Sore throat, painful to swallow: how to treat a throat?

A cold is usually accompanied by inflammation of the oropharynx. Therefore, when a person is sick, it is difficult for him to swallow, he has a cough, a sore throat, a runny nose, and a fever. Associated symptoms include discomfort in the muscles and bones, chills, lethargy, and general weakness. The high temperature causes a headache, and swallowing causes severe discomfort in the throat.

If therapeutic measures are not taken in time, the disease will acquire a chronic form, which is characterized by constant and prolonged colds, malaise and weakness.

There are many reasons that can cause a sore throat; in each individual case, only a doctor can prescribe treatment. Make an appointment with an otolaryngologist at the Rossimed clinic to correctly diagnose the disease.

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Main causes of sore throat

With the onset of cold weather, people increasingly turn to the doctor about colds. During such periods, outbreaks of influenza epidemics are observed. Frequent incidence is observed among people with reduced immunity.

They easily pick up viral and bacterial infections, which are the main cause of discomfort in the throat. Pathogenic microbes enter the mucous membrane of the nasopharynx through airborne droplets or through direct contact with household items, for example, shared dishes, towels, and bed linen.

Patients complain:

• For a sore throat when swallowing.
• Soreness.
• Dry cough.
• Hoarseness of voice.

The cause of such symptoms are toxins produced by bacteria accumulated on the mucous membrane.

However, a sore throat can be caused by vitamin deficiency. In this case, it is necessary to establish proper nutrition. Sometimes it is not possible to restore the deficiency of essential substances through products. In such a situation, the doctor prescribes vitamin complexes.

A sore throat without fever appears as a result of injury to the mucous membrane. However, if an infection penetrates through the damaged areas, then a feverish state will accompany the main symptom.

The cause of discomfort in the larynx can be:

• Dry or air-conditioned air.
• Panic attacks.
• Being in a stuffy room where there is a lot of smoking.
• Injuries caused by sharp objects, such as fish bones.
• Thermal or chemical burns.

In addition, stylohyoid syndrome can cause pain. As well as excessive stress on the vocal cords, for example, when singing or long-term lecturing, in children when screaming and crying.

Complications

You can’t miss work or study, you don’t have time for your health, you don’t have the opportunity or desire to see a doctor, maybe you’re just afraid... There will always be excuses for being indifferent to your health. We underestimate the danger of complications from a sore throat for our body. Meanwhile, failure to consult a doctor in a timely manner can lead to complications of inflammatory diseases of the pharynx and larynx.

• Bronchitis can occur unnoticed, becoming chronic, and can worsen during and after acute respiratory viral infections.
• Pneumonia (pneumonia) has been and remains one of the most dangerous complications of acute respiratory infections and acute respiratory viral infections. About 5% of people with pneumonia die. In Russia, pneumonia ranks 6th in the list of leading causes of death among adults.
• Even in its mildest form, tonsillitis is scary because of its complications - diseases of the joints, kidneys, and myocardium. Repeated sore throats are especially dangerous for the heart. Complications of sore throat occur more often if you are used to enduring the disease on your feet.
• A fairly common complication of ARVI is sinusitis (sinusitis, frontal sinusitis) and other diseases.
• When coughing or sneezing from the oral mucosa, it is possible to introduce an infection into the cavity of the auditory (Eustachian) tube - eustachitis with the development of otitis media. The latter is dangerous due to its transition to a chronic form and the development of persistent hearing loss.
• Common complications of acute respiratory viral infections and acute respiratory infections are exacerbation of existing chronic diseases.

Untreated diseases of the upper and lower respiratory tract, especially against the background of weakened immunity, can greatly worsen the patient’s well-being, in some cases lead to death.

The most common complications of chronic acute respiratory viral infections and acute respiratory infections are dysfunction of the respiratory and hearing organs.

Why does your throat hurt when you don't have a fever?

Hyperthermia is usually present with viral and bacterial infections and colds. The cause is such pathologies as:

• Diphtheria.
• Laryngitis.
• Scarlet fever.

With angina, patients may feel nauseous, loose stools, experience diarrhea, fever, and aching bones and muscles. The reason lies in the general intoxication of the body caused by the accumulation of pus in the retropharyngeal region or an abscess.

Chronic tonsillitis or pharyngitis is not always accompanied by fever.

However, there are cases when patients complain that they have a sore throat for no apparent reason. In such a situation, you should ask what pharmacological drugs have been taken recently. After all, pain can be a side effect of a number of medications.

