Inflammation in the throat

Synonyms

Sore throat, Pharyngitis

introduction

Inflammation in the throat is a disease that is characterized by the presence of inflammatory processes in the area of ​​the lining of the throat.
The inflammation in the throat is clinically divided into an acute and a chronic form. Both types of inflammation in the throat have different causes and require different treatment.

In children in particular, inflammation in the throat is one of the most common diseases. It can be assumed that for every 1,000 patients who see a doctor, approximately 200 will have symptoms of a sore throat. For this reason, the inflammation in the throat is one of the most common reasons for advice in a general practice practice.

causes

Depending on the course of the inflammation in the throat, different causes come into question.

Causes of acute inflammation of the throat

An acute inflammation in the throat is associated in the majority of cases with a simple cold or a flu-like infection. For this reason, the typical viral pathogens of respiratory diseases are usually responsible for the development of the inflammation in the throat.

The most common viral pathogens include adeno, influenza and parainfluenza viruses. In addition, viruses, the main cause of general illnesses, can be responsible for the occurrence of inflammation in the throat. In this context, Epstein-Barr (the causative agent of Pfeiffer's glandular fever), measles and rubella viruses play a decisive role.

Since the immune system is increasingly weakened in the course of the viral infection, bacterial pathogens can also spread in the nasopharynx. This phenomenon is called a so-called bacterial superinfection. Especially in children, the acute form of inflammation in the throat is often caused by group A beta-hemolytic streptococci.

You can read more about this here:

  • Causes of Sore Throat
  • Symptoms of laryngitis

Causes of chronic inflammation in the throat

If the inflammatory processes have been present for more than three months, it is a so-called chronic inflammation in the throat. In contrast to the acute form, chronic pharyngitis is not caused by germs, but by long-lasting irritation of the pharynx. These irritations can be provoked by various factors.

Excessive nicotine and / or alcohol consumption are the most common causes of inflammation in the throat. In addition, inflammatory processes in the area of ​​the throat can be caused by frequent acid regurgitation of gastric acid (so-called acid reflux) and particularly dry room air in overheated rooms. In addition, chronic inflammation of the throat is often provoked by chemical air pollution or dust at the workplace.

Since sufficient purification and humidification of the breathing air cannot be guaranteed in patients with severely impaired nasal breathing (for example due to a crooked nasal septum or repeated sinus infections), the throat is particularly often infected in affected patients. Inflammatory processes in the nasopharynx can also be caused by radiation therapy in the head area or by hormonal changes during menopause (climacteric) arise. The reason for this is the fact that both factors have an inhibiting effect on secretion production and the throat mucous membrane therefore dries out.

Read more on the topic: Sinus infections

Allergic inflammation in the throat

Inflammations in the throat caused by an allergic disease are classified as chronic pharyngitis. In the case of an allergy, the body reacts more strongly to foreign substances than it normally should. This leads to an overreaction of the immune system.

Long-term or recurring exposure to the allergen regularly boosts the immune system. This can cause chronic inflammation. Allergies that affect the airways in particular can cause chronic inflammation in the bronchial system and throat.

More on this:

  • Symptoms of an allergy
  • Sore throat from an allergy

Symptoms

Here the symptoms also differ between acute and chronic course

Symptoms of acute inflammation of the throat

The acute inflammation in the throat makes itself felt early in the affected patient by the appearance of a scratchy sensation in the throat. As a rule, this scratching develops a sore throat within a very short period of time, which can radiate into the ears. In addition, the affected patients typically experience painful swallowing difficulties. For this reason, eating is often perceived as very uncomfortable. Patients with acute inflammation of the throat typically report that their throats feel sore and dry.

Those affected often feel they have to clear their throat. Dry cough is another symptom of acute inflammation in the throat.During the medical examination, the mucous membrane in the throat is clearly red and inflamed. Since most of the time this disease is a viral infection, those affected often experience other respiratory problems. For this reason, a dry cough is one of the typical accompanying symptoms of acute inflammation in the throat.

