Pharyngitis/Tonsillopharyngitis
En Español (Spanish Version)

Definition
Pharyngitis is the swelling and inflammation of the pharynx. The pharynx is the back of the throat, including the back of the tongue. Tonsillopharyngitis is the swelling of the pharynx and the tonsils. The tonsils are soft tissue that make up part of the throat's immune defenses. Both pharyngitis and tonsillopharyngitis are commonly called a sore throat. Sore throats can easily be treated. If you have a sore throat for more than two days, contact your doctor.

Sore Throat Due to Inflammation

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Causes
Many things can cause pharyngitis and tonsillopharyngitis. Causes include:
  • Infection with a virus, such as the viruses that cause influenza (the flu) and the common cold
  • Infection with bacteria, such as the bacteria that cause strep throat
  • Mucus from your sinuses that drains into your throat
  • Smoking
  • Breathing polluted air
  • Drinking alcoholic beverages
  • Hay fever or other allergies
  • Acid reflux from the stomach
  • Allergies
  • Food debris collecting in small pockets in the tonsils
  • Infectious mononucleosis

Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Almost everyone will get a sore throat. These risk factors increase your chance of getting a sore throat:
  • Age: children and teens, and people aged 65 or older
  • Exposure to someone with a sore throat or any other infection involving the throat, nose, or ears
  • Situations that cause stress, such as traveling, working, or living in close contact with people
  • Exposure to cigarette smoke, toxic fumes, industrial smoke, and other air pollutants
  • Having other medical conditions that affect your immune system, such as AIDS or cancer
  • Stress
  • Hay fever or other allergies

Symptoms
Your symptoms depend on the cause of the condition. If you experience any of these symptoms, do not assume it is due to pharyngitis or tonsillopharyngitis. These symptoms may be caused by other health conditions. If you experience any one of them, see your doctor.

Symptoms include:
  • Sore throat
  • Pain or difficulty when swallowing
  • Difficulty breathing
  • Fever
  • Enlarged lymph nodes in your neck

Diagnosis
The doctor will perform a physical exam, looking closely at your mouth, throat, nose, ears, and the lymph nodes in your neck.
  • This physical exam may include:
    • Using a small instrument to look inside the nose, ears, and mouth
    • Gently touching the lymph nodes (glands) in your neck to check for swelling
    • Taking your temperature
    • Examining your ears
  • The doctor will ask questions about:
    • Your family and medical history
    • Recent exposure to someone with strep throat or any other infection of the throat, nose, or ears
  • