and teens due to the risk of Reye’s syndrome. Nonprescription lozenges and sprays may help soothe a sore throat, and saltwater gargles are effective in reducing sore throat pain.

Potential Complications:

If left untreated or inadequately treated, Streptococcus pharyngitis can spread to surrounding tissues, causing sinus or ear infections. Some Streptococcus strains can produce a toxin that causes a scarlet fever rash. More serious complications include rheumatic fever (joints become inflamed and heart valves become damaged) and glomerulonephritis (an inflammatory condition of the kidney tissue that can lead to chronic kidney problems). If symptoms of painful or swollen joints, shortness of breath, rash, or dark-colored urine are seen after strep throat, the doctor should be notified immediately, even if the patient has been treated with an antibiotic.

Preventing the Spread of Infection:

Since Streptococcus bacteria are highly contagious through saliva and nasal secretions, prevention of the spread of strep is similar to viral cold or influenza prevention. This includes hand washing and covering the mouth and nose when coughing or sneezing. Patients should not return to school, day care, or work until they are no longer contagious and have no fever, usually 24 to 48 hours after beginning antibiotics. It is important to finish the entire course of antibiotics even if symptoms disappear, so the infection does not return. If strep throat returns after treatment with antibiotics, there may be close exposure to a strep carrier, a person who carries the Streptococcus bacteria in the throat but has no symptoms of a strep infection. In these cases, it is appropriate to treat the strep carrier to stop recurring infections. Otherwise, strep carriers do not require antibiotics, since they are not at risk of strep infection complications. Streptococcus bacteria can also remain alive on objects such as a toothbrush for several days, so replacing a toothbrush after 24 to 48 hours of antibiotic therapy and thoroughly cleaning orthodontic retainers every day can prevent patients from reinfecting themselves.

90,000 Does the removal of tonsils affect the immune system?

Today, one of the medical issues that causes a lot of controversy is the removal of tonsils (tonsils). Is it worth it or not?

The correspondent of the newspaper “Kazanskie Vedomosti” spoke about this with Boris Revzin, an otorhinolaryngologist of the highest category of the ENT center of the city clinical hospital №16.

– Boris Arkadievich, in what cases does the question of removing tonsils arise?
– Very often we remove tonsils when conservative treatment of chronic tonsillitis is ineffective.Chronic tonsillitis is a prolonged inflammation of the pharyngeal and palatine tonsils, often accompanied by inflammation of the pharyngeal mucosa. If a person has frequent angina (more than twice a year), we first carry out conservative treatment. First of all, the patient is examined for microflora and its sensitivity to various drugs (for this, a swab from the throat is taken). Further, washing the lacunae of the palatine tonsils is prescribed to cleanse them from caseous plugs, massage of the palatine tonsils.And if this treatment does not give a result – namely, long-term remission, then in such a situation it is possible to carry out tonsillectomy – an operation to remove the tonsils.

We also carry out this operation if complications appear in the form of associated diseases in chronic tonsillitis: rheumatoid arthritis, endocarditis, inflammatory autoimmune diseases of the thyroid gland, chronic inflammatory kidney diseases.

An absolute indication for the removal of tonsils is such a complication of angina as a paratonsillar abscess.This is an acute inflammation in the periaminal fiber, a severe purulent lesion of the oropharynx. It occurs when a sore throat is not properly treated, when, for example, a person does not take antibiotics or takes them incorrectly. Or in the absence of treatment for the disease.

– And how does the removal of the tonsils solve the problem of frequent sore throats?
– In cases where there are indications for tonsillectomy. The tonsils are a source of chronic infection for the body. Microbes live in their gaps and caseous plugs are formed: waste products of these microbes, desquamated epithelium and food debris.Sometimes the tonsils, by their very structure, are very loose, with dilated lacunae. In this case, food debris will often get stuck in them, which can lead to their chronic inflammation.

In addition, if antibodies begin to be produced against the causative agent of inflammation streptococcus, then after a while they attack the body’s own cells and tissues. Thus, here we are already dealing with the autoimmune nature of the disease, affecting the tissues of the heart, kidneys, liver, and thyroid gland.

– Why does the question of removing tonsils cause a lot of controversy and there is no consensus among doctors about whether the patient needs to decide on this step? What do you think about this?
– There is often a lot of conflicting information about tonsillectomy in the media and on the Internet. This may be due to the fact that earlier, in the 1970s and 1980s, tonsils were removed very often, which did not always give the desired result. Now we are carefully examining the patient before referring him for tonsillectomy.Before this step, you need to determine if there are any other causes of tonsil disease. Maybe the glands are suffering from upper airway problems, such as deviated septum with delayed nasal breathing, and so on. Or, as often happens in the case of pharyngotonsillitis, the development of a chronic disease is triggered by the Helicobacter bacterium, which causes diseases of the gastrointestinal tract.

– What are the contraindications for this operation?
– Absolute contraindication – blood diseases.Because with tonsillectomy, there may be profuse bleeding. And relative contraindications are gross somatic pathology: myocardial infarction, angina pectoris, severe heart and renal failure, high degree of hypertension, severe diabetes mellitus, active tuberculosis. Do not remove tonsils during menstruation, in the last months of pregnancy and in case of an acute infection. The operation is carried out no earlier than two to three weeks after a sore throat, flu or other illness.

– Can the removal of tonsils lead to a decrease in immunity? After all, they are part of the human immune system …
– No, you don’t need to be afraid of that. First, we do not remove all of the lymphoid tissue. There is lymphoid tissue both at the root of the tongue and in the nasopharynx. The tonsil is also part of the immune system. After removing the tonsils, they take over the function of the tonsils. Secondly, there is still no benefit from diseased tonsils: they do not protect a person from infection, but they themselves are its source and poison the body.

– Is it true that after such an operation a person’s voice can become quieter?
– No, her voice does not become quieter, except perhaps for the first time after the operation.

– Are the tonsils removed under general anesthesia?
– Tonsillectomy is performed under local and general anesthesia. When choosing it, we look at the general picture, the severity of the pharyngeal gag reflex. Because of it, not every patient can, in principle, have this operation without anesthesia.Therefore, if a person has a pronounced gag reflex, it is, of course, more advisable to carry out tonsillectomy under general anesthesia. Many patients themselves want to have this operation performed under general anesthesia.

– How is tonsillectomy performed?
– The operation lasts from 30 minutes to an hour, depending on the severity of bleeding. This is a surgical operation that uses a radio wave scalpel. This state-of-the-art radio wave equipment can reduce bleeding.It is also used after direct excision of the tonsils, when it is necessary to cauterize the bleeding vessels at the site of the removed organ. The radio wave coagulator does this superficially without causing severe burns.

By the way, I want to note that tonsillectomy is not the only type of operation on the tonsils. There is also a tonsillotomy (partial removal of the tonsils), which is usually done in children if the tonsils are enlarged. And lacunotomy – when, after washing the tonsils, incisions are made on them with a radio wave scalpel, in order to seal the grooves in the tonsils in this way, preventing the accumulation of microbes in this organ and the formation of plugs in it.

– Is a lacunotomy an alternative to removing tonsils?
– No. Rather, an intermediate stage between conservative treatment and tonsillectomy. Unfortunately, this method is not as effective as removing tonsils. Perhaps its use for cysts of the palatine tonsils.

Does the removal of tonsils require hospitalization? And if so, how much time does the person spend in the hospital?
– In the absence of any postoperative complications, patients stay in the clinic for two to three days.But even after discharge, we keep in touch with them, just in case. On the first day after the operation, the patient should not talk and eat.

In the following days, in this case, a sparing diet using mainly liquid food is required. Within two weeks after tonsillectomy, the patient should limit physical activity, do not lift weights, do not go to the bathhouse and sauna, and follow a diet.

– Do you have a lot of patients for whom you remove tonsils?
– We carry out about three or four such operations per week.Many do not want to part with the tonsils and go to the lavage ad infinitum.
I would like to add that if there are indications for tonsillectomy, it is better to do it at a young age, when the body can tolerate the operation more easily and have not yet had time to develop complications in the form of associated diseases.

90,000 Who needs to remove tonsils and why

What are tonsils

Glands are outgrowths of tissue in the back of the mouth that contain clumps of cells of the immune system. The correct anatomical name for the tonsils is the palatine tonsils.