In addition, acute inflammation in the throat caused by viruses can lead to runny nose and / or general symptoms such as fever, fatigue and chills. In the case of very pronounced forms of acute pharyngitis, the inflammatory processes can spread to the larynx, the vocal folds and / or the bronchi. As a result, the affected patients develop pronounced hoarseness. In the case of inflammatory processes caused by bacteria, white-yellowish deposits can also be seen in the area of ​​the back of the throat.

Severe flu-like symptoms with a high fever, sore throat and headache indicate the presence of a bacterial superinfection. In this case, swollen lymph nodes can typically be found in the neck area. An acute inflammation in the throat heals completely in most cases within a few days. In the case of very severe symptoms, however, a doctor should be consulted urgently and the presence of an Epstein-Barr virus infection, Pfeiffer's glandular fever, should be excluded.

Read more on the topic:

  • Pain in the throat
  • Pus in the throat

Symptoms of chronic inflammation in the throat

In contrast to the acute form, the symptoms of chronic inflammation in the throat do not appear suddenly. The symptoms typical of chronic pharyngitis usually increase continuously over a period of several weeks. The affected patients mostly notice a dry feeling in the nasopharynx and have to clear their throat frequently. In addition, there may be a cough with mucous sputum.

With particularly pronounced forms of chronic inflammation in the throat, those affected often have the feeling that there is a foreign body in their throat (so-called globe feeling). Based on the symptoms that occur, the chronic form of inflammation in the throat is divided into two subclasses.

  • In the case of the atropic course, the lymphatic tissue (part of the body's own defense system) in the area of ​​the throat steadily recedes.
  • In contrast, hypertrophic inflammation in the throat (synonym: hyperplastic inflammation in the throat) leads to a progressive increase in tissue.

Atropic pharyngitis is clinically characterized by an extremely delicate, pale mucous membrane of the throat showing signs of dehydration. During the examination, the mucous membranes appear as if they were varnished and are covered with tough coatings. Patients with hyperplastic inflammation in the throat often feel like they have a foreign body in their throat. For this reason, they often suffer from gagging and / or the need to clear their throat frequently.

Find out more about the topic here: Chronic inflammation of the throat.

Painless inflammation of the throat

Inflammation of the throat can also occur without pain.
While acute inflammation is usually accompanied by a sore throat and difficulty swallowing, chronic inflammation tends to creep in. Due to the gradual process, there is no sudden severe inflammation of the throat. Therefore, chronic pharyngitis is usually not so strongly associated with pain. In most cases, chemical toxins such as nicotine or radiation therapy are the triggers for chronic pharyngitis.

Sore throat

If the throat is inflamed, the mucous membrane of the throat is usually particularly sensitive and easily irritated. This sensitivity means that even the smallest stimuli can trigger a sore throat.
For example, the pain occurs when speaking or swallowing. This is mainly due to the fact that different muscles in the throat area are moved to speak and swallow. These small movements of the muscles already trigger stimuli on the pain-conducting nerve fibers. When swallowing, foreign bodies (chyme / liquid) get into the throat. If these touch the sensitive mucous membrane of the throat, this also causes pain.

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difficulties swallowing

An inflammation of the throat can also be accompanied by difficulty swallowing, depending on the location.
Especially when the inflammation has been around for a long time and large parts of the throat are affected, there is often pain when swallowing. The mucous membrane is irritated by the sore throat and therefore reacts to every contact with pain. When swallowing, foreign objects such as food and drinks reach the mucous membrane of the throat.

Read more on the topic: difficulties swallowing

Inflammation in the throat with pus formation

The combination of a sore throat and pus suggests a bacterial infection of the throat.
In this case, it is usually necessary to resort to antibiotics. The most common bacterial pathogens are streptococci. They often also attack the tonsils, where they cause yellowish-white coatings, which are also known as pus due to their characteristic distribution pattern.

More on this: Signs of tonsillitis

Bad breath

In the case of a sore throat, there is occasionally a sudden bad breath.
This is not due to poor dental hygiene. Instead, the bad smell comes from the bacteria that have lodged in the throat. Because of their metabolism, these pathogens secrete various substances. These can cause bad breath. If you normally do not suffer from bad breath and suddenly notice a bad taste in your mouth or bad breath, you should take a look down your throat to notice signs of infection such as red throat or plaque in the throat.

