Treatment of chronic pharyngitis

The causes of the development of chronic pharyngitis may be:

• improper treatment of acute pharyngitis
• chronic tonsillitis
• chronic diseases of the nose and paranasal sinuses (sinusitis, sinusitis)
• long-term use of vasoconstrictor drops
• irritants, dust, smoke, smoking and alcohol abuse
• diseases of internal organs (cholecystitis, pancreatitis, chronic gastritis and intestinal dysbiosis)
• nasopharyngitis

According to the localization of the process, it is customary to distinguish:

• mesopharyngitis
• nasopharyngitis
• hypopharyngitis

By type, chronic pharyngitis is divided into:

• simple (catarrhal) pharyngitis
• hypertrophic (granular) pharyngitis
• atrophic or subatrophic pharyngitis

Most often, the symptoms of the disease appear after hypothermia of the body, which is why in everyday life nasopharyngitis is often called a cold.

Different types of disease require different therapeutic methods:

• Catarrhal
• Hypertrophic
• Atrophic
• Subatrophic

Simple (catarrhal) pharyngitis

With catarrhal pharyngitis

the patient complains of
sore throat, sore throat when swallowing
, a feeling of a “lump” in the throat and a dry cough. The mucous membrane of the pharynx is red with mucopurulent discharge.

When suffering from catarrhal pharyngitis, frequent gargling with alkaline solutions and lubrication of the mucous membranes with Lugol's solution or protargol are recommended.

To achieve a lasting and rapid effect, it is necessary to combine the use of local drug treatment with laser therapy.

The use of a course of light therapy with a therapeutic laser allows you to restore the protective and antibacterial functions of the oropharyngeal mucosa. For frequent exacerbations of pharyngitis, the use of 3-5 sessions of photodynamic therapy is indicated.

Catarrhal form is the most common

Introduction

Chronic pharyngitis is a prolonged inflammatory process of the mucous membrane of the back wall of the pharynx. This is a longer lasting inflammation than acute pharyngitis. Chronic pharyngitis manifests itself in a series of relapses - during an exacerbation, the symptoms return again, and after some time they fade again. Such inflammation can last for years, greatly reducing the patient’s quality of life. Another unpleasant point is the risk of complications: it always persists as long as there is a chronic source of infection in the throat.

Most often, chronic pharyngitis develops due to untreated acute pharyngitis. Also at risk are people whose pharynx is exposed to the negative effects of external factors:

• smoking,
• abuse of alcoholic beverages;
• polluted air in the place of residence;
• inhalation of harmful substances, dusty, polluted air in production.

The main signs of chronic pharyngitis are dryness, soreness and discomfort in the throat.

The disease can manifest itself in several forms. Pharyngitis can develop as an independent disease, or can be combined with chronic tonsillitis. This combination of two ENT conditions is called tonsillopharyngitis.

Hypertrophic pharyngitis

For hypertrophic pharyngitis

The patient's complaints are similar to those with the catarrhal form of the disease, but in this case
there is more mucous discharge and it is more viscous
, which causes discomfort, since it is necessary to constantly cough up, which can provoke an attack of vomiting.

With this type of pharyngitis, there are lymphoid accumulations (groups of follicles) on the mucous membrane of the pharynx, which are pronounced.

In case of large accumulation and increase in size, these follicles turn into granules, and the disease is designated as granulosa chronic pharyngitis.

For hypertrophic pharyngitis, alkaline gargling is also recommended; inhalations with essential oils of medicinal herbs (sage, chamomile and eucalyptus) are also useful.

Hypertrophic granulosa pharyngitis

has a characteristic symptom - a tickling sensation in the throat, its other symptoms are similar to those of hypertrophic pharyngitis.

Treatment of granulosa pharyngitis

can be therapeutic and surgical

Therapeutic

– similar to the treatment of catarrhal chronic pharyngitis.

Surgical

the intervention is carried out using a radio wave or laser beam. During surgery, the granules themselves are removed, but to completely cure the pathology, therefore, after removal of the granules, drug treatment is still required.

The patient should stop smoking.