Why are tonsils needed

The tonsils are just a small part of the lymphoid tissue system scattered throughout the body. Tonsil-like masses are present in the back of the nose, on the back of the tongue, and in the small intestine.

The tonsils are involved in the fight against infections, but do not play a special role in this process. That is, after the glands are removed, the person will not get sick more often, since the rest of the immune system will continue to function normally.

Who needs to remove tonsils

Inflammation of the tonsils is called tonsillitis or tonsillitis. For unknown reasons, some people get sore throat often and severely.

Tonsillectomy – surgery to remove tonsils – reduces the frequency and severity of tonsillitis. The only problem is that this procedure is very unpleasant, risky and expensive. Therefore, tonsillectomy should be done only if the benefits outweigh the harm.

According to current clinical guidelines ^{, it is worth removing tonsils if:}

1. During the last episode of angina, a person developed serious complications, such as jugular vein thrombosis, blood poisoning, paratonsillar abscess.
2. Sore throat each time proceeds with pronounced suppuration of the tonsils, severe pain in the throat and high fever. At the same time, the patient is allergic to various antibiotics, which makes it difficult for him to find a medicine.
3. If the child has PFAPA syndrome (episodes of sore throat recur very often, every 3-6 weeks, and are accompanied by a strong fever, sore throat, swollen lymph nodes in the neck and aphthous stomatitis).
4. The patient often suffers from angina (more than 7 times a year), and each episode is accompanied by at least one of these symptoms: a temperature above 38 ° C, a significant increase and soreness of the lymph nodes in the neck, pronounced suppuration of the glands, and the analysis for GABHS infection ^{gives a positive result.}
5. Some experts recommend removing tonsils if a child develops neuropsychiatric disorders due to a streptococcal infection. These are rare conditions, and it is not known for sure if surgery helps in such cases.
6. If it is difficult for the child to breathe at night due to the fact that the tonsils are greatly enlarged ^.
7. If a person suffers from tonsillolitis – round, foul-smelling deposits on the tonsils. Removing the tonsils may be the only long-term solution in this case.

When not to remove tonsils

Removing tonsils can cause serious complications. On the other hand, in 20-50% of patients, angina becomes more rare and milder over time. Therefore, many experts recommend delaying tonsillectomy for at least 12 months if:

1. The patient has had fewer than seven episodes of sore throat in the past year.
2. Over the past two years, a person has had fewer than five episodes of sore throat each year.
3. Over the past three years, the patient has had fewer than three episodes of sore throat annually.

Is it possible to do without removing the tonsils

If the main problem is frequent or very severe sore throats, there are almost no alternative solutions.

Symptomatic treatment ^{and antibiotics allow more or less qualitative control of rare episodes of angina, but are poorly suited if you have to be treated often or if the risk of complications is high.}

As you know, antibiotic treatment with ^{only slightly accelerates recovery from angina and does not provide complete protection against the development of purulent complications.}

Statements about the benefits of various alternative methods of treatment (use of honey, propolis, gargling, etc.) for angina are completely unfounded.

How is the operation going

For the operation, you need to go to the hospital for 1-3 days. Preoperative preparation and the procedure itself take 1–1.5 hours. The actual removal of the tonsils takes about 10-15 minutes.

The patient is sedated during the operation. This is a type of anesthesia that eliminates pain and most of the unpleasant memories, but leaves a person awake so that he can fulfill the surgeon’s requests.In children, the operation can also be performed under general anesthesia.

Many patients are allowed to go home the day after surgery.

For the patient, the most unpleasant part is the recovery period. In the first 7-10 days after the operation, the sore throat is very severe. At this time, all patients need quality pain relief. Not only medicines will help in this, but also cold food, including ice cream.

Children need extra care.Care should be taken to ensure that the child receives adequate pain relief as recommended by the doctor. In addition, it is important that the child drinks at least 1 liter of liquid per day and at least ate a little. Therefore, give the baby everything that he loves. The quantity of food during this period is more important than its quality. Well, preferably ^{, so that the food is soft, without sharp edges, cold or slightly warm.}

What complications can be

Removal of tonsils is a relatively safe operation. But sometimes complications do happen ^.

According to one observation carried out in England, approximately 1 in 34,000 surgeries ends with the death of a patient.

Severe bleeding after surgery occurs in 1–5 out of 100 patients. Other serious complications such as a fracture of the mandible, severe burns, or damage to teeth are rare.

For some unknown reason, some patients have permanent neck pain after surgery.

24 hours after surgery, the risk of severe bleeding becomes negligible.

Conclusions

There are certain clinical indications for tonsil removal. In other cases, surgery can do more harm than good.

If you were advised to remove tonsils, ask why exactly and on what result you can expect.

And read Lifehacker’s tips for making medical decisions and communicating with your doctor.

Gennady Malakhov: “Angina is a creature that needs to be strangled with pants!”

Gennady Malakhov disappeared from our television screens as suddenly as he appeared.The team of the program “ Malakhov + “, which aired on the First Channel, knocked off its feet, looking for the people’s favorite, and having found it, received a resolute refusal to return to the air. But a little time passed, and the scandalous doctor is back on TV. Now we can see him in three programs at once: “Visiting Gennady Malakhov” on “Channel 8”, “1000 little things” on channel “Russia 1” and the renewed program “Malakhov +” on Channel One ( comes out on Thursdays at 16.10).

– Gennady Petrovich, let’s start with the most important thing – your triumphant return. As far as I understand, you were persuaded. What was the most important argument?

Gennady Malakhov: To be honest, the main thing was material interest. As soon as I left, everything around me fell apart. There is even a word for this – collapse. The publishing house that published my books went bankrupt, business partners who promised millions turned out to be simple deceivers.Everything collapsed. But I did not lose heart: I wrote, published the newspaper “Malakhov Pro” , launched a website, posted more than 90 videos on YouTube … I have a lot of projects.

– As far as I understand, this mass did not bring tangible income.

Gennady Malakhov: Yes, my wife and I are still used to living much better. But nothing, resigned. After all, they lived for fifteen years in a house without comforts.

– Tell me, what is your desire today – to educate or earn money?

Gennady Malakhov: I would like to answer this question without guile.On the one hand, of course, money is needed, but on the other, the house has been built, there is a car, the children have grown up. I have a prayer on this, you write down (quickly dictates): “The Supreme Lord, the Creator of the universe, look at me with your particle, grant me strength, health, wisdom, protection, luck, material wealth and money to glorify Your name.” I need funds not to get enough food, but to raise the newspaper, the Healing Cookery project, to make Internet television work. And now there are a lot of programs on TV about health, but all of them are of some kind…

– Without a soul?

Gennady Malakhov: Yes. There are many different upstarts who have served at the institute for several years and are very proud of it. At first I was shy in front of them, and then I decided: why be ashamed, I myself am an academician of folk medicine of Uzbekistan.

– When did you manage to get this title?

Gennady Malakhov: For a long time already. I’ll tell you especially for those who think that I am generally illiterate.I graduated from high school, albeit with a C. Then I got the profession of an electrician at GPTU, which I am very proud of. Then he served two years in the army, and, which is valuable, in a sports company, where he received a master of sports. Then he graduated with excellent marks from the Moscow Institute of Physical Culture and Sports. He changed many professions, was both a refrigeration unit operator, a diver, and the head of a rescue station, by the way, an excellent position: he is his own boss and the money is normal. I could have stopped, but I moved on.

– However, you must admit that all this had nothing to do with medicine.

Gennady Malakhov: The fact is that when I started playing sports, I studied anatomy, physiology, and nutrition. So I got pretty good at this business.

– Did you often get sick as a child? Have you used any folk remedies in your family?

Gennady Malakhov: Of course. My father is a bit urban, and my mother is from the countryside, so there were a lot of recipes for every occasion.I remember drinking tea with St. John’s wort and thinking: “What a delicious herb!” They smeared seizures in the corners of the lips with earwax, sore throat was strangled with pants.

– How’s that?

Gennady Malakhov: It is believed that angina is not just a sore throat, but some kind of creature that must be strangled. The pants are wrapped around the neck, and the child is pulled up slightly on them.

– And did you use similar methods of treatment for your children and granddaughter?

