Keep getting sore throat

Dr. Julina Ongkasuwan says multiple health conditions may play a role in having an itchy, irritated and painful throat.

Having a sore throat can be uncomfortable, or worse. In many cases, sore throats are caused by viral infections but an expert at Baylor College of Medicine says that although this may be the most common cause; multiple health conditions may play a role in having an itchy, irritated and painful throat.

“The most common reason for someone to develop a sore throat would be a virus, and this is often accompanied by a runny nose, cough or malaise,” said Dr. Julina Ongkasuwan, assistant professor of otolaryngology at Baylor.

A severe sore throat may be an indication of possible strep throat, a bacterial infection. Individuals who develop strep throat often have high fevers or pus on the tonsils; however, Ongkasuwan said many other viral infections may be associated with high fevers so she recommends visiting your doctor for a throat swab.

“For most people experiencing a sore throat, I generally recommend rest and hydration. If you are highly concerned then you should get a strep swab, and you really shouldn’t take antibiotics unless the strep swab is positive,” she said.

Those who experience strep throat multiple times a year may be a candidate for tonsillectomy. “According to the Academy of Otolaryngology Head and Neck Surgery, if an individual has documented strep throat seven times in one year, five times per year for two consecutive years, or three times per year for three consecutive years, they can consider having their tonsils removed,” Ongkasuwan said.

Other health conditions that can cause sore throat are reflux, tonsil stones, muscle tension, and mononucleosis, also known as mono. Acid reflux can cause heartburn and if the acid reaches the throat it can also lead to throat discomfort. Tonsil stones refer to food debris that get stuck in the tonsils resulting in inflammation and irritation.

For throat pain that persists beyond three weeks and is accompanied by difficulty swallowing or weight loss, Ongkasuwan recommends visiting a doctor to rule out any severe health conditions.

There are ways to sooth a sore throat without having to take antibiotics, such as non-caffeinated warm tea or hot water with honey.

“Sore throats are very common. While viral infections are the most common cause, severe or persistent pain may be indicative of a more serious problem. If your throat pain lasts longer than 3 weeks or if you are concerned, visit your local doctor.”

Sore throat

Sore throats are common and not usually serious. Most people will have at least 2 or 3 every year. Children and teenagers are more likely to get sore throats than adults.

Most sore throats will clear after a few days without the need for medical treatment. After a week, almost 9 in 10 people will be well again.

Symptoms

Sore throats are usually a symptom of a viral infection. Most sore throats are caused by a virus so antibiotics won’t help.

Symptoms include:

  • painful throat, especially when swallowing
  • dry scratchy throat
  • redness in the back of the mouth
  • bad breath
  • mild cough
  • swollen neck glands

You may also have a runny or blocked nose, sneezing, fever and a tickly cough.

Causes

Sore throats are caused by infections called tonsillitis.

Sometimes your voice gets hoarse too. This is called laryngitis.

Viruses cause tonsillitis and laryngitis.

Glandular fever is one kind of viral tonsillitis.

Croup is one kind of viral laryngitis.

Sometimes they can be caused by bacteria (strep throat). With bacterial infections you will usually feel sicker and take longer to get better. Your immune system may clear the strep throat or you may need an antibiotic.

Treatment

Over-the-counter painkillers can usually relieve the symptoms of a sore throat.

While it may sound obvious, try to avoid hot food and hot drinks as this could irritate your throat. Eat cool, soft food and drink cool or warm (not hot) liquids. Adults and older children can suck lozenges, hard sweets, ice cubes or ice lollies.

To help relieve the pain and discomfort of a sore throat you can:

  • use paracetamol or ibuprofen
  • use medicated lozenges or anaesthetic sprays, although there’s little proof they help

You can buy them from a supermarket or from a pharmacist without a prescription.

Your GP

Usually, you do not need to see a GP if you have a sore throat.

See your GP if:

  • you have a sore throat and a very high temperature, or you feel hot and shivery
  • you have a weak immune system – for example, if you have diabetes or you’re having chemotherapy
  • you often get sore throats
  • you are worried about your sore throat

A severe or long-lasting sore throat could be something like strep throat (a bacterial throat infection) or tonsillitis.

If you still have a sore throat after 2 weeks, it’s best to get it checked.

