Sore throat

Sore Throat
A sore throat usually goes after a few days. Simple treatments that you can buy can ease symptomsuntil the sore throat goes. Usually, you would only need to see a doctor if symptoms are severe,unusual, or if they do not ease within 3-4 days.
What is a sore throat?
Sore throat (pharyngitis) is very common. It is usually caused by an infection in the throat. Soreness in the
throat may be the only symptom. In addition, you may also have a hoarse voice, mild cough, fever, headache, feel
sick, feel tired, and the glands in your neck may swell. It may be painful to swallow. The soreness typically gets
worse over 2-3 days and then usually gradually goes within a week. In about 1 in 10 cases the soreness lasts
longer than a week. You may also develop a sore throat if you have a cold or flu-like illness.
Tonsillitis is an infection of the tonsils at the back of the mouth. Symptoms are similar to a sore throat, but may
be more severe. In particular, fever and generally feeling unwell tend to be worse. You may be able to see some
pus which looks like white spots on the enlarged red tonsils.
What is the treatment for sore throat and tonsillitis?
Not treating is an option as many throat infections are mild and soon get better.
Have plenty to drink. It is tempting not to drink very much if it is painful to swallow. You may become
mildly dehydrated if you don't drink much, particularly if you also have a fever. Mild dehydration can make
headaches and tiredness much worse.
Paracetamol or ibuprofen ease pain, headache, and fever. To keep symptoms to a minimum it is best to
take a dose at regular intervals as recommended on the packet of medication rather than now and then.
For example, take paracetamol four times a day until symptoms ease. Although either paracetamol or
ibuprofen will usually help, there is some evidence to suggest that ibuprofen may be more effective than
paracetamol at easing symptoms in adults. Paracetamol is usually the preferred first-line option for
children, but ibuprofen can be used as an alternative. Note: some people with certain conditions may not
be able to take ibuprofen. So, always read the packet label.
Other gargles, lozenges, and sprays that you can buy at pharmacies may help to soothe a sore throat.
However, they do not shorten the illness.
Do I need an antibiotic?
Usually not. Most throat and tonsil infections are caused by viruses, although some are caused by bacteria.
Without tests, it is usually not possible to tell if it is a viral or bacterial infection. Antibiotics kill bacteria, but do notkill viruses. However, even if a bacterium is the cause, an antibiotic does not make much difference in mostcases. Your immune system usually clears these infections within a few days whether caused by a virus or abacterium. Also, antibiotics can sometimes cause side-effects such as diarrhoea, feeling sick, rash, andstomach upsets.
Therefore, most doctors do not prescribe antibiotics for most cases of sore throat or tonsillitis.
An antibiotic may be advised if the infection is severe, if it is not easing after a few days, or if your immune systemis not working properly (for example, if you have had your spleen removed, if you are taking chemotherapy, etc).
Things to look out for
In nearly all cases, a sort throat or tonsillitis clears away without leaving any problems. However, occasionally atypical sore throat may progress to cause complications. Also, a sore throat is sometimes due to an unusual, butmore serious, illness. Therefore, for the sake of completeness, the sort of things to look out for include thefollowing: Possible complications
Sometimes the infection can spread from the throat or tonsils to other nearby tissues. For example, to cause an
ear infection, sinus infection or chest infection.
Infectious mononucleosis (glandular fever)
Infectious mononucleosis is caused by a virus (the Epstein-Barr virus). It tends to cause a severe bout oftonsillitis in addition to other symptoms. See separate leaflet called 'Glandular Fever (Infectious Mononucleosis)'for more details.
Quinsy - also known as peritonsillar abscess
Quinsy is an uncommon condition where an abscess (a collection of pus) develops next to a tonsil, due to a
bacterial infection. It usually develops just on one side. It may follow a tonsillitis or develop without having had
tonsillitis. The tonsil on the affected side may be swollen or look normal, but is pushed towards the midline by the
abscess next to the tonsil. Quinsy is very painful and can make you feel very unwell. It is treated with antibiotics,
but also the pus often needs to be drained with a small operation.
Other uncommon causes of throat or tonsil infections
Other infections can sometimes cause a sore throat or tonsillitis. For example, a thrush infection of the throat, or
certain sexually transmitted infections.
Noninfective causes of sore throat
An allergy such as hay fever can cause a sore throat. A sore throat can be the first symptom of throat cancer (but
this is rare and mainly affects older smokers).
Medication such as carbimazole
Carbimazole is a drug that is used to treat an overactive thyroid gland. If you are taking carbimazole and develop
a sore throat then you should have an urgent blood test. This is because a sore throat may be the first warning of
a serious side-effect to carbimazole (agranulocytosis - which is a low level of white blood cells). This serious
side-effect needs urgent treatment. Agranulocytosis can occur as a side-effect of various other drugs.
The 'take home' message is . see a doctor if symptoms of a sore throat are severe, unusual, or if they do notease within 3-4 days. In particular, seek urgent medical attention if you develop: difficulty in breathing; difficultyswallowing saliva; difficulty opening your mouth; severe pain; a persistent high temperature; a severe illness,especially when symptoms are mainly on one side of the throat.
Further reading & references
Sore throat - acute; Prodigy (April 2008)Respiratory tract infections, NICE Clinical Guideline (July 2008)Management of sore throat and indications for tonsillectomy, Scottish Intercollegiate Guidelines Network -SIGN (April 2010) Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical
conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its
accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
For details see our conditions.


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