Gennady Malakhov: Of course.Once we went with our daughter to swim, she was then 14 years old, a transitional age. I see, her pimples have gone down her back. Well, I say, you are rotting alive! Well, let’s drink kerosene. And I just insisted on kerosene walnuts. After a week and a half she says: “Look, dad, my back has become clean.”

– It helped! Let’s get back to your career. You started writing books while working at the rescue station. Where does so much time come from?

Gennady Malakhov: There is also a duty, not every day something happens, especially in winter: rarely anyone will fall under the ice.You sit in the landing stage and type. I had a huge thirst for knowledge about a person: anatomy, chakras, extrasensory perception. Through my friend, I took out various books and retyped them – so that knowledge would enter me not through eyes, but through hands, or rather.

– But what to do with your ill-wishers? For example, Anatoly Wasserman suggested opening a criminal case against you.

Gennady Malakhov: He doesn’t really know me. Now I will simply read the verses:

I am the measure of the universe, and the depth, and the width, and the embodiment of knowledge,

I am the root of words, the source of happiness and worlds,

I form being, my, hers, The entire universe,

I am the source of my love, which I fill the cosmos with.

This is how I live and prosper, and I will live and prosper,

Embody love and happiness.

I will fill all the worlds with this,

Where will I be, where will you be,

After all, you and I are two measures of this beauty.

– Cosmically, Gennady Petrovich! I see you are an admirer of Derzhavin’s style.

Gennady Malakhov: Do you know what I’m interested in now? What is health built from? How does a person grow into space with thoughts and actions? And also, healing with love, presence, kindness, information.My wife wonders how I write this all day without getting up. How could it be otherwise, if I am in a comfortable environment, surrounded by beautiful things, listen to pleasant music, inhale incense …

– I am not an expert, but what you are talking about resembles feng shui.

Gennady Malakhov: Yes, yes!

– You are ready to talk endlessly about health – physical and mental. Does anything else bother you in life? Painting, movies, books?

Gennady Malakhov: I enjoy reading Leo Tolstoy.

– What’s your favorite with him?

Gennady Malakhov: “War and Peace”. I liked the way he portrayed the human character. My thought has now taken an interesting turn. The Creator Himself looks at a person: how will he manifest himself, what will he achieve? Not with rags and intelligence. One must live harmoniously in the world. And then they will grab money, drive away somewhere, live there and are afraid. (Laughs.)

– You often refer to past and future lives, visited India.Admit it, are you a Buddhist?

Gennady Malakhov: Interesting question. Indeed, I have studied many teachings, but still I live in Russia, a Christian country, and our religion is no worse than others. Live and prosper! In the same India, completely different dreams are dreamed, other saints come.

– Do saints come to you in a dream?

Gennady Malakhov: And it happens. In India, for example, more and more goddesses are wearing such a crown that you think: e-mine! But at home is different.The last time, not long before my, as you say, triumphant return, I dreamed of a small icon of the Most Holy Theotokos, oozing myrrh. I reached out to her with my hand, but some force threw me to my knees. He picked it up, smeared himself – wow! No, I’m a Christian, but I respect Muslims, Buddhists, Hindus – everyone!

– As a person far from traditional medicine, I will ask, perhaps, a strange question: how to overcome an aversion to urine?

Gennady Malakhov: Very simple.We are all urine therapists: for nine months we swim in amniotic fluid – I quote from the medical encyclopedia – which is formed as a result of the work of the excretory system of the fetus. That is, in your urine. It turns out that this is the best environment for the formation of the fetus. Therefore, using it after some shocks, we recover, return to a state of comfort. And you don’t need to drink urine – it works better externally.

Interviewed by Dmitry Bykov
(Based on materials from Panorama TV)

The editors are not responsible if you decide to use the advice given in the interview.

90,000 Treatment of sore throat – causes, diagnosis and treatment

Treatment of sore throat can be carried out in different ways

Treatment of uncomplicated sore throat is carried out on an outpatient basis, at home. In the case of a paratonsillar abscess, hospitalization is necessary, its opening and suction of pus. A general practitioner is involved in the treatment of uncomplicated angina; if necessary, he can give a referral to an ENT doctor.

Indications for hospitalization

• Severe angina in young children, especially with difficulty breathing
• Angina caused by diphtheria bacillus
• Purulent complications of tonsillitis (see.Complications section)
• Complications of angina on internal organs

Medicines

Medicinal treatment of angina (tonsillitis) depends on what infectious agent it is caused by. Currently, one of the big problems is the unjustifiably widespread use of antibiotics in situations in which they are not indicated. This mainly concerns viral tonsillitis and pharyngitis, in which the presence of streptococcus has not been confirmed. Frequent and widespread use of antibiotics, in many cases without a doctor’s prescription, leads to the development of drug resistance in bacteria, and this antibiotic no longer acts on them.Due to its resistance, the bacteria spreads further and can cause not just sore throat, but serious infectious diseases.

Basic rules on how to treat tonsillitis (tonsillitis) are as follows:

• Tonsillitis caused by a virus (symptoms include runny nose, cough, hoarseness, conjunctivitis, etc.) does not require antibiotic treatment.
• Streptococcal tonsillitis always requires antibiotic treatment, since it has the likelihood of complications in internal organs and joints.
• Penicillin antibiotics are most suitable for the treatment of streptococcal tonsillitis and pharyngitis. Other options than treating sore throat (tonsillitis) caused by streptococcus can be first-generation cephalosporins and macrolides, they are used in case of patient intolerance to penicillins.
• The course of antibiotics, if prescribed, should be at least 7-10 days in an adequate dosage prescribed by a doctor. Self-reduction of the dose or termination of the course leads to the emergence of resistant forms of bacteria.

Persons who are carriers of streptococcal infection, but do not show symptoms of the disease, in most cases do not need antibiotic treatment, except in special situations. As a rule, the number of bacteria living in the throat of carriers is small and insufficient to infect others (except for people with severe immunodeficiencies, for example, leukemia, HIV, chemotherapy, etc.). Rheumatic fever and other complications are very rare in carriers of streptococcus.

A special case is viral tonsillitis in a streptococcus carrier.At the same time, tests and analyzes may reveal a positive response to streptococcus, although the disease itself is not caused by it, but by the virus. Antibiotics are not required.

The first 1 – 2 days you should try to stay in bed, then you can get up and walk around the house. A plentiful warm drink is necessary. Cold, spicy and very hot (for example, hot tea, coffee) should be excluded from food. For severe sore throat, food should be semi-liquid.

Additional drugs in the treatment of sore throat are: antipyretic, pain relievers for the throat, as well as local therapy (lubrication of the tonsils, gargling, etc.)P.). Aspirin should be avoided in children because it can cause a rare but severe complication (Reye’s syndrome).

Paracetamol (1 gram for adults, children by age) or ibuprofen can be used to lower the temperature. To relieve the condition, rinsing with a warm solution of table salt (1 teaspoon per glass of water) helps. There is no fundamental difference in what medicine to gargle with sore throat. You can choose the one that suits you from those available in the pharmacy, since their effectiveness is about the same.

If, in addition to sore throat, there are other symptoms, such as a runny nose or hoarseness of the voice, you should use the appropriate means as prescribed by your doctor.

Removal of tonsils

Removal of tonsils in children was widespread in past years, now it is used less often and only for strict indications. In any case, the decision on the need for surgery is made by the ENT doctor.

The main indication for the removal of tonsils is frequent recurrent tonsillitis caused by beta-hemolytic streptococcus:

90,096 More than 6 episodes of streptococcal sore throats (laboratory confirmed) in one year 90,097
• More than 4 episodes per year in 2 years
• More than 3 episodes a year for 3 years.
• Chronic tonsillitis associated with streptococcus, refractory to antibiotic treatment
• Repeated paratonsillar abscess
• Complications of angina such as rheumatic fever, joint damage.

In some cases, together with the tonsils, the doctor can remove the adenoids, if there is their growth. After removal of the tonsils, re-infection of the pharynx with hemolytic streptococcus almost never occurs.

Terms of treatment of angina and prognosis

Typically, acute tonsillitis lasts about 7 days, but in some cases, depending on the reactivity of the body, it can last up to 2 weeks even with proper treatment.In most cases, with adequate treatment, the disease goes away without complications, and ends with a full recovery.