Read more on the topic: Bad breath

therapy

The choice of the most suitable treatment strategy depends primarily on the course of the inflammation in the throat. In addition, the therapy depends on the underlying cause.

Therapy for acute inflammation of the throat

Since the acute inflammation in the throat is usually a viral infection, antibiotic treatment is not very effective. For this reason, therapy is typically purely symptomatic in the presence of an acute inflammation in the throat.

Pain reliever medicines (Analgesics) be applied. In particular, drugs that contain the active ingredient ibuprofen or paracetamol are particularly suitable for the treatment of acute throat inflammation. In a direct comparison of the two active ingredients, however, ibuprofen is preferable. The reason for this is the fact that ibuprofen has anti-inflammatory properties in addition to its analgesic effect. Both drugs are equally suitable for lowering the fever that may be associated with the inflammatory processes.

In addition, difficulty swallowing can be relieved by using throat tablets with a local anesthetic effect. If a bacterial origin of the inflammation in the throat can be proven by a rapid test, antibiotic therapy should be initiated. Since these cases are usually a streptococcal infection, penicillin is the first choice antibiotic.

If an abscess can be shown in the affected patient during the clinical examination, surgical treatment must be initiated immediately. Otherwise, the abscess may open spontaneously and the abscess cavity will empty inside the body. The transfer of the bacterial pathogens into the bloodstream can then lead to blood poisoning (sepsis) provoke.

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Therapy for chronic inflammation in the throat

The most important measure in the treatment of chronic inflammation in the throat is the identification of the causative agent (trigger). Once the cause of the chronic inflammation in the throat has been identified, it should be avoided as far as possible. For patients who regularly consume alcohol and / or nicotine, this means that smoking and / or drinking must absolutely be stopped. As soon as the trigger of the inflammatory processes is stopped, the inflammation in the throat usually subsides within a few weeks.

The healing process can also be positively influenced by taking anti-inflammatory drugs. Medicines in particular that contain the active ingredient ibuprofen or diclofenac are particularly suitable for alleviating the symptoms typical of chronic inflammation in the throat. In addition, drugs that moisturize or soothe the mucous membranes can accelerate the healing process. In addition, special salt or sage solutions, as well as sage sweets, Emser pastilles or Islamoos can provide relief. The long-term use of disinfecting solutions, on the other hand, should be urgently avoided.

If the inflammation occurs in the throat in the course of radiation treatment, then spraying with artificial saliva (active ingredient class of the so-called glandosans) can be helpful. Patients who have developed inflammatory processes in the throat area due to obstruction of nasal breathing usually require surgical treatment.

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Over-the-counter drugs

Over-the-counter medications can help with sore throat against various components of the condition.
Medicines with the active ingredient benzocaine are the main anti-sore throats. These include AnginHEXAL dolo throat lozenges and Neo-angin Benzocaine dolo. Plant-based remedies often contain eucalyptus oil or linden blossom and have a cough-relieving and pain-relieving effect. Various drugs with the name Dobendan work specifically against the pathogens, and these drugs also relieve sore throats and hoarseness. Pain relievers such as ibuprofen and paracetamol are also used.

Further information: Neo Angin®

Prescription drugs

On the one hand, prescription drugs include all types of antibiotics. In addition, many active ingredients from non-prescription drugs are subject to prescription due to a higher concentration. The drugs used include: Amoxicillin, Cotrimoxazole, Erythromycin, and Rocithromycin.
ASA (Aspirin®), ibuprofen and paracetamol are used as pain relievers. They also have an antipyretic effect. In combination preparations with antibiotics or other active ingredients, they often require a prescription. Acetylcysteine ​​and ambroxol are prescribed for their expectorant effects.

These home remedies can help

Home remedies are particularly recommended for throat infections caused by viruses.
Medicinal treatment is usually not necessary here. However, symptoms such as a sore throat and hoarseness can be treated particularly well with home remedies. If you have a sore throat due to a sore throat, you should take special care to drink a lot. This will keep the throat moist. Sage tea, tea with ginger and a hot lemon are especially effective against the sore throat. The ingredients of sage and ginger work against the pathogens in the throat and thus help the body to fight them.