Some people cannot tolerate tobacco smoke. Even one breath is enough to start coughing and tickling. The reaction to atmospheric pollution by chemical vapors also manifests itself. Therefore, people who work in hazardous industrial conditions, as well as those living in environmentally unfavorable areas, complain that they have a sore throat.

Another reason that causes pain that radiates to the ear is neuralgia of the upper larynx, as well as osteochondrosis of the neck. Similar signs also occur in the presence of neoplasms.

Having considered the various manifestations of sore throat and the causes of its occurrence, it is worth paying attention to the provoking factors. Among which doctors highlight:

• Smoking, including passive smoking.
• Passion for oral sex.
• Decreased protective function. If an adult’s body is able to cope with an infection, then a child with an unformed immune system is easily susceptible to the disease.
• Allergy. Unpleasant sensations in the throat appear mainly in the morning.

In addition, the throat may hurt in patients with HIV and diabetes. The cause is often chemotherapy and hormonal treatment.

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Types of pain

“Anything can hurt: the back wall of the pharynx, the tonsils, the hypopharynx, the nasopharynx, the epiglottis with the root of the tongue,” says Vladimir Zaitsev. The main thing is to understand that there is a difference in sensations with one or another localization of pathogenic microorganisms.

1. Pain worsens when swallowing

One of the options for soreness in the throat area is pain, which intensifies when swallowing. At the same time, it is not sharp, diffuse, but intensifies when swallowed and swallowed. Here doctors usually talk about the most common situation: acute pharyngitis. “When a person became hypothermic, the back wall of the throat became cold, and it became inflamed. At the same time, there is no mucus flowing down the back wall, the throat just hurts,” notes the ENT doctor. You can go to the mirror, shine it with a flashlight and see redness on the back wall. And it will also be spilled all over the back wall.

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Here it is worth understanding, the otolaryngologist emphasizes, that if a person ignores this situation and does not begin to be treated, then the disease may progress to the chronic stage. “In this case, the pain will also change its character: instead of acute pain when swallowing, there will be a feeling of dryness of the back wall, its complete dryness, then there will be a feeling of rawness, soreness, burning, and there may be a desire to drink something or even put oil drops in the nose, to soften the wall of the pharynx,” says Vladimir Zaitsev. He emphasizes that the condition cannot be ignored. You can also see that the mucous membrane is suffering from dryness by looking in the mirror: it will be noticeable that it is not filled with water.

2. Sore throat is associated with the nose

Another type of pain appears when, for example, the tonsils are removed, or if a person has problems with the nose that lead to sleep apnea, snoring and the fact that his mouth is constantly open during sleep. “Such a situation will sooner or later lead to subatrophic pharyngitis. Due to the constant drying of the back wall of the pharynx, the mucous membrane will stop working as it should,” says Vladimir Zaitsev.

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3. Aching pain on the right and left

There may also be a problem when there is bad breath, weakness, lethargy and an aching sore throat, discomfort in the throat. This is what the condition of chronic tonsillitis or exacerbation of chronic tonsillitis looks like. “When there is a history of it, pain and discomfort do not appear in the center of the pharynx, but the pain will be localized on the sides: on the right and left. Also, against the background of such pain, low-grade fever appears: its values ​​rise to 37.3-37.5 degrees. At the same time, plugs in the tonsils will be visible, such small white curdled grains,” notes Vladimir Zaitsev.

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4. Throat hurts sharply and constantly

If the pain in the throat is unbearable and sharp, the temperature jumps above 38.5, and a scarlet throat is visible, very painful, then with a high degree of probability we are talking about acute catarrhal sore throat. “The temperature is high, the pain is very strong, sometimes it doesn’t even allow you to swallow saliva, as a result of which it just starts flowing from the mouth, it even gets to this point,” says the otolaryngologist.

5. Pain in the neck area

When hoarseness appears, this indicates that the inflammation has moved from the oropharynx just below, to the larynx, says the ENT doctor. “When there is acute inflammation of the larynx, acute laryngitis develops. However, it will not necessarily be accompanied by a complete absence of voice (aphonia); dysphonia may also be present. Here, too, against the background of incomplete closure of the ligaments, pain will appear. But it will not be localized at the level of the palate or along the back wall of the pharynx. It will be marked slightly lower, at neck level. The person himself will even point to his neck, describing his condition,” says Vladimir Zaitsev. Laryngitis, as the otorhinolaryngologist emphasizes, can be subacute, acute and chronic.