90,000 Chronic tonsillitis and halitosis

Otorhinolaryngology

Olesya Golubtsova:

We are on the Mediametrics channel, we are starting the “Online Reception” program. Our guest today is an otorhinolaryngologist Larisa Viktorovna Ponomareva, a doctor of the highest category at the MedicCity clinic.We will talk about such popular diseases as chronic tonsillitis and halitosis.

Oleg Druzhbinsky:

The program is hosted by Oleg Druzhbinsky and Olesya Golubtsova. Larissa, thank you very much for coming. The theme, indeed, is for the summer, and for what it is necessary to love ENTs.

Olesya Golubtsova:

In the process of preparing for the program, I looked at the statistics. I wondered: how common is tonsillitis? To be honest, the data that I saw on the Internet diverged from my ideas.There was such a figure: 10% of the entire population of the globe. I remembered that we were undergoing medical examination somewhere in the 11th grade, and after visiting the otorhinolaryngologist, practically the whole class was diagnosed with chronic tonsillitis. Tell us what, our sample or information on the Internet – which is closer to the truth?

Larisa Ponomareva:

About 10%, I doubt the statistics, not enough. Now with the prophylactic medical examination, our opinions began to diverge. According to the latest data, over 50% of the population has been diagnosed with chronic tonsillitis.Previously, he underwent medical examination.

Oleg Druzhbinsky:

Let’s, about the symptoms of chronic tonsillitis, maybe someone does not know. I heard the name, but I don’t remember exactly what it is. Specify the symptoms of tonsillitis, which affects half of the population.

Larisa Ponomareva:

Let’s start with the fact that tonsillitis is a disease of the tonsils. We have 7 tonsils in fact, tonsillitis can be any tonsil. The lymphoid ring consists of 7 tonsils, any can become inflamed and called a sore throat.Adenoids are also called angina, only adenoids of the tonsils. Having been ill once, perhaps, they did not heal so well, they didn’t take a full course of antibiotics, and chronic inflammation remains. The tonsils are composed of lacunae, crypts. They are so deep that a process is slowly going on in the tissue, inflammation occurs in it and chronic tonsillitis occurs, certain symptoms appear.

Olesya Golubtsova:

So it’s always an untreated sore throat?

Larisa Ponomareva:

Most often.Weak immunity, not noticed, latent. My throat hurt, there wasn’t even anything. The patient says: “I have never had a high temperature, I have not had a plaque.” Nevertheless, the clinic and symptoms of chronic tonsillitis.

Oleg Druzhbinsky:

Chronic tonsillitis – is it when a person often catches a cold? A cold breeze blew – he was already coughing, snot and all that.

Larisa Ponomareva:

This person already has chronic tonsillitis and, unfortunately, is often prone to colds.Chronic tonsillitis is of an infectious and allergic nature. Everything is interconnected here and has already been proven, for more than one year they say that immunity is weakening against the background of chronic tonsillitis. The tonsils play such a role.

Olesya Golubtsova:

I would say that when the slightest wind blew, or something else, different symptoms of a cold appear, and with tonsillitis it always starts from the throat. I suffer from this, just a little – everything immediately goes to the throat.

Larisa Ponomareva:

Throat, there is pharyngitis, when the back of the throat hurts.

Olesya Golubtsova:

How then is pharyngitis different from tonsillitis?

Larisa Ponomareva:

Pain in the back wall, discomfort, perspiration, coughing. With angina, with exacerbated tonsillitis, there will be a temperature, chills, the condition will be … When swallowing pain.

Olesya Golubtsova:

The nature of this pain? Do I understand correctly that tonsillitis is exactly the tonsils? Is the back wall pharyngitis?

Larisa Ponomareva:

Yes.

Olesya Golubtsova:

The difference is clear.

Oleg Druzhbinsky:

What should half of the population do with this misfortune, I’m not afraid to say so?

Olesya Golubtsova:

In general, “chronic” – what does it mean? What is absolutely impossible to cure?

Larisa Ponomareva:

Unfortunately, no. If there is already the word “chronic”, unfortunately, regardless of the age category, if chronic tonsillitis happened, then it already exists.

Oleg Druzhbinsky:

You mentioned that there was an incompletely treated first inflammation of the tonsils. Several times I heard that the doctor prescribes a course of antibiotics for a week, the person drank for 3 days and quit. This is a direct path to the chronicles, right?

Larisa Ponomareva:

Quite. Because of the patient’s incompatibility, they really do not follow through. This is not what we want to prescribe to drink 7 days or 10. The effect of the antibiotic on this microorganism will be exactly as many days as prescribed, because it has already been verified.

Oleg Druzhbinsky:

The antibiotic did not kill the microbe, but only hardened it. He did not die, but partisan and is waiting for the right moment to show everyone.

Larisa Ponomareva:

Yes. The symptoms are gone, the pain is gone, the temperature is gone – that’s it. They fed it, created the flora, and went on.

Non-compliance with doctor’s prescriptions, incomplete treatment of tonsillitis lead to a chronic state of the disease.

Olesya Golubtsova:

As far as I understand, there are different types of chronic tonsillitis? Is it divided into different ones?

Larisa Ponomareva:

There are different types of tonsillitis, and carriage, it is not because a streptococcus or someone coughed, and he had a sore throat, got infected, no.Beta-hemolytic streptococcus is the most dangerous type of microorganism. It provokes lymphoid tissue and acute inflammation occurs, which is fraught with complications. Tonsillitis can be chronic simple: you have been ill, and no longer bother you. You come, the doctor will look, say: you have chronic tonsillitis, you are recommended to be sanitized, follow up, at least show up once a year. There is a second form of tonsillitis, when the borderline state. We treat such patients for a certain period of time. We have been observing them for 2-3 years.

Olesya Golubtsova:

Borderline with what?

Larisa Ponomareva:

With a surgical method of treatment.

Olesya Golubtsova:

That is, this is a serious form.

Larisa Ponomareva:

Of course. We sanitize the tonsils, prescribe treatment. 2 times a year the patient comes and we monitor for this period whether there were sore throats or not, or he was quiet, calm, no complications, sore throats did not arise.

Oleg Druzhbinsky:

Larissa, you said 7 tonsils; some have become inflamed and consider that you are a chronicler for life. The breeze blew, sat down at the window, it slipped through you, and you want a week – get medical treatment, if you want – don’t get medical treatment, you will still be ill for a week. Question: what if you take and remove the tonsils?

Larisa Ponomareva:

Not at all!

Oleg Druzhbinsky:

Please wait. Previously, they cut, the adenoids were cut, the tonsils were cut.

Larisa Ponomareva:

They are removed. During puberty, our lymphoid tissue develops in the opposite direction. It decreases and some islets remain. This is enough to protect the body and the immune system. If this process has not happened. Adenoid tissue, most often in children, noses do not breathe, a green runny nose is constant, since the ears are already blocked, everything hurts. This is adenoid angina. Yes, if such a patient, a child from year to year, does not go, this lymphoid tissue does not decrease.Although now, according to the latest recommendations, we are trying to save in order to avoid allergies and bronchial asthma in the future.

Oleg Druzhbinsky:

As a person who has lived for a long time, excuse me, I remember well that in Soviet times in schools, as soon as you cough, you need to cut out the tonsils and everything will be fine. Is it not fashionable now?

Larisa Ponomareva:

No, now we are approaching very carefully. This is not true. We observe. If it does not go conservatively, that is, he comes, we wash him, but winter has come – sore throat, spring has come – sore throat.This patient has a scar on his tonsils, there is nothing to keep, then we already – yes, put the 3rd form of tonsillitis.

Olesya Golubtsova:

But you are trying to bring him into remission.

Larisa Ponomareva:

Yes.

Oleg Druzhbinsky:

3rd form – what is it?

Larisa Ponomareva:

The 1st form is a simple form, the 2nd form is a toxic-allergic, conservative method of treatment, and the 3rd form of toxic-allergic tonsillitis – we are already preparing for surgical treatment.

Olesya Golubtsova:

What are the methods and means of modern medicine to translate chronic tonsillitis into the form in which it would give a normal quality of life, would not constantly bother you? You said washing – I also know from experience what there is.