Antibiotics

GPs don’t usually prescribe antibiotics for sore throats. This is because antibiotics will not usually relieve your symptoms. They won’t speed up your recovery either.

Your GP will only prescribe them if they think you have a bacterial infection.

When to go to your emergency department

Call 999 or go to your emergency department (ED) if :

  • you have difficulty breathing
  • you’re drooling or can’t swallow your saliva
  • your symptoms are severe and getting worse quickly

Related topic

The emergency department

Girl with sore throat

What is sore throat?

A sore throat can be caused by a virus or a bacterial infection. It is also called pharyngitis, which means inflammation of the pharynx (the back of the throat).

It usually means you have a virus like a cold or the flu. Your body will normally fight off the infection within a week without the need for medical treatment. Antibiotics cannot be used to treat a virus.

What causes a sore throat?

The most common cause of a sore throat is a virus like a cold, the flu or glandular fever.

Less than 1 in 3 sore throats is caused by a bacterial infection. Some sore throats are caused by the bacteria Strepococcus pyogenes. This is sometimes called a ‘strep’ throat. If bacteria are the cause, you tend to become very unwell and your infection seems to get much worse. If the sore throat is caused by bacteria, you may benefit from antibiotics.

Sometimes a sore throat can be caused by tonsillitis or mouth ulcers.

Sore throat symptoms

If the sore throat is caused by a cold, you may also have a runny nose, cough, possibly fever and feel very tired.

If it’s a strep throat, other symptoms may include:

  • swollen glands in the neck
  • swollen red tonsils
  • rash
  • fever
  • tummy pain
  • vomiting

Sore throat diagnosis

If you or child has a sore throat and you are worried about the symptoms, see your doctor. Seek medical attention if:

  • you have trouble breathing or swallowing
  • you have a stiff or swollen neck
  • you have a high fever

They will examine you by looking at your throat with a torch and feeling your glands. They may take a swab from the throat to see if you have a bacterial infection.

Sore throat treatment

There is no way to cure a sore throat that is caused by a virus. You can just treat the symptoms with pain relief. The sore throat should clear up in 5 to 7 days.

If the sore throat is caused by bacteria, you may benefit from antibiotics.

Self-care of a sore throat

Along with being sore, your throat may also be scratchy and you may have difficulty swallowing. To help with the symptoms, try gargling with warm, salty water or drinking hot water with honey and lemon. Warm or iced drinks and ice blocks may be soothing.

Avoid foods that cause pain when you swallow. Try eating soft foods such as yoghurt, soup or ice cream.

It is important to stay well hydrated so drink plenty of water. If you have an existing medical condition, check with your doctor about how much water is right for you.

Keep the room at a comfortable temperature and rest and avoid heavy activity until symptoms go away.

Smoking or breathing in other people’s smoke can make symptoms worse. Try to avoid being around people who are smoking. If you are a smoker, try to cut down or quit. For advice on quitting smoking, visit the Quit Now website.

Find out more about self-care tips if you have a high temperature (fever).

See your doctor if:

  • your sore throat becomes worse
  • your sore throat does not improve after 5 days
  • you are concerned

Not sure what to do next?

If you are still concerned about your sore throat, check your symptoms with the healthdirect Symptom Checker to get advice on when to seek medical attention.

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self care, talking to a health professional, going to a hospital or calling triple zero (000).

Summit Medical Group Web Site

What is a viral sore throat?

A viral sore throat is an infection of the throat caused by a virus.

What is the cause?

Many different viruses can cause a sore throat, including:

  • Flu viruses
  • Common cold viruses
  • Coxsackievirus, which causes a very painful throat infection called herpangina
  • Infectious mononucleosis (“mono”) virus

What are the symptoms?

The symptoms will vary slightly depending on the type of virus causing the infection.

Symptoms of flu virus infections may include:

  • Sore throat
  • Cough
  • Fever
  • Muscle aches

Symptoms of infection with a cold virus may include:

  • Sore throat
  • Runny nose
  • Cough
  • White bumps on the tonsils
  • Mild soreness and swelling of the lymph nodes in your neck

Symptoms of herpangina may include:

  • Sore throat
  • Fever
  • Headache
  • Poor appetite
  • Pain in the stomach, neck, arms, and legs
  • Painful sores on the throat, tongue, or roof of the mouth

Symptoms of infectious mononucleosis may include:

  • Fever
  • Extreme, prolonged fatigue lasting at least 1 week and usually longer
  • Swollen tonsils
  • White coating on the tonsils and throat
  • Red spots on the roof of the mouth
  • Large swollen lymph nodes (“glands”) in the neck
  • Faint red rash on the chest or whole body

How is it diagnosed?

