How many of us don't know a sore throat? It can appear even when there seems to be no reason for it. Especially often painful swallowing worries in the cold season, when the number of provoking factors increases significantly. This symptom accompanies many diseases of the ENT organs, but in most cases it is a sign of pharyngitis. Pharyngitis is a lesion of the pharyngeal mucosa by an inflammatory process.
The disease can develop as an independent pathology or be a complication of angina, sinusitis or laryngitis. This is due to the spread of microbes and inflammation from the primary focus due to inadequate treatment or the addition of a secondary infection.
According to statistics, more than 70% of cases of referral to an otolaryngologist are the result of viral infection and the development of inflammation of the pharynx. Viral pharyngitis can be caused by coronaviruses, adenoviruses, influenza, rhinoviruses, RS viruses or parainfluenza. The peak incidence occurs in the winter period of the year, especially during an epidemic, but the flow of patients has been increasing since October.
To a lesser extent, the onset of the disease is influenced by bacterial pathogens, for example, streptococci, staphylococci, pneumococci, Haemophilus influenzae or corynebacteria. Fungal pharyngitis is rarely diagnosed, although its prevalence has been increasing recently. Candida fungi are normally present in the oropharynx but do not cause inflammation. With a weakening of immunity or the influence of negative factors, they can be activated and provoke a disease.
Pharyngitis in adults can develop due to contact with an allergen when the body reacts to it in the form of an allergy. The role of the "provocateur" can be animal hair, fluff, pollen, hygiene products, detergents, medicines or food.
Sore throat can also occur due to:
- exposure to a traumatic factor, for example, after eating solid foods (nuts, crackers), when the mucous membrane of the oropharynx is injured and inflammation is provoked. This group of reasons also includes damage to the mucous membrane by a foreign element when children play with small elements of toys or buttons;
- surgical intervention on the neck and ENT organs;
- eating cold drinks or foods;
- prolonged inhalation of cold air, for example, when running outside in winter;
- the presence of infectious and inflammatory diseases of the oropharynx and nasopharynx, for example, tonsillitis, sinusitis or laryngitis.
As a result of exposure to the listed factors of infectious and non-infectious origin, acute pharyngitis develops in adults. It is characterized by a rapid onset and severe symptoms. However, do not forget about the chronic course of the disease, which flutters due to improper treatment or its absence at all in acute pharyngitis. The predisposing factors that increase the risk of a chronic form of the disease include:
- long-term smoking and alcohol abuse;
- long-term use of drugs for the nose with a vasoconstrictor effect (Naphthyzin);
- professional hazards (work in the paint and varnish, mining industry);
- frequent ARVI;
- caries and other infectious foci in the oral cavity;
- dry, polluted air;
- overstrain of the vocal apparatus of vocalists, lecturers or announcers;
- Long-term exposure to an allergen, such as living in a room with animals or if mold is present
- hypovitaminosis;
- hormonal fluctuations;
- systemic diseases accompanied by dry mucous membranes, for example, Sjogren's disease;
- violation of nasal breathing, when a person has to breathe through the mouth, thereby drying out the mucous membrane of the throat.
Chronic pharyngitis cannot be cured without removing the provoking factor (smoking or occupational hazards).
Pharyngitis is most often diagnosed in people with low levels of immunity. For a year, the number of cases of the disease can reach 5-6 times. Gradually, the inflammation becomes chronic and worries almost constantly. The decrease in immunity is facilitated by severe comorbidities, infections and a predisposition to allergies.
Symptoms of the disease
The defeat of the throat, depending on the strength of the provoking factor and the resistance of the immune defense, can manifest itself with rapidly developing symptoms or proceed in a sluggish form.
An acute illness is characterized by:
- severe sore throat, which after a few hours turns into pain syndrome. Pain bothers while swallowing saliva, talking, or even at night, interfering with sleep. It can spread to the ear area if the inflammation covers the tubopharyngeal ridges;
- dryness in the oropharynx;
- discomfort in the throat;
- fever fluctuates at the border of 37.4 degrees, but with flu or bacterial infection, the temperature can exceed 38 degrees;
- regional lymphadenitis, when, when probing closely located lymph nodes, their swelling and soreness is felt;
- fast fatiguability;
- decreased appetite due to intoxication and soreness in the oropharynx.
The diagnosis of pharyngitis is established on the basis of clinical symptoms, features of the history of the disease, pharyngoscopy data and bacteriological examination. If necessary, PCR or ELISA is performed. As for the acute form, with pharyngoscopy, hyperemic palatine arches, as well as the posterior pharyngeal wall, are visualized.
In addition, inflamed lymph granules are noted, but there are no signs of damage to the tonsils.
We draw attention to the fact that a sore throat can be one of the first signs of measles, scarlet fever or rubella.
Chronic inflammation of the pharynx does not have such violent symptoms in comparison with acute pharyngitis. It is not characterized by hyperthermia and a noticeable deterioration in the condition. A person may be disturbed by dry mouth, a feeling of a foreign lump in the oropharynx, perspiration and a constant desire to "cough up". With the appearance of a cough and hoarseness of the voice, it is worth suspecting the spread of inflammation to the larynx, so in this case it will be possible to talk about chronic laryngitis.
The cough is usually dry, more like a "coughing". The presence of mucus on the posterior pharyngeal wall provokes a constant swallowing movement. This fails to remove mucus, which irritates the person and interferes with proper sleep.
Having examined pharyngitis, what it is, now you can consider the forms of the disease associated with a chronic course:
- atrophic - characterized by thinning of the mucous membrane. It becomes dry, mucus is noted on its surface (viscous, dried out in places). The mucous membrane looks shiny, and dilated blood vessels are visualized through it;
- hypertrophic - manifested by the formation of areas of growth of lymphoid tissue, which are randomly located on the posterior pharyngeal wall. Hyperplastic tubopharyngeal ridges are also observed, which are visible behind the palatine arches.
The listed signs indicate the presence of chronic inflammation. During periods of exacerbation, hyperemia and swelling of the mucous membrane additionally appear.
How to confirm the diagnosis?
To confirm pharyngitis in adults, it is enough to conduct an instrumental examination, which includes pharyngoscopy, as well as laboratory tests:
- PCR and ELISA methods are used when a viral origin of the disease is suspected;
- cultural analysis makes it possible to establish the type of bacterial pathogens by analyzing a culture that has grown on a nutrient medium. After that, an analysis is carried out for the sensitivity of pathogenic microorganisms to antibacterial drugs. This allows you to choose the most effective antibiotic for each case.
Of course, do not forget about a detailed story to the doctor about the presence of concomitant chronic diseases and the peculiarities of the course of the period on the eve of the onset of symptoms (contact with an allergen, a sick person or drinking cold drinks). This will help to establish the cause of the pathology and choose a therapy.
>Complications
What is pharyngitis is a little clear. In fact, it does not pose a threat to life, but it is also not worth neglecting the treatment. Due to the progression of the disease, not only nearby organs can suffer, but also the heart and joints. The fact is that the spread of infection through the bloodstream leads to damage to those organs that are most sensitive to a particular pathogen.
So, how the disease can be complicated.