Larisa Ponomareva:

Sanitation. The amygdala consists of crypts, of lacunae, where the epithelium is exfoliated, leukocytes are added, plus food debris, and caseous masses, caseous plugs are obtained.A patient comes to me somehow, says: I have pus there. The patient saw a white cork, says “pus”. This is a caseous mass. Sanitation. We prescribe a lavage of these tonsils, 7-8 lavages. You can add phonophoresis, ultrasound.

Olesya Golubtsova:

7-8 in what period?

Larisa Ponomareva:

Spring, autumn, 2 times a year. We spend every other day. For lymphoid tissue, it is always best every other day.

Oleg Druzhbinsky:

Tell me please, does the patient wash himself during the washings, or does he come to you?

Larisa Ponomareva:

No, this is a medical procedure.This is a reorganization. There are 2 methods. There is a Tonsilor apparatus, mine is mine, there are seconds. The patient is required to open his mouth, take a breath. Or there is a special cannula for washing the tonsils. It’s all in the doctor’s office, in sterile conditions. The procedure is only medical. Before her, we must examine the patient, first we differentiate. You can’t just want to rinse. Not everyone can wash and not everyone needs to wash, because the amygdala is a self-cleaning organ if the amygdala is healthy. If you have never been sick, you do not have chronic tonsillitis, but there are crypts, lacunae.

A healthy tonsil is a self-cleaning organ. Not everyone and not always need to wash it.

Olesya Golubtsova:

It is not necessary to fill in any furatsilin yourself.

Larisa Ponomareva:

No, you don’t need to fill it with furacilin. I will also say: you cannot squeeze out. They are squeezed out with toothbrushes and spoons, and they come with paratonsillar abscesses or injured tonsils. This is dangerous.The blood supply is very good, and what will it bring, where will the blood supply take when we push?

Oleg Druzhbinsky:

Tell me, what is the function of the tonsils? Why does the body need them?

Larisa Ponomareva:

Production of T-lymphocytes as the immune system.

Oleg Druzhbinsky:

They support the immune system. But do they not produce hormones?

Larisa Ponomareva:

No.

Olesya Golubtsova:

I heard such an opinion that if, for example, an infection, and you removed the tonsils, then it immediately goes deeper. That this is an additional barrier, which is why they should not be removed.

Larisa Ponomareva:

This is there too. But, it should be said, a myth. Just as if you do a puncture for sinusitis, then you will inject, go to the doctor almost every day, it is better not to do it. Also about the tonsils. Not. If a person has a tendency to bronchitis, he will cough initially and with tonsils.With any cold, there will be a cough, a sore throat, a sore throat, and will be accompanied by a cough, bronchitis will be. If such tonsils are removed, naturally, he will be without sore throat, but he will have bronchitis. That is, it will not be reflected in any way.

Olesya Golubtsova:

Why don’t you recommend deleting then?

Oleg Druzhbinsky:

And they say to him: what are you, the tonsils are a filter that holds back any byaka for our body!

Larisa Ponomareva:

Tonsils are not a filter, they are like a barrier.They are for our immune system to function. You see, nothing superfluous happens. At one time it decreased in size, went beyond the arches, and that’s it, the person lives. And for those who have a pathological condition, they were not accepted, they were unlucky, and often sick, then you have to choose: either they are beneficial to you, or more harm. Prescribing antibiotics 5 times a year is also not very good. Therefore, only the doctor will decide. It does not happen that “I want”, “I do not want”, this is not the right organ.

Olesya Golubtsova:

I know that very often people do not go to the doctor and begin to prescribe themselves, the pharmacy will advise local antibiotics.Is this normal, is it possible to cure exacerbation of tonsillitis with local antibiotics without taking it internally? Or can they even do harm?

Larisa Ponomareva:

The harm will be done. For example, a situation: a sore throat. Pulls, sore throat, uncomfortable, red throat. They buy an antiseptic and dissolve. Yes, if pharyngitis, if the back of the pharynx, as we said earlier, then it will help. A systemic appointment is mandatory: rinsing, lozenges, lozenges and everything is fine, everything ends because of a viral infection.Against the background of the virus, I got sick, recovered. And angina is most often a bacterial flora, and you can’t help with any pshikalki, because there is hemolytic streptococcus in the lacuna.

Olesya Golubtsova:

Can you look at your own throat in the mirror and understand?

Larisa Ponomareva:

Plaque on the tonsils, temperature 39-38 °, the onset of the disease on one side, from 37 ° can begin. It hurts to swallow, somehow it hurts, not yet extra, but it hurts – that’s it, the next day there will be a second tonsil and a plaque will appear, and there will be a high temperature.

Olesya Golubtsova:

Can’t you cure yourself with a local antibiotic?

Larisa Ponomareva:

You can heal. But how much? Probably, you can patiently rinse, you can anesthetize, spray with lidocaine, but …

Oleg Druzhbinsky:

All who became chronicles. This is all hello to parents, because, apparently, the first illnesses were in adolescence or school age. The child was treated incorrectly, that’s all.Or not? Or does he recover during maturation?

Larisa Ponomareva:

Probably not, you can’t blame all the parents at once. It means a lot, of course, how the child took the medicine, how many times he rinsed, he was lying at that time or running. Here, most likely, the individuality of the organism, and is there any resistance to this prescribed antibiotic, addiction. Maybe he was prescribed an antibiotic, but he was not so sensitive to it.

Olesya Golubtsova:

Speaking of prescribing antibiotics: is it necessary to take a bacterial culture? There are again 2 opinions.There is a prescription for antibiotics, so to speak, of a wide spectrum of action, but there are doctors who say: no, you definitely need to take a smear in the laboratory and find out what bacteria you have.

Larisa Ponomareva:

Here according to the situation. The smear takes 5-7 working days to prepare. You came, you have a sore throat. I cannot but assign you. I see that a person has a sore throat, and I will tell him: we will wait. While sowing, he will have a paratonsillar abscess and he will die. And that’s all. Or it will get a complication.

Oleg Druzhbinsky:

Tell us about this abscess. What are the risks of tonsillitis?

Larisa Ponomareva:

Chronic tonsillitis, or acute tonsillitis, why do you need to drink, rinse, and soak? The people refuse to take the sick leave because they have to work. What is it fraught with? Not only a complication of paratonsillar abscess. When the capsule forms, the capsule is purulent. I didn’t rinse it out, didn’t come out, and an abscess appears, like a real one.The amygdala alone becomes dense, the mouth does not open, already trismus, can neither eat nor drink, even those come that the saliva is already flowing. There is only a surgical method, respectively, again, an antibiotic. It happens that they did not hit on resistance, they needed another series of antibiotics. Complications after untreated sore throats are collagen diseases: polyarthritis, vasculitis. Infectious myocarditis, even at a young age. Do not wait to hope that the period will pass and by old age will get sick, because in childhood he had a sore throat.No, this is a young age. A short period of time passes and complications appear. Glomerulonephritis, scary things that, unfortunately, lead to disability after treatment. Polyarthritis.

Olesya Golubtsova:

I still want to know what other ways there are, let’s say, to improve your quality of life if you have a diagnosis of chronic tonsillitis. We said that washing 2 times a year is understandable. What else? Maybe physiotherapy, procedures?

Larisa Ponomareva:

Only the doctor will prescribe all this for you.

Olesya Golubtsova:

May I come to the doctor, ask?

Larisa Ponomareva:

… can I assign it? Can I want it? Tonsil and tonsil strife. If there are only scars and adhesions, there is no point in prescribing physiotherapy. The blood flow increases, and there, in the crypts, streptococci, staphylococci are sitting inside, figuratively speaking. Naturally, it intensifies and enters the bloodstream, toxicoinfection develops. And you are sluggish, you do not get sick, and there is no working capacity.You wake up in the morning, and as if you had not slept. There is no cheerfulness. It is called.

Olesya Golubtsova:

Did you just say about physiotherapy?

Larisa Ponomareva:

If the assignment is incorrect. Therefore, there is no standard as such that you have been washed and assigned to everyone. The doctor is oriented.

Olesya Golubtsova:

Is it possible to find out in which option physiotherapy can be prescribed, and what it will be, warming up?

Larisa Ponomareva:

Not warming up.As a rule, sanitization first. Only on sanitized tonsils, so as not to cause such a condition. On clean tonsils, on clean tissues, phonophoresis or ultrasound with special preparations is prescribed. With the help of a physiotherapeutic technique, they are superimposed on the tonsils, you hold the ultrasound for 20-30 seconds and that’s it. This is good, it gives the result for long-term remission. The patient then says: my throat no longer hurts, it does not come for 2 years, I forgot what it is. Good technique, it didn’t go away. There is less and less of it, because with physiotherapy we are now solving the question: do we need it at all.This gives good results.