Pharyngitis - symptoms and treatment

Treatment of acute pharyngitis begins with organizing a regimen and nutrition :

• gentle regime with enough sleep;
• creating conditions for the normal functioning of the mucous membrane - cool, moist air, eliminating active and passive smoking, contact with dust and irritants;
• diet excluding spicy and rough foods;
• warm drinks, alkaline rinses and inhalations [12].

Sometimes these measures already lead to an improvement in the condition. As prescribed by a doctor, to reduce the symptoms of pharyngitis caused by inflammation, complex products are used in the form of tablets, aerosols, rinses :

• antiseptics (chlorhexidine, hexetidine, benzydamine, iodine preparations, plant extracts, etc.);
• sometimes antibiotics (gramicidin);
• anti-inflammatory drugs (ketoprofen);
• local anesthetics (lidocaine, tetracaine, menthol) [13].

The choice of drugs is large, but excessive use can lead to suppression of the normal microflora of the pharynx, decreased local immunity, allergic reactions, damage to the mucous membrane; in addition, their effectiveness in viral infections has not been proven [7].

To reduce the temperature, non-steroidal anti-inflammatory drugs (ibuprofen, paracetamol) are prescribed.

Treatment of bacterial pharyngitis

Specific treatment of acute and chronic pharyngitis in adults with bacterial pathogens, especially with GABHS (group A beta-hemolytic streptococcus) is systemic antibiotic therapy. The drugs of choice are antibiotics from the group of semisynthetic penicillins (amoxicillin). Often sick children who have a variety of pathogenic flora on their mucous membranes are prescribed protected aminopenicillins (amoxicillin + clavulanic acid). When mycoplasma or chlamydia is detected, antibiotics are prescribed when the process descends into the bronchi and lungs or the disease becomes protracted [7]. Macrolide antibiotics (azithromycin, clarithromycin) are used.

Viral pharyngitis does not require antibiotic therapy.

Treatment of fungal pharyngitis

For mycoses, local antimycotic agents are used (co-trimoxazole, pimafucin, 2% alkaline solution). If local therapy does not help, antifungal antibiotics (amphotericin B) or special antifungal agents (ketoconazole, mycoheptin, fluconazole) are prescribed.

Treatment of chronic pharyngitis

Treatment of chronic pharyngitis during an exacerbation is no different from treatment of the acute form of the disease. It includes symptomatic therapy, proper organization of daily routine and food intake.

Purulent pharyngitis is not isolated, so there are no separate recommendations for its treatment.

Treatment of pharyngitis at home

Mild acute viral pharyngitis, if you follow a home regimen and regular warm drinks, goes away within seven days. However, the disease can occur not only due to a viral infection, but also for another reason. Therefore, without making a diagnosis, you should not self-medicate.

Physiotherapy

For obsessive dry cough and dry throat, you can use inhalations with saline solution as directed by your doctor.

Surgery

Surgical treatment consists of correcting the nasal septum and removing nasopharyngeal polyps. Surgery is necessary if the cause of chronic pharyngitis is constantly difficult nasal breathing. Removal of adenoids and tonsils is carried out according to strict indications. The decision on the need for surgery is made by an otolaryngologist after a thorough diagnosis.

Atrophic pharyngitis

Atrophic pharyngitis is the final stage of chronic pharyngitis. In addition, this disease can occur independently against the background of dystrophic diseases of the gastrointestinal tract.

With atrophic pharyngitis, the mucous secretion becomes very viscous and dries into crusts, which cause significant discomfort to the person - they are located in the nasopharynx, from where they are released in fragments or whole casts.

With atrophic pharyngitis, the mucous membrane of the pharynx is dry and pale, blood vessels are clearly visible through it, lymphoid granules consist of scar connective tissue.

The pharyngeal reflex may completely disappear, which indicates that atrophic pharyngitis affects the nerve endings.

Treatment of atrophic pharyngitis is long-term, its effectiveness depends on the degree of atrophy, the general condition of the body and the cause that led to the occurrence of this pathology.

Atrophic pharyngitis

has two directions in treatment - general and local.

Local treatment

atrophic pharyngitis is aimed at increasing the activity of the glandular apparatus of the pharyngeal mucosa, which should lead to increased production of mucus and an increase in reparative biologically active substances in it.