It is often hard to tell whether a sore throat is caused by a virus or by strep bacteria. In general, the main symptom of strep throat is a severe sore throat with trouble swallowing. Other possible symptoms of strep are fever, swollen lymph nodes in the neck, white spots on the tonsils, and sometimes headache. On the other hand, sneezing, a runny nose, and nasal congestion are common symptoms of infections by a virus, including those that cause sore throats.

To diagnose a viral sore throat, your healthcare provider will review your symptoms and examine you. He or she may also take a throat swab to check for strep throat. Many offices and clinics now have very accurate rapid throat swab tests that allow diagnosis of strep within a few minutes or a few hours.

If your provider suspects mononucleosis, a blood test may also be done.

How is it treated?

The treatment of a viral sore throat is similar to that of the common cold. Your healthcare provider will usually not prescribe antibiotics because antibiotics do not kill viruses. To relieve pain:

  • Take nonprescription pain medicine.
  • Gargle with warm water. Some people feel more relief if some salt is added to the water.

Other possible treatment depends on the type of virus causing the infection.

How long will the effects last?

The effects will last as long as the virus affects the body. Most viral infections last from several days to 2 weeks. Mononucleosis may last longer.

Virus infections can be more serious for older adults.

How can I take care of myself?

To help take care of yourself, take the full course of treatment your healthcare provider prescribes. Get lots of rest until the fever is gone.

For a sore throat:

  • Drink chicken soup, cold drinks, and other clear, nutritious liquids. If it is painful to eat, don’t eat solid food. When you can eat, eat healthy foods.
  • Do not smoke cigarettes or breathe secondhand smoke.
  • Gargle and spit with warm saltwater (1/4 teaspoon salt per 8 ounces, or 240 mL, of warm water) as often as is comfortable.
  • Suck on hard lozenges or candy.
  • Take nonprescription pain relief medicine according to the directions on the package.
  • Limit activities, especially those requiring talking.

If you have a fever:

  • Ask your healthcare provider if you can take aspirin or acetaminophen to control your fever. Do not give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.

If you have diarrhea:

  • Drink clear liquids such as water, juice, tea, and bouillon often during the day.
  • Reduce your normal activities until the diarrhea has stopped.
  • If you are nauseated, suck on ice chips.
  • When you feel better, eat soft foods like cooked cereal, rice, applesauce, baked potato, and soups. You may also have carbonated drinks.
  • Return to normal eating 2 or 3 days later. Avoid alcohol, milk products, and highly seasoned and spicy foods for several more days.

Ask your provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent spread of viral sore throat?

If you have been diagnosed with a viral sore throat:

  • Avoid contact with others until your symptoms are gone. However, many viruses are most contagious before symptoms start.
  • Wash your hands after coughing, sneezing, or blowing your nose.
  • Use tissues when coughing or sneezing and throw them in the trash right away.
  • Wash your hands before touching food or food-related items such as dishes, glasses, silverware, or napkins.
  • Don’t share food or eating utensils with others.
  • Use paper cups and paper towels in bathrooms instead of common drinking cups or shared hand towels.

7 reasons why you’re getting frequent colds

  • On average, according to the Center for Disease Control and Prevention, adults get about two to three colds each year.
  • Stress and lack of sleep can increase your risk of getting frequent colds.
  • Practicing good hygiene, eating right, sleeping, and reducing stress all help keep colds away.

Runny nose, sore throat, cough, congestion, sneezing, and just feeling awful are all signs that you might have a cold. According to the Center for Disease Control and Prevention (CDC), adults on average have about two to three colds each year. When you consider that the average cold lasts seven to 10 days, that’s 18 to 20 days out of 365 each year.

Although that may not seem like much, the common cold can be debilitating — especially if you’re one of the many people who get several colds a year. From missed work days and reduced productivity to a decline in your ability to participate in daily activities, it’s important to pinpoint the reason you’re getting frequent colds.