Olesya Golubtsova:

But, as I understand it, this is done not during the period of exacerbation, precisely during the period of remission, as a prophylaxis?

Larisa Ponomareva:

Yes, as prevention. I tell patients all the time: you don’t wait for you to get sick. I will not sanitize you on sore tonsils. Naturally, you will be treated first. Then the inflammation will pass, you will come there will be sanitation, treatment with drugs.Phytopreparations that are then taken remotely. Treat, rinse, scan, and prescribe our usual herbal pharmaceutical preparations for the course.

Oleg Druzhbinsky:

You said that the tonsils mainly support the body’s immunity. For those who don’t know: the immune system is a mysterious internal substance. If you are allergic to something, then for some reason your immune system thinks that it is very harmful for you, it starts to malfunction.It makes you sneeze, cough when looking at a cat, for example, and so on. You can look for a lot of different kinds of imbalances in the immune system. If all 7 beautiful tonsils are somehow damaged, violated, then the immune system immediately works worse or not?

Larisa Ponomareva:

If there is no remission, there will be persistent chronic tonsillitis, then, of course. As a rule, such children are mainly allergic, often sick children. They are just children who are often ill.

Oleg Druzhbinsky:

Once upon a time, even in my youth or adolescence, I remember they told me that if you have bad tonsils, you will be ill all the time for completely different reasons.Is that so or not? Or not quite a direct relationship?

Larisa Ponomareva:

Women’s diseases are also associated, there are also men’s diseases, they are associated with chronic tonsillitis. Even the topic was discussed that the presence of chronic tonsillitis affects the sexual sphere. In our country, in my opinion, even the doctor made a report on this topic.

Olesya Golubtsova:

I still have a question about prevention. I asked what other methods there are, because this is exactly the main thing that people need to pay attention to, how to avoid exacerbation.This is also very interesting to me. I read that there are some laser techniques. How can a laser help?

Larisa Ponomareva:

Laser techniques. In fact, there are no laser techniques for treating chronic tonsillitis in the treatment standards. The method exists, it exists, it gives a good result. But, that you will only be treated with a laser and it will help you – there is no such thing, everything is taken together. Only in this way.

Olesya Golubtsova:

What is this, what is the impact? I’m interested.For me, a laser is something very aggressive, some kind of burning out.

Larisa Ponomareva:

No, not aggressive. There, a special device, which is inserted into the lacuna of the amygdala, is supplied with certain laser beams. The beams are not aggressive. This is not the laser that is operated, removed. This is the wrong laser at all. It is a portable device.

Olesya Golubtsova:

Do we have such equipment for clinics, in polyclinics, or not?

Larisa Ponomareva:

Yes, I worked in the city, there is a laser.In the state. Also phonophoresis, ultrasound with “Tonsilor”. Even, I want to say, earlier there was probably better equipment for the treatment of tonsillitis, because he was part of our dispensary group. Our patients were observed 2 times a year.

Olesya Golubtsova:

And now what happens, the equipment is worse, or what happened?

Larisa Ponomareva:

No, I say that it was aimed specifically at prevention, treatment, prevention of chronic tonsillitis.It’s not just that, the neck hurts.

Olesya Golubtsova:

What about ultraviolet light?

Larisa Ponomareva:

Ultraviolet refers to physiotherapy, but it is like an ambulance. A runny nose appeared, the throat ached – yes, so that the infection did not spread. Previously, they did everything in the gardens, now I don’t know. This is a tube. These are all working therapy.

Olesya Golubtsova:

Oleg, now we can confidently move on to the topic of halitosis.Please tell us what is halitosis?

Larisa Ponomareva:

Halitosis is bad breath. As a rule, patients come to us, to ENT specialists. They communicate at work, communicate, communicate at a certain distance, and they have a bad breath.

Oleg Druzhbinsky:

And what is the reason, what is nature?

Larisa Ponomareva:

They think that it is chronic tonsillitis, that there are traffic jams, remove them now and everything will be over.In fact, there are several reasons for halitosis. These are diseases of the gastrointestinal tract, gastritis, changes, liver diseases also give bad breath. Dental problems, periodontal disease, carious teeth, and improper oral care also lead to unpleasant odors. I saw an almond plug: “It smells bad for me.” You scan, but it doesn’t always save you.

Olesya Golubtsova:

Halitosis is a diagnosis? How to qualify?

Larisa Ponomareva:

It stands in the nomenclature as a unit.The card says: halitosis.

Oleg Druzhbinsky:

Is it in the classifier, right? You, as an ENT, what are you doing about it?

Larisa Ponomareva:

A man comes, I look. My problem, I see, really that the gaps are closed and I prescribe a treatment for him, if it’s mine. If I see that I am helpless here, mine is not mine, but there will be a smell, there is another problem, I write him a recommendation to the dentist, or do a gastroscopy, go to a gastroenterologist, and pass certain tests.To direct a person, in any case, a person must be correctly, competently directed.

Oleg Druzhbinsky:

I talked to several programs with dentists, they touched on this topic. It is usually believed that a flaw in the teeth then manifests itself in this way. But it may not be teeth. He repaired his teeth, but everything remained.

Larisa Ponomareva:

Young people come, good teeth, they haven’t been installed yet, and no implants, nothing but treated caries, but the smell is coming.This is not a problem with the teeth. And the gums are beautiful, far from periodontal disease.

Olesya Golubtsova:

Is there a diagnostic confirmation method to write halitosis on the card?

Larisa Ponomareva:

As an ENT we do not do this. We do not diagnose and there is no narrow special method. Now this problem has already been raised and more attention has been paid. Probably, before people were more notorious, because not everyone can come and say: my breath smells, it bothers me.It began to gradually come into use. There are special research methods for this. One of the probably unpleasant methods, when the doctor needs to understand what kind of smell is going on, because the smell can be sulfur, or a rotten egg, or the smell of acetone. You have to understand where and what kind of putrid smell comes from, there is a whole classification. There was a screen and a tube, the patient exhales, and the doctor on the other side of the screen catches.

Oleg Druzhbinsky:

Yes, you can sympathize with the doctors. But on the other hand, how not to go to you?

Larisa Ponomareva:

That’s it.Gradually, the problem did not go away and a method was developed, called halimetry.

Olesya Golubtsova:

No, wait. What’s next? Dismantled: it smells like a rotten egg, or it smells not like a rotten egg, but raw, moldy. Further, does the method of treatment differ?

Larisa Ponomareva:

This is not a method. Here you refer the patient to the gsatroenterologist, or …

Olesya Golubtsova:

That is, it is important to understand where the smell comes from, from the stomach or from the teeth?

Larisa Ponomareva:

Of course.Because “our” smell of serous masses.

Oleg Druzhbinsky:

Is there a precise definition of what is taken from what? There is a problem; or to you, or to the dentist, or to the gastroenterologist? What smells like and to whom with what to go?

Larisa Ponomareva:

I’m sure I won’t tell you now. Indeed, a person must know, because this is life, one must understand where to go, what to handle and what it is. Smells … How to say? To a gastroenterologist – the smell of acetone, a rotten egg.There is a physiological smell, which you have awakened, you haven’t eaten anything yet, you haven’t brushed your teeth, you have a physiological one. That is, bacteria, our pathogenic flora.

Oleg Druzhbinsky:

I was told that saliva contains a large number of bacteria. A terrible thing! On hands less.

Olesya Golubtsova:

I also read that, in addition to all different pathologies and diseases, there is also a reason, like dry mouth, that this can also be the cause of a bad smell.With this to go to the ENT?

Larisa Ponomareva:

No. Dry mouth – here you need to deal with an endocrinologist: is it not diabetes mellitus in a patient when dryness occurs? Isn’t it a hormonal disorder? There is dryness not only of the mucous membranes, for example.

Oleg Druzhbinsky:

Maybe you need to put a humidifier in the room at night?

Larisa Ponomareva:

Not everyone sleeps with their mouths open. I also analyze when I start communicating with patients.Maybe relaxed, snoring, mouth open, nose stuffed up. You collect anamnesis and then you can work.