General treatment

atrophic pharyngitis is aimed at increasing immunity.

Self-medication will not help. It is ineffective and dangerous

Causes and course of the disease

Contributors to the occurrence of this disease are: often recurrent acute inflammation of the posterior wall of the pharynx (acute pharyngitis), diseases in the paranasal sinuses, chronic tonsillitis, acute tonsillitis (angina), and inflammatory diseases of the nasal cavity that last for a long time.

The development of chronic pharyngitis is also influenced by the following factors:

• Unfavorable ecological and climatic environmental conditions - dry air, elevated air temperature, dust, gas pollution and dustiness, exposure to harmful chemicals;
• Smoking and alcohol abuse;
• Disorders in the endocrine system, causing hormonal imbalance;
• Diseases affecting the gastrointestinal tract;
• Allergy;
• Dental caries;
• Too spicy food, etc.

Complications of the disease

It is necessary to treat pharyngitis in a timely manner and in compliance with all instructions. A seemingly harmless disease can cause serious consequences for the body.

Depending on the nature of the pathogen, pharyngitis causes different complications. These include:

1. Decreased immunity and, as a result, increased sensitivity to viral diseases.
2. Inflammation of the lymph nodes and salivary glands.
3. Inflammatory processes of the middle ear and auditory tube lead to hearing loss.
4. Tracheitis and chronic bronchitis.

If pharyngitis is not treated, there is always a chance that it will become chronic.

Diagnosis of the disease

Making a diagnosis is usually not difficult. The main diagnostic method is pharyngoscopy - direct examination of the pharynx. To identify the causative agent of the disease, the patient is sent by an ENT doctor to conduct a series of laboratory tests: a general, biochemical blood test, and a throat smear.

To identify the cause of chronic pharyngitis, additional tests may be needed to locate the site of primary infection. The patient may undergo:

• X-ray or CT scan of the paranasal sinuses;
• endoscopy of the nasopharynx;
• gastroscopy.

Causes of the disease

A natural process for humans is nasal breathing.
The nasal passages are designed so that inhaled air enters with a slight delay. During these pauses, it warms up, is filtered and in this form is supplied to the body. When the nose is stuffy and breathing occurs through the mouth, the risk of pharyngitis increases - because the air does not pass through the “filters” and enters through the mouth with bacteria, viruses, dust, etc. The unnatural process causes the pharynx to dry out, it becomes a favorable environment for the development of pathogenic flora . The second common cause of pharyngitis is a runny nose due to ARVI. In this case, the source of inflammation is in the throat, developing gradually. Frequent treatment of the nasal passages with vasoconstrictor drops negatively affects the condition of the pharynx, which also causes the development of the disease.

Other reasons include:

• vitamin deficiency and malnutrition;
• bad habits;
• injuries;
• individual characteristics in the structure of the nasopharynx;
• long-term treatment with antibiotics;
• chemical fumes;
• ingress of allergens.

Often, pharyngitis is caused by previous diseases, for example, diabetes mellitus, dental caries, heart failure, kidney failure, sinusitis, sinusitis and others.

Prevention of chronic pharyngitis

Prevention of chronic pharyngitis includes significant adjustments to habits and lifestyle - this is the only way you will reduce the risks of developing the disease.

Preventive measures to prevent the development of chronic pharyngitis include:

• timely treatment of acute pharyngitis and other inflammatory ENT diseases;
• reducing cases of contact with irritating harmful substances at work and allergens;
• cessation of smoking and drinking alcoholic beverages;
• treatment of gastrointestinal diseases;
• limiting the consumption of spicy and sour foods;
• strengthening the immune system;
• avoiding crowded places during ARVI epidemics;
• maintaining the required level of humidity and temperature in the room.

Causes

The disease can be caused by:

• exposure to external irritating factors - inhalation of dry, polluted, excessively hot or cold air, toxic irritants;
• infection - contact with the mucous membrane of the pharynx of various pathological microorganisms. Usually these are streptococci, staphylococci, pneumococci, viruses or fungi.

Often an acute inflammatory process affecting the tissues of the pharynx is a complication of a primary cold - acute respiratory infections, acute respiratory viral infections, influenza, sinusitis, rhinitis, and less often caries.