| Complication | Symptoms | Diagnostics | Notes (edit) |
|---|---|---|---|
| Peritonsillar abscess | It is manifested by severe sore throat, the presence of a foreign lump in the throat, difficulty swallowing, febrile hyperthermia and enlarged lymph nodes. As the person progresses, it becomes difficult to open his mouth and talk. | Pharyngoscopy, ultrasound, smear analysis and bacterial culture of purulent discharge. | Pharyngitis is caused by a bacterial pathogen. |
| Chronic form | Dryness, perspiration in the oropharynx, desire to cough up. | Pharyngoscopy, examination of throat swabs. | Pharyngoscopy, examination of throat swabs. |
| Retropharyngeal abscess | Clinically present with severe sore throat that spreads to the neck, ear, and nasopharynx. It is difficult for a person to swallow, chew and talk. Temperature can reach 39 degrees | Fringoscopy, laryngoscopy, ultrasound, analysis of material taken from the throat | It is characterized by purulent inflammation, which is usually diagnosed in children and people with weakened immune systems |
| Sepsis | Hectic fever, symptoms of bronchitis, pyelonephritis, meningitis and other septic complications associated with infection of internal organs | Ultrasound, bacterial culture, pharyngoscopy. | Usually, blood poisoning occurs due to an increase in ulcers in the throat, when local immunity cannot cope with bacteria and inflammation. Develops in weakened people (after surgery, with severe diseases, immunodeficiency) |
| Sinusitis | The patient is worried about nasal congestion, thick greenish discharge, febrile fever, headache and nasal voice | Rhinoscopy, pharyngoscopy, smear examination, radiography of the paranasal sinuses | Develops as a result of the spread of infection through the nasopharynx |
| Laryngitis, tracheitis, bronchitis | Cough, low-grade fever, hoarseness | Faringo-, laryngoscopy, X-ray of the lungs, analysis of smears from the pharynx. | Speakers, teachers, workers in hazardous industries (dust, smoke, chemicals) are particularly affected. |
| Otitis | Ear pain, nausea, vomiting, dizziness, unsteadiness in gait | Otoscopy, pharyngoscopy, smear analysis | May be accompanied by labyrinthitis and meningitis in an advanced stage |
| Rheumatic fever | Heart pain, shortness of breath, heaviness in the chest, tachycardia, joint pain, erythema on the skin | Blood test (ESR, C-reactive protein, ASLO titer), ECG, pharyngeal culture, echocardiography, chest X-ray | The cause of the disease is the activation of streptococcal infection. |
| Glomerulonephritis | Increased blood pressure, lumbar pain, swelling | Urine analysis, ultrasound | Often diagnosed during childhood |
Prevention Tips
It will most likely not be possible to completely avoid the development of pharyngitis throughout life, because for the appearance of a sore throat, it is enough to overeat ice cream or get caught in the cold rain. However, with the help of recommendations, you can significantly reduce the incidence of the disease and prevent the development of complications.
These tips will help to avoid not only sore throat, but also inflammation of other localization in the ENT organs. Pharyngitis prevention:
- to prevent the spread of infection and inflammation, it is necessary to regularly visit the ENT doctor in the presence of chronic tonsillitis or sinusitis. This will help control the activity of the underlying disease and prevent its exacerbation;
- preventive examination of the dentist and sanitation of foci of infection (with caries, gingivitis) makes it possible to limit the infectious site and prevent the spread of infection;
- control over the activity of concomitant somatic pathology, since its exacerbation reduces the level of immune defense;
- proper nutrition. It is recommended to give up "light" carbohydrates, foods with trans fats, spices, smoked meats, crackers and chips. You can replace them with fruits, vegetables, fish, dairy products and cereals;
- sufficient drinking regime. It is necessary to drink a total of 1.5-2 liters of still water, juice, compote, jelly and tea per day. This allows you to maintain a normal water-electrolyte balance and ensure the body is cleansed of waste products;
- good sleep and protection from stress help maintain a normal psycho-emotional state;
- sports activities, morning exercises or dosed physical activity. Swimming or cycling is suitable for this;
- wet cleaning, ventilation and humidification of the air can reduce the irritating effect on the mucous membrane, because dry air and dust predispose to the development of pharyngitis;
- walks in the fresh air are required even in the winter season, since oxygen saturation of the internal organs is necessary for their full functioning. The brain is especially sensitive to hypoxia, which is why a person may experience dizziness, headaches, inattention and drowsiness;
- hardening. These procedures should be started when the person is healthy, with the most comfortable water temperature, gradually increasing the difference. It is better to start hardening in childhood, so that the child's body can easily adapt to changes in temperature, and the immunity is strong;
- vitamin therapy. Periodically, you need to take mineral complexes and vitamins, for example, Aevit, Duovit, Supradin or Alphabet;
- dosed sunbathing and sea procedures perfectly tone the body and strengthen the immune system. Spa treatment is especially useful;
- breastfeeding and timely vaccination are important for children.
If pharyngitis nevertheless develops, prevention and therapy will help to quickly get rid of the disease, preventing the generalization of the infection. And remember that the foundation for immunity is laid in childhood, therefore, having formed a strong defense of the body, you can only maintain it and not worry about the appearance of diseases of the ENT organs.