The effect of various lozenges is mainly based on the fact that saliva production is stimulated.

homeopathy

Various globules with their respective active ingredients can be used for throat infections. Both the dose and the agent used depend on the type of sore throat.
Hepar sulfuris is especially recommended for purulent infections. Even if the tonsils are affected by the inflammation, Hepar sulfuris is the drug of choice. If the inflammation affects the salivary glands as well as the throat, Mercurius globules can be taken.
Medicines containing Phytolacca decandra also help with particularly severe sore throats. Globules can relieve symptoms, especially in the early stages of a sore throat. However, depending on the severity of the sore throat, a doctor should also be consulted, who may be able to prescribe antibiotics and pain relievers.

When should an antibiotic be taken?

Antibiotics are drugs that only work against bacteria. Therefore, antibiotics make no sense for most throat infections. In most cases, the inflammation is triggered by viruses, for which antibiotics are absolutely ineffective.

Bacterial throat infections usually have a more severe course and last for several weeks, unless treated early with antibiotics. In addition, there is a high risk of infection with bacterial inflammation. The most reliable sign of a bacterial throat inflammation is the presence of white-yellowish deposits (pus sticks) in the throat.

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diagnosis

Diagnosing a suspected inflammation of the throat involves several steps.
The most important step is the detailed doctor-patient conversation (anamnesis). During this conversation, the patient concerned should describe the symptoms he has perceived as explicitly as possible. Symptoms that do not directly affect the pharynx (e.g. fever, tiredness and fatigue) also play an important role in the diagnosis of inflammation in the throat. In addition, the doctor usually asks the patient concerned about possible nicotine and / or alcohol consumption. A truthful statement in this regard is particularly important because frequent consumption of alcohol as well as smoking represent a risk factor for the development of chronic inflammation in the throat.

Diagnosis of acute inflammation of the throat

If an acute inflammation in the throat is suspected, diagnosis is usually carried out by means of an endoscopic examination. If there is an acute inflammation, the back of the pharynx will typically appear red and swollen. In addition, the endoscopic examination reveals possible involvement of the palatine tonsils. If it is suspected that the inflammatory processes are caused by a bacterial infection, small pus sticks can be seen in the area of ​​the tonsils. A smear of the tonsils followed by a rapid test can help to unequivocally detect a streptococcal infection.

Since an inflammation of the throat is often accompanied by inflammatory processes in the middle ear (otitis media), the ears should also be examined. Often it is even possible to distinguish whether a viral or bacterial infection is present based on the typical tympanic membrane. This distinction has a decisive influence on the choice of the most suitable treatment measures.

If the affected patient has difficulty swallowing on one side and has difficulty opening the mouth, an abscess may have formed. In some cases, this abscess protrudes into the throat and can be detected with a simple mirror examination or during endoscopic examination of the throat. In addition, an abscess in the area of ​​the throat can be detected with the help of an ultrasound examination or magnetic resonance imaging (MRI).

Diagnosis of chronic inflammation of the throat

The mirror examination is also used as a diagnostic measure in the event of a suspected presence of chronic inflammation.
During the examination, the affected patient typically has a pale, smooth, and varnished throat wall. In addition, a possible obstruction of nasal breathing should be excluded by examining the nose. In addition to recognizing the chronic inflammation in the throat, the causes of the development of the inflammatory processes also play a decisive role in the treatment.

Can this be a sign of HIV?

In principle, an inflammation of the throat can be an indication of HIV, but under no circumstances is there a suspicion of HIV infection with every inflammation of the throat.As a rule, the initial infection with the human immunodeficiency virus (HIV) presents itself like the flu, so that a sore throat can be one of the initial symptoms.

Anyone who has been carrying the HI virus for a long time must expect a significantly weakened immune system. As a result, the body can no longer adequately defend itself against pathogens. Therefore, as the disease progresses, infections become more frequent and severe. Particularly in winter, people infected with HIV therefore often suffer from infectious diseases that can also trigger throat infections.