INSIDER asked four doctors to share their thoughts on why you might be getting the sniffles more often than you should.

You’re a smoker

One reason you may find yourself catching colds frequently is because of smoking. Cedrina Calder, preventive medicine doctor and health expert told INSIDER that the chemicals found in cigarette smoke have been found to alter the immune system’s natural response by weakening it.

“It directly affects the cells of the immune system which causes you to become more likely to catch frequent colds,” she explained.

Additionally, Calder said that smoking temporarily damages the tiny little hairs of the respiratory tract that normally help to clear out mucus and debris which carry germs.

“By damaging these hairs, it puts you at a greater risk of getting respiratory infections like the common cold,” added Calder.

To prevent frequent colds, she said the best solution is to stop smoking altogether. Speak to your doctor about quitting smoking and your options for helping to break the habit.

Your hygiene is lacking

It’s best to wash your hands after being in public places. Smith Collection/Gado / Contributor

Are you an avid hand-washer or do you only scrub in the shower? If you’re slacking on your hygiene, don’t be surprised if you find yourself with the sniffles on a regular basis.

“When you don’t stick to strong hand hygiene practices, you are creating an environment that sets the stage up for recurrent infections like a cold,” said Dr. Nesochi Okeke-Igbokwe, physician and health expert. That’s because viral particles caused by the common cold may spread easily, especially when you ignore your hand hygiene.

Read more: You’re probably washing your hands wrong and the results can be pretty gross — here’s the right way

You’re stressed out

According to Calder, stress can weaken the immune system’s ability to fight infection by decreasing the number of immune cells and blunting the immune system’s response to infection.

To reduce the number of colds you’re getting, Calder recommended addressing some of the stressors that you have in your life. You might also want to consider stress-reducing practices like yoga, meditation, or mindfulness techniques to help cope with stress.

Read more: 6 little things you can do every day to feel less stressed

You’re sleep deprived

Poor sleep habits can lead to a weakened immune system. Mita Stock Images/

Do you wake up rested and ready to face the day or do you play the snooze game with your alarm? If you’re not getting the recommended seven to nine hours of sleep each night, you might be increasing the odds that you’ll end up sick.

“The effect of sleep deprivation goes beyond simply feeling chronically tired and lethargic,” Dr. Nesochi Okeke-Igbokwe told INSIDER.

“Lack of sleep is linked to a weaker immune system and heightened susceptibility to the common cold,” she added. That’s why she said to work on cultivating strong sleep habits to get quality sleep every night.

You’re not eating healthy foods

If you’re eating unhealthy foods, Dr. Frank Lipman told INSIDER that your immune system is probably lower than ideal and you’re likely picking up bugs easily.

To counter this, Lipman said to avoid sugar and processed foods, both of which might decrease immune function. And instead, he recommended loading up on nutrient-rich whole foods, like well-sourced organic, grass-fed and finished animal protein, nourishing soups, colorful salads, and green-leafy veggies which are packed with flu-fighting phytonutrients.

You’re spending more time indoors

Germs are easily spread indoors. Flickr / Tech Hub

If you’re spending more time indoors due to the bitter cold or you just find yourself inside more than usual, you might be experiencing frequent colds, according to Jason Abramowitz, MD at ENT & Allergy Associates.

“During the colder months, people are indoors more, which leads to more indoor contact and spreading of germs,” he explained. Abramowitz also said that colder temperatures can slow down the immune system, which makes it easier to get sick.

Plus, being inside means more exposure to dust, and Abramowitz said this can trigger allergies, which can often feel like the common cold.

You have a weakened immune system

If you have a weakened immune system, you’re at a higher risk of developing health problems such as the common cold. In addition to recurrent pneumonia, bronchitis, and sinus infections, frequent colds are also common if your immune system is compromised.

Do you regularly experience sore throats? The medical explanation

Do you know what’s causing your throat pain? When should you see a doctor?

What is a Sore Throat?