Olesya Golubtsova:

There are many variations of the smell, and the reasons can be the most serious, up to diabetes.

Oleg Druzhbinsky:

Let’s, let’s get back to the nose. Before the broadcast, I asked to create a poll. Not on the air, but very popular among my friends. I mean pshikalka in the nose. A person puffs all the time, every hour or two, or even more often, his nose gets clogged.I got hooked on this business and sits there. Tell us about it, what is happening, and most importantly, how to get off of it? It’s uncomfortable: it’s over and the person cannot breathe.

Larisa Ponomareva:

When you see the nasal mucosa of such patients who, with great experience, endlessly puff, it already looks pale, the vessels are so constantly forced to constrict. The vessels also have muscles, they work the same way. Why is it happening? Pshiknul – decreased, breathed well, did not pshiknul – that’s all.In fact, when you look at a patient, he didn’t pshiknul, you do rhinometry with him – the nose is breathing, everything is fine. And he doesn’t have enough, “No, I’m not breathing,” the subcortex is already connected. This is called addiction. Psychosomatics. Everything breathes, but it seems – does not breathe. We have a technique: you substitute a cotton swab, the patient breathes in and out. There is such a breath! And he doesn’t breathe. “I don’t have enough, my nose is not breathing, I have to pshiknut.” Unfortunately, yes, there is addiction.

Oleg Druzhbinsky:

Tell me, is it true they say that something is specially mixed into these pshikalki drugs, almost drugs, so that a person gets hooked and buys all the time? Or is it a myth?

Larisa Ponomareva:

I will not name the drug.There is a drug that was invented back in 1936 in Germany. Unfortunately, we still use it. It is sold in pharmacies, it is available, there are no problems with it at all. He has a direct relationship. He pshiknul once – well, two. It is practically impossible to get off of it. Our patients are called addicted to this drug. Half the trouble. Constricts the small vessels of the eyes, brain. Why is it written on each vasoconstrictor drug that strokes, heart attacks are contraindicated, it is impossible to pshik.

Olesya Golubtsova:

That is, it narrows not only in the nose, but also in the eyes.

Larisa Ponomareva:

Of course. This is not all harmless. This is not because “do not pshikayte, or spoil the nose, mucous.” Not.

Olesya Golubtsova:

But, will you give us hope? After several years of such addiction, is it possible to get rid of it?

Larisa Ponomareva:

Possibly. It all depends on the person, on his desire, his attitude. Now there are a number of drugs that help get away from vasoconstrictors.

Oleg Druzhbinsky:

Advise something on how to leave. Tell the way.

Larisa Ponomareva:

As I always tell my patients: if you breathe, don’t worry, you will breathe! “But of course, I’ve been pissed off for 20 years.” There you look: the partition is good, there is no need to operate, and the sink. There are only surgical noses, there is no way, pshikay, do not pshikay, he needs to be operated on, but there are those who just need to stop pshikay.

Oleg Druzhbinsky:

Is there something to replace?

Larisa Ponomareva:

Yes, there is.I start by explaining. There are drugs everywhere, both in the nightstand and in the car, where I am – there are these bottles everywhere. Collect everything, tie it on 2 knots and, if it’s a pity to throw it away, give it to your wife or entrust it to someone, because not everyone can take it and throw it away. Buy a menthol pencil, or have a nasal inhaler. Plugged nose – put a pencil, closed it, inhaled. Without affecting the mucous membrane, menthol vapors are great. Perfectly removes. It’s like an ambulance. For consolidation, there are a number of nasal glucocorticosteroids that have a therapeutic effect.They are prescribed only by a doctor, they are selected only by a doctor, because this effect on the mucous membrane is a hormonal drug that has a number of contraindications and side effects. And everything works out great. The prognosis is good, that’s it, I’ve sighed. You appoint someone up to a month, he comes in 2 weeks a new one. It is imperative to show: the drug is working or not working, after 2 weeks control.

Olesya Golubtsova:

So, you can get rid of long-term dependence in a month?

Larisa Ponomareva:

Of course! If within 2 weeks the patient comes and says: yes, I already practically breathe, I already less often, I do not remember about my nose.So, you understand: everything, the matter has moved.

Olesya Golubtsova:

Friends! I think that on this good, positive note, we will conclude our broadcast today. It is really important that in a month you can get rid of long-term addiction.

Thank you, Larisa Viktorovna!

Our guest was Larisa Viktorovna Ponomareva, a doctor of the highest category otorhinolaryngologist. Olesya Golubtsova and Oleg Druzhbinsky were with you.

Oleg Druzhbinsky:

Thank you! Be healthy!

Larisa Ponomareva:

Thank you!

90,000 Angina: difficult questions about a simple disease – Yarreg

Angina is an acute infectious disease of the whole organism.It is most characterized by inflammation of the tonsils (tonsils). The causative agent of the disease in most cases is streptococcus.

Often, patients come to see a doctor and say that they have frequent sore throats, but it turns out that they take any discomfort and sore throat for them.

Angina is characterized by an acute onset: high fever, sharp pain in the throat, aggravated by swallowing, enlargement of the submandibular lymph nodes. Also, a common sign of sore throat is plaque on the palatine tonsils of white color of various shapes, in the features of which only a doctor can figure out (after all, plaque occurs with diphtheria, mononucleosis and other diseases).Neither a runny nose nor a cough, which is characteristic of ARVI, usually does not happen with angina. Angina is an insidious disease, fraught with complications such as myocarditis (damage to the heart muscle), arthritis (joint disease), kidney disease. That is why it is so important to see a doctor in a timely manner. Only he should and can make the correct diagnosis and prescribe treatment.

BEFORE THE DOCTOR’S ARRIVAL

Angina is contagious, it is best to move the patient to a separate room for the duration of the illness or to fence off his bed in the common room with a screen.It is imperative to observe bed rest. In addition, the patient should have a separate dish, which should be boiled or doused with boiling water after each use. The patient should have a separate towel, as well as a handkerchief, which should be used when coughing and sneezing, covering his mouth.

The room in which the patient is located should be ventilated more often, wet cleaning should be carried out in it so that dust containing microbes does not rise into the air. The diet should be sparing – warm (not hot!) Food (soup, liquid porridge, soft-boiled eggs, etc.)), plenty of drink (milk, tea, cranberry juice). Exclude spicy, salty and solid foods (cookies, crackers, cutlets with a crispy crust).

It is very important to start gargling immediately to relieve pain and remove pus. Moreover, it is not so much the amount of liquid that matters as the frequency of rinsing – 1/3 – 1/2 cup every 30 – 60 minutes. For rinsing the throat, a pale pink solution of manganese, a solution of furacilin is most often used. In addition, you can treat the throat with a warm infusion of sage or chamomile.To prepare it, take 1 tablespoon of the plant, pour a glass of boiling water and leave for 10 minutes. The resulting infusion is filtered through cheesecloth.

Chewing propolis is good for any stage of the disease. After eating, you need to slowly chew it in pieces the size of a fingernail. For a day you need to “eat” about 5 g. To distinguish good propolis from the old and less strong, you should know that when you chew fresh in your mouth you feel a slight burning sensation and numbness of the tongue. You can use this product, provided that you are not allergic to honey.

If the temperature has dropped, put an alcohol compress on your neck for 2 hours (alcohol is mixed with water in a 1: 1 ratio). You can make a frequent iodine net on the skin of the neck in the area of ​​\ u200b \ u200bthe lymph nodes and tie a light woolen scarf for dry heat. A compress made from a concentrated solution of baking soda gives a good effect – stir a teaspoon of baking soda in 1/4 cup of hot water (just not boiling water). Prepare in advance a 10×6 cm gauze folded in 4 – 6 layers, a piece of cellophane (a little more gauze), cotton wool, a scarf.Liberally moisten gauze with soda solution, squeeze lightly and put on your neck, then cellophane, cotton wool, scarf. Take off after 2 hours.

PREVENTION

ANGINA

One of the factors predisposing to a sore throat disease can be sick teeth, which always accumulate microbes. Therefore, treat them in a timely manner, keep your mouth clean – brush your teeth daily, rinse your mouth after eating.