Read more on the topic: Symptoms of HIV

Inflammation of the throat in pregnancy

If you have a sore throat during pregnancy, you should always consult a doctor.
The inflammation is usually caused by a viral infection, which can be cured with home remedies such as drinking plenty and bed rest. Pain therapy may be necessary due to the sore throat. Since many medications are not approved for use by pregnant women, it is essential to discuss the use of medication with a doctor. Bacterial inflammation is usually treated with antibiotics as well. This therapy should also be discussed well with a doctor, as many antibiotics are not recommended for pregnant women.

forecast

The prognosis of an inflammation in the throat depends largely on the form of the disease. In the case of acute inflammation, the prognosis is very good if a suitable therapy is initiated promptly.

The causative viral and / or bacterial pathogens can be treated well in most cases. Since bacterial infections can be treated with a suitable antibiotic immediately after diagnosis, the healing time of bacterial inflammation in the throat is significantly shorter. Viral infections that can only be treated symptomatically, on the other hand, usually persist much longer.

In patients with chronic inflammation of the throat, healing can only be achieved after the underlying trigger is removed. Smokers in particular should immediately stop using nicotine if inflammatory processes occur in the nasopharynx.

Read more on this topic at: Duration of a sore throat

Duration of inflammation in the throat

How long a throat infection lasts depends on what triggered the inflammation.

Acute pharyngitis that is viral lasts for a few days. Even without special treatment, this type of pharynx is quickly healed.

If, on the other hand, there is a bacterial throat inflammation, the disease can drag on for several weeks. Even with antibiotic treatment, therapy for one to three weeks is necessary. Both forms are considered to be acute pharyngitis, as they are triggered abruptly by a pathogen and subside again after a comparatively short time.

In contrast, a chronic throat infection takes longer to heal. No germs are responsible for the disease. Instead, it is mostly chemical influences such as nicotine and tobacco, alcohol, reflux (backflow of stomach acid through the esophagus and into the throat) or radiation therapy that trigger the inflammation. Such chemical toxins, to which the pharynx is regularly or over a longer period of time, the mucous membrane is chronically affected.

Read more on the topic: Duration of a sore throat

incubation period

The incubation period is the period between infection and the onset of symptoms.
However, it is usually only a few days. After the incubation period, symptoms such as sore throat and difficulty swallowing, a reddened throat, swollen lymph nodes and fever appear. However, affected people are contagious before they even notice the infection. Depending on the pathogen, the risk of infection begins one to two days before the symptoms begin.

That is how long a sore throat is contagious

If the throat infection is left untreated, the affected person can be contagious for more than three weeks.
If the inflammation of the throat is treated with antibiotics (this is only necessary if the inflammation is triggered by bacteria), the person affected is no longer considered to be contagious after 24 hours. The infection usually takes place via the respiratory tract. Pathogens can therefore be transmitted to other people when you cough, for example. In addition, it can also be transmitted via germs on the hands, which is why sick people should wash their hands as regularly as possible.

How do you know if you are still contagious?

With a sore throat, the signs of infection vary depending on the type of inflammation. Bacterial inflammation is particularly contagious, and the germs stay longer in the throat of the person affected. Even after the pus deposits in the throat have subsided, thorough hand hygiene should still be observed for a few days in order not to accidentally pass on any remaining pathogens.

Viral inflammation is contagious as long as there are sources of droplet infection. These include coughing and sneezing in particular, as they throw germs into the air. Chronic inflammation of the throat, on the other hand, is not contagious.

When can you start exercising again?

If you do sports with a sore throat, you risk a significantly longer course of the disease. The body's defenses are weakened during the illness phase due to the additional physical strain. This allows the pathogen to implant itself better in the body. In addition, it is not fought as effectively, which is why it stays in the body longer.

Inflammation of the throat in particular can also be a symptom of a systemic (affecting the whole body) disease such as the flu. Often there are additional symptoms such as fever. In this case, exercise can cause heart damage. Therefore, physical activity should be avoided for a while. The guideline for this is to be banned from sports for about a week after the symptoms have subsided.

prevention

Since the acute form of inflammation in the throat is a viral and / or bacterial infectious disease, it can only be prevented to a limited extent.
Above all, compliance with simple hygiene measures (for example regular disinfection of the hands) plays a decisive role in this context. Chronic, inflammatory processes in this area, however, can be avoided by avoiding risky factors (e.g. alcohol and nicotine).