And it definitely needs to be treated. “If laryngitis is not treated, the inflammation may go away, but hoarseness may remain. The vocal cords will get stuck in this state, settle down, and the person will continue to live with this hoarseness forever,” says the specialist.

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6. Pain in the epiglottis area with suffocation

“The epiglottis is a kind of flap, a petal that closes the entrance to the trachea, and, for example, when taking a sip of water or swallowing food, it protects the organ from water and food entering further into the trachea, lungs and bronchi,” notes the doctor. At the same time, there are situations when this well-coordinated system fails. This could be:

• against the background of decreased immunity;
• during extreme heat;
• in case of injury.

In all these cases, the epiglottis can become inflamed and noticeably increase in size. “Here a characteristic pain appears, which cannot be confused with anything: suffocation, squeezing pain not at the level of the oropharynx, but slightly below, there is a feeling of lack of air. This is a bright moment, it’s called epiglottitis,” says Vladimir Zaitsev. In an acute situation, they say that the epiglottis increases in size, swells, is tense and red; naturally, therapy is required, usually with antibiotics.

There is also a situation when an abscess of the epiglottis develops: this is already a purulent process, when opening of the formation and its cleaning is required.

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7. The root of the tongue hurts

There is also such an option as inflammation of the root of the tongue. There is a lingual tonsil on it, notes the otorhinolaryngologist, which is part of the lymphoid tissue. The root of the tongue may become inflamed on its own. A lingual sore throat develops. “The temperature is as high as with a sore throat, but a person reflexively feels pain at the level of the tongue, but not at the tip or from the sides, but in the very depths. A feeling of suffocation may also develop because the airways are nearby,” says Vladimir Zaitsev.

It is also worth remembering that there is a condition when it is not so much pain that develops, but a burning sensation, itching, a desire to scratch, and there may also be slight soreness. In such a situation, notes Vladimir Zaitsev, they talk about pharyngomycosis, that is, a fungus in the throat.

Associated symptoms

Each pathology is characterized by a certain set of symptoms. So, with a cold and acute respiratory infections, in addition to fever and sore throat, a runny nose and cough, nasal congestion and difficulty breathing can be observed.

Associated symptoms of ARVI and influenza are:

• General weakness.
• Muscle, joint and headaches.
• Hyperthermia.

When infected with viruses, a rash on the skin, enlargement of the spleen and lymph nodes in the neck and armpits may occur.

“Throat and stomach hurt,” or what do you know about adenovirus

During seasonal ARVI, cough and sore throat are an “expected” phenomenon. But what if traditional respiratory symptoms are combined with diarrhea or vomiting? Perhaps it is an adenoviral infection.

Special signs

Adenovirus, unlike many respiratory viruses, affects not only the respiratory tract, but also the mucous membrane of the small intestine. In addition, the conjunctiva of the eye comes under attack.

It leads to:

• copious mucous discharge from the nose,
• sore and sore throat,
• cough (first dry, and later with sputum),
• symptoms of conjunctivitis, such as redness of the eyes, watery eyes, a feeling of dryness and “sand” in the eyes,
• as well as abdominal pain, diarrhea, vomiting
• and fever, the duration of which can reach 2 weeks.

Moreover, if intestinal symptoms may not develop during the entire infection, then the “characteristic” eyes are an important distinguishing feature of the adenovirus.

Where can you get infected?

Adenovirus is extremely infectious and resistant in the external environment. And the source of infection can be sick people or household items on which the virus remains active for up to 8 days.

You can become infected:

• when the patient coughs and sneezes,
• consuming food prepared without sanitary standards (thorough hand washing is required),
• and even through contact with the feces of an infected person (for example, when changing a diaper for an infected child).

You can “catch” the virus even in a swimming pool if the water is not properly disinfected. And, obviously, this viral infection is not uncommon in children's groups.

How dangerous is this?

Adenovirus infection, in most cases, does not pose a threat to health or life. And it usually ends without consequences after 7-14 days. Whereas in weakened patients, the infection can drag on and reach 6 weeks.

This same category of patients most often develop complications in the form of:

• pneumonia,
• otitis,
• bronchospasm
• severe keratoconjunctivitis.

However, Rospotrebnazor experts note that complications of adenoviral infection are always associated with the addition of pathogenic bacterial flora (staphylococci, streptococci and others).

How to identify adenovirus

The classic symptoms of adenoviral infection, as a rule, do not require additional tests. And the help of laboratory diagnostic methods is mainly resorted to at the earliest stage of the infectious process or in case of doubt about the diagnosis.