Another factor is the cooling of the body – wearing insufficiently warm clothing during the cold season.For some, especially in summer in hot weather, it is enough to drink cold water, eat ice cream to get sick with sore throat. Therefore, in order to avoid this, it is necessary to increase the body’s resistance. To carry out systematic general and local hardening in order to accustom the body to quickly and without harm to health adapt to cold, heat, strong winds. Air and sun baths, water procedures (rubdowns, douches, showers, etc.), exercise, sports, just being in the fresh air are well tempered.The correct (seasonal) choice of clothing also contributes to hardening.

To increase the resistance of the mucous membrane of the pharynx to diseases, systematic gargling with water is useful. In this case, the temperature of the water is gradually reduced with each rinse (from warm to cold). Hardens and strengthens a weak throat and loose almonds water with natural sea salt (a tablespoon in a glass of boiled water). It is necessary to rinse daily in the morning and in the evening, especially in damp and cold seasons. But not when you are already sick!

PHARMACY ON THE HOUSE

Prescription 1 .Dilute raw red beet juice with water. The solution should taste good, gargle.

Recipe 2 . Beet broth. Medium-sized beets are poured with water and boiled until soft. The resulting broth is cooled, filtered and used for rinsing.

Recipe 3. 2 – 3 chopped garlic cloves pour a glass of boiling water, leave for 1 hour, rinse.

Recipe 4. Onion. Drink fresh juice for angina 1 teaspoon 3-4 times a day.

Prescription 5. Propolis ointment. Melted 100 g of butter in a clean enamel bowl, bring to a boil. Cool to 60 degrees and add 10 g of crushed propolis, heat to 80 degrees with continuous stirring for 10 minutes, filter. The cooled ointment is ready for use. Store the ointment in a glass container in a cool, dark place. 10% propolis ointment, prepared in butter, is also recommended for oral administration in case of pneumonia, sore throat and even in the complex treatment of tuberculosis, 10 g 2 – 3 times a day 1.5 hours before meals or 1.5 hours after food with warm milk.

HEALING POT

Recipe 1 . 1 tablespoon of chamomile, 1 tablespoon of honey, pour 250 ml of boiling water. Use as a gargle.

Recipe 2 . Elder. Pour 3 – 4 tablespoons of flowers with a glass of boiling water, boil for 5 minutes over low heat, cool, drain. Decoction gargle with sore throat, cough, inflammation of the mouth.

Recipe 3 . Blueberries. Thick decoction of fruits: pour 100 g of dry fruits with 0.5 liters of water, boil until the amount of water decreases to 0.3 liters.Gargle.

Recipe 4 . Fragrant violet. Tincture for alcohol. 25 g of flowers per 10 ml of alcohol. Take 20-30 ml of tincture 3 times a day before meals. Rinse: 10 ml of tincture in 1 glass of warm water – after meals and at night.

Recipe 5 . Lemon. With the onset of sore throat, traditional medicine recommends chewing lemon slowly, especially the zest. After that, do not eat for 1 hour. Repeat after 3 hours.

Recipe 6 . A decoction of willow bark.For 1 glass of water 15 g of finely chopped bark, boil for 10 – 15 minutes, drain. Gargle.

You can share your proven methods of combating diseases by calling: 72-77-43, 32-96-47, 72-94-75. Be healthy!

Treatment with enthusiasm – Ogonyok No. 47 (5400) dated 30.11.2015

Grandma’s technologies in the fight against influenza work well and today

Masha Traub

Children, as all mothers know, get sick at the same time, in turn and out of turn.Following the children, dad usually falls ill, and when the exhausted mother seems to have cured everyone, then she gets all the viruses from all family members. Husbands and teenage sons are the worst affected. They lie down and roll their eyes. “What? Where? Throat? Temperature?” No, they have everything at once. Paper handkerchiefs are scattered around the room, cups are piled up on the bedside table – they cannot drink tea with raspberries, they do not want honey, they are already sick of milk. Rinsing does not help, nose drops are also pointless. Better to do nothing at all.

My daughter was treated obediently, but a bad example is contagious: she refused to drink the syrup, she demanded to crush the tablets between two teaspoons, otherwise “they get stuck in the throat”, the chamomile broth is bitter, the lemon is sour. I’m tired of cartoons, books too, I want ice cream and go for a walk.

While they were capricious, I went to the market to buy chicken, to cook broth.

– Will you take goose fat? – Asked me the saleswoman Valya, from whom I buy chicken.

Of course, I took goose fat.It’s a pity there was no badger. And she began to treat children the way they treated me in childhood.

So goose fat, outwardly and inwardly. It smells as if all the eggs along with the sausage are rotten in the refrigerator and have been lying like this for about a year. Only badger fat smells worse. When my grandmother rubbed my chest, I sat with my fingers pressed to my nose and breathed through my mouth. When my grandmother rubbed my back, I generally tried to breathe every other time.

It was difficult to wash off the fat. Only laundry soap took him. Dust was also good.But these are still flowers. Drinking hot milk with melted fat on an empty stomach was a test of courage. I wound circles around the mug, then gathered my strength, pinched my nose and took three large sips. It was impossible to persuade me on the fourth sip. I gritted my teeth. How disgusting it was! Even the liquid fish oil, which I also regularly drank, did not seem so disgusting.

This was followed by sitting over boiled potatoes under the covers until you suffocate.If I tried to crawl away from the potatoes, my grandmother painfully slapped me on the back of the head and I again dived into the pan.

– Breathe well, breathe deeply! – Grandma commanded. But it is impossible to breathe over potatoes – you are suffocating with steam. In addition, there is a heavy fleece blanket on his head. I was considered to be too long for air only when my grandmother was convinced that I had become crimson.

Massage with hot hard-boiled eggs around the nose seemed like a blessing, because after that there was a more difficult procedure – instillation.Beet juice was dripped into my nose. If anyone does not know, he is wildly pinched and needs to be diluted with water, but the grandmother always forgot about it. So I screamed like crazy, rubbed my nose with all my might and tried my best to recover as quickly as possible. Because the juice tears everything inside – long and hard. I would like to temporarily tear off my nose and rinse it in water.

Only black radish with honey was worse than beet juice. Grandmother cut off half of the radish like a lid, cut a hole and put honey there.She did this in the evening, which meant that in the morning I would need to swallow the resulting juice. At this point I wanted to rip my head off, rinse it and put it back.

So at the market I bought fat, honey, and black radish. I flew home – my children do not want to be treated with modern means, with flavors, flavors, then they will be treated with folk remedies. I boiled potatoes and cooked goose fat with milk and radish with honey. The children looked at me with undisguised horror. Of course, they did not expect such a trick and, not without interest, agreed to undergo treatment in a different way.We took a sip, ate it, and sat over the pan. And then the scream started. The children screamed, groaned, ran from me all over the apartment and reported that they were already completely healthy. They were ready to drink any medicine and syrups, milk and butter, and gargle with anything. Not goose fat or radish! Not potatoes! And it’s my hands have not yet reached the beetroot juice. But I already stood my ground and continued to smear them, give them water, I also fed onions with garlic. So, to consolidate the effect.

The children recovered immediately.The son announced that he would go to school tomorrow, and the daughter said that it would be better to go to dances, to prepare for school and to music, just not to stay with me and the radish. Indeed, in the morning they were already cheerful. Of course, they were cheerful – I also poured mustard into their socks for the night. True, the children smelled not very pleasant, one might even say unpleasant. It was as if they hadn’t washed for a long, long time, then they tumbled into the ground, and then dried up and didn’t wash for another month. But nothing – but now they know what laundry soap looks like.

– Mom, my mustard is stuck to my feet and does not come off! The son shouted in horror.

I grinned and did not rush to help. They will know how to get sick.

What else were we treated with? My friend Lena, who often had a sore throat as a child, received aviation kerosene. Lenin’s mother took a huge long knitting needle, wound cotton wool and climbed down her daughter’s throat. Aviation kerosene was brought to her by the neighbor’s second cousin, who worked as a pilot. Lenin’s mother very deftly wielded a knitting needle. So now my friend, who has already become a mother herself, suffers – it is impossible to find aviation kerosene in Moscow, and my daughter has angina.I advised her to goose fat on an empty stomach. Lena already shuddered – she was also given this in childhood, however, with honey. And instead of beets, onion juice was dripped into her nose – grandmother rubbed it on a small grater, squeezed it into her nose.