Pharyngitis is understood as an inflammatory process localized in the pharynx. The process can be acute or chronic, in which periods of remission are followed by an exacerbation. At the same time, acute pharyngitis is rarely an independent disease. Usually it is one of the symptoms of diseases that affect the respiratory tract. Chronic pharyngitis is an independent pathology, in the development of which a significant role is played not only by various pathogenic microorganisms, but also by provoking factors.
The most common causes of the disease are:
- inhalation of cold, dry, polluted air;
- hypothermia;
- exposure to occupational hazards that are present in hot shops, cement plants, flour mills;
- long-term foci of infection;
- the presence of concomitant diseases occurring with a decrease in immunity;
- pathology of the gastrointestinal tract, characterized by the throwing of acidic contents from the stomach into the esophagus and throat.
Smoking is a factor that has an extremely negative effect on the development of respiratory tract pathology. Among patients who smoke, or those who passively receive a certain amount of nicotine when breathing, the frequency of inflammatory diseases of the upper respiratory tract and oncopathology is 2 times higher.
Clinical signs
For children, a chronic inflammatory process in the pharynx is uncharacteristic. This course is usually observed in patients after 30 years. With a genetic predisposition, incorrect treatment of acute pharyngitis, as well as exposure to unfavorable factors, the acute course of the disease can be transformed into chronic pharyngitis, which is characterized by a long course, the nature of the lesion, and prognosis.
Chronic pharyngitis is characterized by the following symptoms:
- cough;
- a feeling of soreness and scratching in the throat;
- sore throat;
- dry mouth, in connection with which there is a desire to take a sip of water;
- constant choking, desire to swallow saliva.
An exacerbation of chronic pharyngitis usually develops after hypothermia or exposure to other hazardous components in the inhaled air. The initial symptom is a sore throat that worsens when swallowing, especially with an "empty" throat that does not contain a lump of food. It can give off to the ear or neck. After a short period of time, a dry cough appears. Over the next day, the symptoms increase.
Chronic pharyngitis occurs with a satisfactory general condition. Sometimes a prolonged course may be accompanied by malaise, decreased appetite. Temperature readings are usually within normal limits. In rare cases, an exacerbation of the process can be characterized by an increase in temperature to subfebrile levels.
Characteristic of cough
Against the background of local treatment with anti-inflammatory and antiseptic agents, pain in the throat regresses. Over time, coughing comes to the fore. By nature, it is dry, harsh, paroxysmal. May disturb patients during the day as well as during a night's sleep. Such a course exhausts the patient, interferes with rest, and leads to irritability.
Cough with pharyngitis is characterized by a persistent course, difficult to treat. It can disturb the patient for several weeks while maintaining its intensity.
Strong cough tremors lead to the development of pain in the epigastric region, which is caused by the tension of the muscles of the diaphragm when coughing. This pain syndrome regresses after the clinical manifestations of the disease decline.
Complications of the disease
The most common complication of chronic pharyngitis is the spread of inflammation to nearby tissues with the development of laryngitis, tracheitis, bronchitis. Bronchopneumonia develops much less frequently. The effect of chronic pharyngitis on hearing is possible.
This happens when the auditory tube is involved in the process, which connects the tympanic cavity with the nasopharynx. The Eustachian tube is narrow, its diameter does not exceed 2 mm, therefore, even a slight narrowing as a result of inflammation and edema leads to dysfunction. As a result, congestion develops in the middle ear, contributing to inflammatory processes.
Such a complication of the disease as otitis media is most often observed in the acute course of pharyngitis. The chronic process is accompanied by damage to the organ of hearing in exceptional cases. However, the progression of symptoms, which is manifested by tinnitus, congestion, hearing loss, is a reason to report new complaints to an otolaryngologist and conduct an otoscopy.
Therapeutic measures may include the appointment of local or systemic antibiotics. The otolaryngologist can only determine the treatment tactics based on the results of an otoscopy.
Diagnostics of various forms of the disease
Chronic pharyngitis can be diagnosed by performing pharyngoscopy. This study is informative, accessible, and does not require special equipment. It consists in a visual examination of the pharynx using an additional light source and a spatula, which is pressed on the tongue to provide better opportunities for examination.
The pharyngoscopic picture depends on the form of the lesion. Depending on the nature of the lesion of the mucous membrane, the catarrhal form of pharyngitis, hypertrophic and atrophic, is distinguished. Each of them is characterized by its own characteristics, which is reflected in the symptoms of the disease, determines the treatment tactics. It should be borne in mind that for all forms of lesion, objective signs are not significantly expressed in comparison with the clinical manifestations of the disease.
The most common and beneficial is the catarrhal form of inflammation. It is typical for her to have an edematous and hyperemic mucous membrane of the pharynx. The same form of an acute process most often occurs with diffuse inflammation, including damage to the larynx, tonsils, and nasopharynx.
Chronic pharyngitis is characterized by a local lesion affecting only the posterior pharyngeal wall.
When exacerbated, it may be covered in mucus. The period of remission proceeds without any peculiarities from the side of the mucous membrane.
The hypertrophic form of pharyngitis on an objective examination is characterized by a pronounced tuberosity of the posterior wall formed by lymphoid follicles. Such formations do not interfere with swallowing food, but lead to constant choking, a feeling of a foreign body in the throat. This form of pharyngitis must be differentiated from pharyngeal cancer, which can also be characterized by the presence of tumor-like formations on the posterior pharyngeal wall. In doubtful cases, a biopsy of the altered area of the mucous membrane is performed, which makes it possible to reliably clarify the pathology.
Thinning of the mucous membrane is typical for the atrophic form of pharyngitis. During remission, she looks pale, even cyanotic. Vessels are visible through its thinned layer.
In the acute period, thinning and dryness of the mucous membrane leads to the formation of dry crusts that adhere tightly to the back wall. With this course of the disease, patients often complain precisely of dry mouth, a constant desire to moisturize the throat. When the process spreads, the condition worsens, difficulties may arise with swallowing food. There is choking, a feeling of a lump in the throat.
This form of chronic pharyngitis has attracted increased attention, since it is regarded as the last stage in the development of the disease.
The atrophic form of pharyngitis is very difficult to treat and, in fact, is a precancerous condition.
In this regard, such patients are subject to regular medical examinations.
The presence of a cough for more than three weeks is a reason to consult an otolaryngologist, to conduct a pharyngoscopy. Despite the general satisfactory condition of the patients, the treatment of chronic pharyngitis is long-term and complex. The elimination of provoking factors is the most important step on the path to recovery.