A sore throat refers to pain or irritation of the throat and can come from many causes however viral infections are most common. A sore throat can affect people of all ages, however the risk for a sore throats is higher for those who work in health care, with children, smokers or exposure to secondhand smoke, people with allergies, those with a compromised immune system, dry air or pollution/irritants in the air or sharing close space with others. The symptoms relating to sore throats will depend on the underlying cause however a sore throat caused due to a viral infection such as the common cold cannot be treated with antibiotics as they will not be effective. Rest and pain management are advised for those suffering from viral infections. As a sore throat can sometimes be caused due to a bacterial infection such as strep throat, it is important to see your doctor if symptoms are severe as antibiotics may be required. See your doctor if you have any other medical problems such as asthma, heart disease, HIV, diabetes, or are pregnant as you may be at a higher risk for complications.

Tip: Most sore throats don’t require medical attention however, see your doctor if your sore throat lasts for longer than one week or if your pain is severe, you have a high fever, rash or bloody mucous, red tonsils or white spots on the back of your throat or changes in breathing or swallowing or frequent sore throats.

Common Causes of Sore Throats –

A Cold or Flu: A sore throat is often the first sign of a cold and often gets better after a few days. If your sore throat is caused by a cold, you may also experience a runny nose, congestion, sneezing, cough, mild body aches, and headache. The flu usually comes on suddenly, and those with the flu often have a fever, fatigue, muscle and body aches while some people may experience vomiting and diarrhoea. Over the counter medications and lozenges may provide some relief from symptoms. (Lozenges should not be given to young children) Antibiotics cannot treat a cold virus as antibiotics are only effective against bacteria.

HIV: The first stage of HIV infection (the primary stage) presents its self as a “flu-like” illness and symptoms such as fever, headaches, sore throat, fatigue, chills, rash, muscle pain, swollen lymph nodes while some may not experience any symptoms at all. Also, a person who is HIV-positive may have a chronic or a recurring sore throat due to a secondary infection. Get tested!

Mononucleosis: (mono) usually caused by the Epstein-Barr virus (EBV) typically occurs in teenagers. Mono can be spread through contact with saliva, mucus from the nose and throat. Because the virus can be spread through saliva, it is nicknamed the kissing disease. People with mono often have a high fever, swollen lymph glands, sore throat, weakness, and fatigue. There’s no specific treatment for mononucleosis as antibiotics don’t work against viral infections. Bed rest, and drinking plenty of fluids is advised. See your doctor to confirm the cause of your symptoms.

Tonsillitis: is an inflammation of the tonsils (tissue masses located at the back of the throat) and can be caused by both viruses and bacteria. Those who have tonsillitis may have throat pain, redness or a white/yellow coating on the tonsils, hoarseness or loss of voice, headache, earache, difficulty swallowing or breathing, swollen glands in the neck or jaw area and bad breath. If the tonsillitis infection is bacterial then antibiotics will be given however if the infection is viral antibiotics will not help and the virus must run its course for the symptoms to resolve. Taking an over the counter pain reliever may help. For those experiencing tonsillitis regularly, they may benefit from a tonsillectomy (removal of the tonsils).

Strep Throat: Caused by an infection of streptococcus bacteria and spreads by having contact with an infected person’s saliva or nasal secretions. Those who are infected with strep throat may experience a severe sore throat, red, and swollen tonsils, sometimes with white patches, painful swallowing, tender lymph nodes in the neck and fever. It is important that if strep throat is suspected that medical attention is sought, or it may lead to more serious health complications such as rheumatic fever (a disease that may harm the heart valves). Strep throat is treated using antibiotics, which kill the bacteria causing the infection. It is important to take medications exactly as prescribed by your doctor including finishing the course even if you feel better.

Diphtheria: A bacterial infection which causes severe inflammation of the nose throat and windpipe and is easily spread. Signs and symptoms may vary from mild to severe and usually start with a sore throat and fever two days after exposure. In severe cases, a grey patch develops in the throat which can block the airway. The neck may swell due to large lymph nodes. If it’s left untreated, diphtheria can cause severe damage to your kidneys, nervous system, and heart. If suspected talk to your doctor. Vaccinations are available for Diphtheria.

Measles: (rubeola), is a viral infection of the respiratory system. Measles spreads when people breathe in or have direct contact with virus-infected fluid, such as the droplets sprayed into the air when someone with measles sneezes or coughs. Symptoms include a distinct rash, cough, fever, red eyes, runny nose, sore throat and tiny white/blue spots in the mouth. Talk to your doctor about vaccination. Whooping cough: is contagious and spreads through contaminated droplets in the air produced during coughing. Whooping cough usually evolved over a period weeks and usually starts with a sore throat, fever and a cough which worsens over time. Antibiotics are required in the early stages of infection.