The most informative analysis in this case is PCR diagnostics of the material (throat swab or feces) for adenovirus.

The study can be ordered separately or immediately in combination with other ARVI viruses (for example, “ARVI-Screen”), which will allow you to immediately carry out a differential diagnosis. True, the PCR technique sharply loses its reliability if treatment, both local (rinses, sprays) and general, has already begun.

A blood test for IgA antibodies to adenovirus does not have these shortcomings.

They appear in the blood during the initial period of the disease, and continue to circulate for some time after recovery.

However, children, as you know, “don’t like” blood tests, so this examination format is more suitable for adults.

Diagnosis of diseases

The choice of treatment tactics depends on the type of pathology. Therefore, it is necessary to carefully examine the patient. Diagnosis begins with collecting anamnesis. The doctor asks questions that help determine the symptoms characteristic of a particular disease. He is interested:

• The timing of the appearance of the first signs of illness.
• The time when the severity of symptoms increases. This could be at night or in the morning.
• Which side of the throat is the pain more intense - the right or the left? This is usually how acute pharyngitis manifests itself.
• The presence of hoarseness and changes in voice may indicate sore throat or laryngitis.

If only the right or left side hurts, then the presence of neoplasms can be suspected. In babies, the cause may be teething.

Differential diagnosis is necessary to identify pathologies such as Hilger's syndrome, gastroesophageal reflex, dysfunction of the thyroid gland and adrenal glands, cervical osteochondrosis, esophageal varicose veins.

Often a sore throat appears during myocardial infarction.

The second stage of diagnosis involves examining the patient. The doctor assesses the condition of the mucous membranes of the nose and mouth. It can detect plaque, swelling, redness, signs of injury, and neoplasms.

If an infection is suspected, a swab is taken and sent for testing to a laboratory.

A clinical blood test can reveal the inflammatory process.

If there are complaints of pain radiating to the ear, otoscopy is prescribed.

When your throat hurts...

And this is how infectious and non-infectious causes of pain in the throat are distinguished:

• Infectious causes:

— Viral 70% (rhinoviruses, coronoviruses, adenovirus, influenza and parainfluenza viruses…) — Bacterial 15%. The most common cause is Group A B-hemolytic streptococcus (GABHS) - Fungal. The main causative agent is representatives of the genus Candida. The most pathogenic Candida albicans is 50% of all cases!

• Non-infectious causes:

— Allergic — Traumatic: cold drinks, ice cream, hot food, tobacco smoke from active and passive smoking, excessive consumption of spices, mustard, horseradish — Burns and injuries of the larynx

— Neuralgic conditions

— Benign and malignant neoplasms;

— Diseases of other human organs and systems

— Exposure to an irritating factor: gastroesophageal reflux, postnasal drip

Infectious causes of pain

Viral causes include primarily acute respiratory diseases, infectious mononucleosis, influenza, measles, and rubella. In addition to pain in the throat, the patient complains of the following symptoms: headaches, runny nose, nasal congestion, cough, fever, weakness, loss of appetite. Etiological diagnosis is difficult, especially in routine practice. In this situation, doctors are forced to rely on literature data. In most cases (20-30%), it is not possible to accurately identify the virus that caused the disease in a given person. Data from successful verification of the diagnosis place rhinoviruses in 1st place in the etiology of ARVI of the upper respiratory tract (30-50%). It should be noted that the influenza virus causes only 5 to 15% of cases of all acute respiratory viral infections.

Lesions of bacterial etiology are the cause of a sore throat in 50% of cases. Bacterial infections are most often localized in the tonsil area (acute tonsillitis). Their characteristic symptoms are: severe pain in the throat; weakness and decreased performance; increased body temperature; redness of the palate, white plaque on the tonsils; enlarged lymph nodes.

Pharyngomycosis in the vast majority of cases is caused by yeast-like fungi of the genus Candida (oral thrush). Sometimes the causative agents are mold fungi (aspergillus, penicillin, geotrichum). To trigger the pathological growth of fungi, which leads to an inflammatory process, it is necessary to reduce the body's defenses. Therefore, pharyngomycosis accompanies the following diseases and conditions:

• long-term antibiotic therapy;
• diabetes;
• tuberculosis;
• metabolic diseases (obesity, thyroid pathology);
• oncological diseases (during chemotherapy);
• HIV.

