Sore Throats

What are the symptoms of this condition?

Sore throats are characterised by pain and discomfort on swallowing. The back of the throat may look red and sore, and the tonsils may be swollen (see the diagram). Eating and drinking will be uncomfortable. There may be hoarseness of voice and discomfort on speaking if the voice box or larynx is involved, and a high temperature may also be present.

What is the cause of the condition?

In most cases, a sore throat is the result of a viral or bacterial infection and can often accompany a cold or flu.

The infection causes a generalised inflammation of the structures of the throat. In particular, the tonsils may be involved; they may become swollen, causing tonsillitis, in which case you should see your doctor.

It is the inflammation of the delicate surface of the throat that causes the pain on swallowing, and general discomfort. A sore throat will look red and inflamed, and whitish spots of pus may sometimes be seen at the back of the throat. If the tonsils are involved they may also show similar signs of infection.

Most of these throat infections are viral in origin, and will settle down without needing any medicines other than simple soothing preparations. However, a bacterial throat infection can sometimes follow on from the original viral infection; these infections can be more serious, may spread to the tonsils and might eventually need antibiotic therapy.

On rare occasions, sore throats can occur as a side effect of other drugs or medications, especially ones which affect the body's immune response, making it less effective at fighting infections - carbimazole, sulphasalazine and methotrexate are three prescription-only medicines which may cause a sore throat as a side effect, which must be referred immediately to your doctor.

Some asthma inhalers may also cause a sore throat as a side effect - especially the steroid-based 'preventer' inhalers, which are usually brown or orange in colour.Some of the powder in the inhaler impacts against the back of the throat during inhalation, which can reduce the throat's ability to fight infections. This can be minimised by rinsing the mouth with water after using the inhaler, and also by using a 'spacer' device, which reduces the amount of powder which hits the back of the throat; sometimes the problem may be related to your inhaler technique. Your pharmacist can advise you about the correct way to use your inhaler.

Taking high doses of steroids in other ways, for example in a tablet form for the treatment of arthritic conditions, may also allow throat infections to develop as steroids can reduce the body's immune response to fighting infections.

What complications might occur?

Normally there are no serious complications resulting from a sore throat. Sometimes a bacterial infection can spread through the throat or tonsils, and will require antibiotic treatment; a sore throat persisting for longer than seven days may indicate a bacterial rather than a viral infection. A degree of pain on swallowing is quite normal with a sore throat, but if the pain is so severe that swallowing becomes difficult, this is a sign that a doctor needs to be consulted.

In severe cases, the infection can progress from the throat up into the ear to cause an ear infection. Pain in and around the ear, a high temperature, or dizziness are signs this may be happening and will need medical attention.

What can I do to treat myself?

Sore throats often accompany colds or flu, and many of the general self-treatments for those conditions are applicable here.

Drink plenty of fluids and do not allow yourself to become dehydrated. Rest, to allow the body time to fight the infection. Try to maintain your food intake; eating may be painful, but it is still important to get vitamins and nutrients into your body. If taking solid food is very difficult, supplement your diet with nourishing drinks and use an appropriate medication to ease the throat pain; soft foods may be easier to swallow than hard crunchy foods.

Simple painkillers, such as aspirin or paracetamol, can be taken when appropriate to relieve the pain and discomfort; they will also relieve the general symptoms of colds and flu, and anaesthetic lozenges or sprays will calm the irritationthe irritation in the throat. Gargling may also offer some relief, with mouthwashes, or soluble aspirin to reduce any inflammation. There are a large number of remedies and medications suitable for treating sore throats, and these will be covered in the next section.

Feel free to consult the Pharmacy2U pharmacist for advice and help on selecting the best medication for your sore throat.

What treatments are available for me to purchase?

Non-prescription treatments for sore throats include antiseptic preparations, soothing preparations for the inflamed surfaces, and local anaesthetics that numb the inflamed areas and reduce the pain. These are summarised below.

Antiseptics
Many lozenges and gargles contain an antiseptic ingredient, such as cetylpyridinium. These may help to prevent or treat secondary bacterial infections, but have no benefit in the treatment of viral infections. However, sucking any lozenge will help to lubricate and soothe sore throats.

Local anaesthetics
Some sore throat treatments contain a local anaesthetic, such as lidocaine or benzocaine, which numbs the throat. These products are available as lozenges, including Merocaine and Dequacaine; or sprays, such as Vicks Ultra Chloraseptic.

To view the full range of sore throat treatments available from Pharmacy2U Click here.

What treatments are available from my doctor?

The majority of sore throats are unlikely to need any intervention from a doctor - viral infections cannot be treated with antibiotics. As most throat infections are viral in nature, there is probably no need to see a doctor, at least not to start with. Only if the soreness persists for more than a week, if you have difficulty in swallowing, or if the infection has spread beyond the throat, should a doctor be consulted. Antibiotics may be needed to kill any secondary infections that are present.

What additional investigations might be needed?

Swabs of the throat might be needed to isolate the organism responsible for the infection, if it is not responding to self-treatment. The swab would be sent to a laboratory with the results being returned within a few days, so that an antibiotic can be prescribed that is shown to be effective at managing the infection.

Any other information I should have?

Throat infections are usuallyare usually caused by a self-limiting viral infection. They do not normally require medical intervention, and can be treated successfully at home with non-prescription remedies. A doctor's opinion should be sought if the throat is not improving after ten days of treatment, or has spread to the ears - however, if you are taking any other medicines from your doctor that might cause a sore throat as a side effect, such as those mentioned above, talk to your doctor as soon as you can. If you are unsure about how to treat your sore throat please ask the Pharmacy2U pharmacist for advice.