Allergies: to pet dander, moulds, dust and pollen can cause a sore throat. The problem may be complicated by postnasal drip (when mucus runs down the back of your throat), which can irritate and inflame the throat. If you also experience sneezing, and a runny nose regularly talk to your doctor about allergy medications.

Dryness: Dry indoor air (especially when using heating) can make your throat feel rough and scratchy. Breathing through your mouth often due to chronic nasal congestion can also cause a dry, sore throat.

Irritants: Outside air pollution, cigarette smoke (smoker or secondhand smoke) and exposure to chemicals can also cause chronic sore throats. Chewing tobacco, alcohol and eating spicy foods also can irritate your throat.

Muscle strain: Trying to talk to someone in a noisy environment, yelling or talking for long periods without rest can cause a sore throat and hoarseness.

Gastroesophageal Reflux Disease (GERD): a digestive condition that occurs when stomach acid flows back into the oesophagus (the tube that carries food from the mouth to the stomach). This condition can cause a sore throat, hoarseness, heartburn, regurgitation of stomach contents, nausea, dry cough, and the feeling of having a lump in your throat. If you have acid reflux, your doctor may suggest some diet and lifestyle changes and may prescribe medication.

Tumours: Cancerous tumours of the throat, tongue or voice box (larynx) can cause a sore throat. Other signs or symptoms may include hoarseness, difficulty swallowing, noisy breathing, a lump in the neck, and blood in saliva or phlegm.

Tuberculosis: Also known as TB. Do you have a persistent cough? Or a sore throat due to coughing? Do you experience chest pain, pain when breathing or coughing, fatigue, night sweats, chills? Are you coughing up blood or have you lost weight recently? See your doctor for a TB test today.

When Should I See a Doctor?

Most sore throats don’t require medical attention however, see your doctor if your sore throat lasts longer than one week or if your pain is severe, you have a high fever, rash or bloody mucous, red tonsils or white spots on the back of your throat or changes in breathing, swallowing or you experience frequent sore throats. If you have any other medical problems such as asthma, heart disease, HIV, diabetes, or are pregnant as you may be at a higher risk for complications see your doctor. Make a note of when symptoms started. Have you been in contact with any recent, possible sources of infection, such as a friend or family member with a sore throat or a cold? If antibiotics are required (for a bacterial infection) they must be taken exactly as advised and completed (even if you are feeling better) or the infection may return. If your pain or symptoms are worsening even if you are taking antibiotics to let your doctor know. Get immediate care if you or your child are experiencing severe signs such as difficulty breathing or swallowing or unusual drooling (which may indicate an inability to swallow).

Risk factors for Sore Throats –

Although anyone can get a sore throat, some factors make you more susceptible:

Being a child or teenager: Children and teens are most likely to develop sore throats are most likely to have strep throat.

Exposure to tobacco smoke: Smoking and secondhand smoke can irritate the throat and also increases the risk of several types of cancer.

Having allergies: If you have seasonal allergies or ongoing allergic reactions to dust, moulds or pet dander you are more likely to experience sore throats.

Exposure to chemical irritants: common household chemicals can cause throat irritation.

Chronic or frequent sinus infections: increase the risk of a sore throat as drainage from the nose can irritate the throat or spread infection.

Living or working in close quarters: Viral and bacterial infections spread easily anywhere people gather.

Having decreased immunity: You’re more susceptible to infections in general if your resistance is low. Common causes of lowered immunity include HIV, diabetes, those on chemotherapy drugs, stress, fatigue, and poor diet.

Testing and Diagnosis –

Before treating your sore throat, your doctor will need to determine the cause of your symptoms and will require a full medical history, list of medications or supplements you are currently taking and perform a physical examination. He or she will use a lighted instrument to look in your throat for signs of inflammation or white patches which may indicate strep throat. Your doctor will feel for swollen glands in the neck and check your breathing, a throat swab and blood test may be also required. If the cause for your sore throat is still unknown, you may be referred to an allergist or ENT (ear, nose and throat speciallist) for further testing.