The disease begins in the same way as all pharyngitis - with discomfort in the throat. The fungal nature of the process can be suspected based on the characteristic itching and burning. Patients complain of constant soreness and dry mouth. Pain for pharyngomycosis is very characteristic; it intensifies with swallowing and is more intense than with a bacterial infection.

Non-infectious causes of sore throat

Pain in the throat can be a result of exposure to various allergens: food, pollen, house dust, fur and secretions of pets, etc. In addition to discomfort and pain in the throat, patients are concerned about congestion and clear discharge from the nose, sneezing, itchy eyes .

Various external factors can cause pain: mechanical injuries to the larynx, chemical or thermal burns. Hard pieces of food and bones can injure the larynx. Chemical burns can be caused by inhaling vapors of harmful substances at work or by ingesting harmful substances while eating. Thermal burns most often occur when eating hot foods or drinks.

Pain in the throat may be a manifestation of neurological disorders. Usually this condition is accompanied by a feeling of a lump in the throat, difficulty swallowing, and headaches. This feeling can manifest itself constantly, or maybe with a certain frequency.

Other causes of sore throat accompanied by sore throat and cough: drainage of discharge from the nasopharynx due to adenoiditis or sinusitis, space-occupying formations of the nasopharynx (cyst/bursa of Thornwald); irritation of the respiratory tract by dry air, smoke, including active and passive smoking. In adults, a common cause of such complaints, often with a feeling of a lump in the throat, a “foreign body,” is an exacerbation of chronic pharyngitis associated with pathology of the gastrointestinal tract: gastritis, esophagitis, gastroesophageal reflux, cholecystitis, gastric ulcer. Severe dysphagia, regurgitation and pain when swallowing can be caused by varicose veins of the esophagus. Chronic pathology of the kidneys, endocrine system, blood, previous radiation and chemotherapy can lead to the formation of a chronic inflammatory and atrophic process in the pharynx. The first manifestation of hyperglycemia (increased blood sugar) may be thirst and dry mouth, accompanied by catarrhal changes in the pharynx. Similar complaints occur with Itsenko-Cushing syndrome. In patients with hypothyroidism, swallowing is often impaired, speech becomes slurred due to swelling and dryness of the tongue and lips, and it is difficult to perform pharyngoscopy.

Hypovitaminosis can also cause discomfort and pain in the throat. Vitamin A deficiency causes dryness and erosion of the mucous membranes. Vitamin B2 deficiency produces a triad of symptoms: dermatitis, cheilitis and glossitis (bright red, smooth and shiny dry tongue), accompanied by burning and pain in the mouth when talking and eating. Vitamin C hypovitaminosis occurs with dietary deficiency of ascorbic acid, inflammatory processes in the intestines and is manifested by pain, hemorrhagic and ulcerative-necrotic manifestations in the oral cavity and in the area of ​​the palatine tonsils, mobility and tooth loss.

Diseases of the spine (cervical osteochondrosis, tuberculous spondylitis, radiculitis) can cause pain in the throat. Neuralgia of the glossopharyngeal nerve manifests itself as intense pain in the pharynx, especially against the background of chronic stress in anxious and suspicious patients. Metabolic disorders, intoxication, and trauma contribute to its occurrence. Characterized by unilateral pain in the root of the tongue, tonsil, lasting several minutes, accompanied by dry throat and subsequent hypersalivation. Neuralgia of the superior laryngeal nerve gives similar symptoms, but also includes a painful dry cough and spasm of the vocal folds when inhaling.

Diagnosis and treatment

As we can see, there are many reasons why your throat hurts. And to determine the real cause of this condition, an examination by an otolaryngologist is necessary. If during the diagnostic process with an ENT doctor it becomes clear that the problem is not from the ENT organs, you may need to consult related specialists: a neurologist, gastroenterologist, allergist, endocrinologist. In this case, the patient is sent for CT, MRI, ultrasound of the thyroid gland, gastroscopy, etc.

Every person who has a sore throat needs a medical examination and diagnosis. The sooner you make an appointment, the more effective the treatment will be, and the risk of complications will be minimal.

When to see a doctor

In addition, qualified medical assistance will be required:

• When there are no signs of a cold, but the pain is intense and does not go away for two days.
• The temperature rises sharply and reaches critical levels.
• Purulent formations are visible on the mucous membranes of the throat.
• If the changed voice is not restored within 2 weeks.

An ambulance will be called if the intensity of the pain does not allow you to swallow saliva or the swelling of the mucous membranes is severe, which causes difficulty breathing, in which extraneous noises in the form of whistling and wheezing are heard.