Treatment of a Sore Throat –

If your sore throat is caused by a viral infection which is the most common cause, it will usually clear up on its own and will not require medical care. Over the counter pain management, bed rest and drinking plenty of fluids are advised. Bacterial infections such as strep throat will require antibiotics. If your sore throat is worsening, see your doctor. If you are experiencing difficulty breathing or swallowing see your nearest emergency department. If antibiotics are given they must be taken exactly as advised and completed even if you are feeling better or the infection may return.

Pain Management at Home:

No matter the cause for your sore throat these at home strategies may provide you temporary relief from pain:

Treat pain and fever: Take over the counter pain relief medication. Only take as advised and talk to your doctor if you have any questions or concerns.

Rest: Get plenty of sleep and rest your voice.

Drink fluids: Drink plenty of fluids to keep the throat moist and prevent dehydration.

Salt water gargles: 1/2 to 3/4 teaspoon salt to One cup of pure water can help soothe a sore throat. Gargle the solution and then spit it out.

Suck on a lozenge: Lozenges can soothe a sore throat, but you should not exceed the daily recommended dose as they can cause stomach upset. Lozenges are also a choking hazard for young children and shouldn’t be used for children under 4yrs.

Avoid aggravating your pain: Avoid harsh cleaning products and cigarette smoke.

Warm Drinks: Such as tea (caffeine free is best) warm water with honey, soup or broth may sooth a sore throat.

Try Ice blocks: This may soothe a sore throat.

Humidify the air: Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat or sit for several minutes in a steamy bathroom.

Prevention –

Practice good hygiene and prevent the spread of germs:

Wash your hands: thoroughly and frequently, especially after using the toilet, before eating, and after sneezing or coughing.

Avoid sharing: food, drinking glasses or utensils.

Avoid contact: With shared surfaces: door knobs, kitchen benches, public handrails or drinking fountains.

Cough or sneeze: into a tissue and throw it away. When necessary, sneeze into your elbow.

Use alcohol-based hand sanitisers as an alternative to hand washing when soap and water aren’t available. Wash your hands as soon as you can.

Regularly clean: telephones, TV remotes, keyboards, and phones.

Avoid close contact: with people who are sick (kissing, hugging, shaking hands).

Wear a filtering mask: when cleaning to avoid inhaling dust or airborne particles from cleaning products.

If you smoke, quit: Talk to your doctor if you need help quitting.

Avoid exposure: to secondhand smoke, pollen, dust, and mould.

Humidify your home: if the air is dry and, you frequently experience sore throats.

A nagging sore throat may be an early sign of cancer

“Sore throat that won’t go away ‘could be a sign of cancer’ doctors warned,” reports The Independent.

Cancer of the larynx, or voice box, affects about 1,700 people a year in the UK. Most cases develop in people aged 60 and above and it is more common in men. It can be treated, and early detection and treatment can make a real difference. Laryngeal cancer is strongly linked to tobacco smoking, secondhand smoke and heavy drinking.

The main symptom of laryngeal cancer is hoarseness. But researchers have now looked at the records of 806 patients with laryngeal cancer and 3,559 without it to see if there are other warning signs GPs should be aware off.

Their analysis suggests that certain combinations of symptoms may require further testing. A potentially serious pattern of symptoms was found to be when hoarseness was combined with a persistent sore throat. Other potential “red flags” included combinations of sore throat with earache, difficulty breathing, difficulty swallowing and insomnia.

Hoarseness, however, remained the most common individual symptom.

The research could be used to update or expand clinical guidelines about when GPs should refer people with suspected cancer for further tests.

If you do have a sore throat, there is no need to panic as it is highly unlikely to be due to cancer and your pharmacist should be able to recommend suitable treatments. But if symptoms do not pass within 1 week then contact your GP for advice.

Where did the story come from?

The researchers who carried out the study were from the University of Exeter. The study was funded by the National Institute for Health Research and published in the peer-reviewed British Journal of General Practice and is free to read online.

The UK media’s coverage of the study was generally accurate. However, when reporting the risks of particular symptoms, the media reports did not make clear that these figures applied only to people aged over 60. So, the use of a photograph of a young woman with a sore throat by the Mail Online is arguably inappropriate and may cause unnecessary alarm.

What kind of research was this?

This was a case control study. Case control studies are used to investigate risk factors associated with a rare outcome, such as laryngeal cancer. In this case, researchers wanted to see what symptoms people reported to GPs in the year before being diagnosed with laryngeal cancer, and whether these reports were more common in people with cancer than without.

What did the research involve?

Researchers used anonymised patient information from the UK’s Clinical Practice Research Datalink network of more than 600 general practices. They found all cases of people 40 or over, diagnosed with laryngeal cancer between 2000 and 2009, who had a record of a consultation with a GP in the year before their diagnosis. They then matched them with up to 5 patients from the same practice, of the same age and sex.

The researchers conducted a literature search and looked on patient forums to find any symptoms that had previously been linked to laryngeal cancer. They focused on 10 commonly reported symptoms, then looked for reports of these symptoms in the records of the people in the study, to see how often they’d been reported to GPs by people with or without laryngeal cancer.

The researchers used the data to calculate the positive predictive value of symptoms alone or in combination. Positive predictive value tells you what percentage of people with that symptom have the disease in question. Importantly, the calculation was done for people aged over 60, because there were few people with laryngeal cancer in younger age groups.

What were the basic results?

The study confirmed that hoarseness is the single symptom most closely linked with laryngeal cancer. 52% of people diagnosed with laryngeal cancer had reported hoarseness in the year before diagnosis, compared to 0.25% of people without cancer.

The researchers calculated that 2.7% of people over 60 reporting hoarseness would have laryngeal cancer. No other symptom was as strongly linked to cancer on its own. However, other combinations of symptoms did raise the risk. For people over 60 with hoarseness, the likelihood of cancer rose further if they also had insomnia (5.2% of people with both symptoms having cancer), persistent shortness of breath (7.9% of people), mouth symptoms (4.1%), blood tests that showed inflammation (15%), earache (6.3%), difficulty swallowing (3.5%), or persistent sore throat (12%).

For people over 60 without hoarseness, 3% or more of people with the following combination of symptoms were found to have laryngeal cancer:

How did the researchers interpret the results?

The researchers said: “These results provide new evidence that GPs should consider relevant when ascertaining whether to refer a patient for suspected laryngeal cancer.”

They point out that chances of laryngeal cancer “rose considerably” when hoarseness thought to be down to an infection persisted, and say GPs should “encourage re-attendance should the hoarseness persist”.

Conclusion

This study provides useful information for GPs about which symptoms, together or in isolation, might warrant a referral for investigation for possible laryngeal cancer.

The study has some limitations. The researchers relied on the GPs to record symptoms accurately and consistently, and say they may have missed some symptoms recorded in free text boxes rather than coded separately. People diagnosed with laryngeal cancer saw GPs more often, so had more chance to report symptoms. That means some people without cancer may have had symptoms such as sore throat, but did not report them. This could slightly overestimate the risk attached to symptoms.

The research provides new evidence to help GPs weigh up which patients may need referral for investigation, and which should be followed up to ensure their symptoms resolve. Even then, the study authors make the point that selecting the right patients for investigation of possible cancer “is not simply a matter of totting up symptoms and PPVs (positive predictive values)”. They say GPs’ clinical experience is also important for making these decisions.

However, there’s no need to panic if you get a sore throat. The vast majority of sore throats are caused by colds or infections. They pass quickly and often need no treatment. Sore throats, ear aches and other symptoms of infection are particularly common in children and young people. Even among older adults, the proportion of people with a sore throat or other symptoms who will be found to have laryngeal cancer is still very low.

However, people should get persistent symptoms – alone or in combination – checked out, especially if they last longer than you’d expect from a cold or chest infection.

Analysis by Bazian
Edited by NHS Website

Links to the headlines

Persistent sore throat ‘can be cancer sign’

BBC News, 29 January 2019

Sore throat that won’t go away ‘could be sign of cancer’, doctors warned

The Independent, 29 January 2019

Do YOU have a persistent sore throat? Researchers warn the symptom could be a sign of CANCER in your larynx

Mail Online, 29 January 2019

Links to the science

Shephard EA, Parkinson MAL, Hamilton WT.

Recognising laryngeal cancer in primary care: a large case–control study using electronic records

British Journal of General Practice. Published online January 29 2019

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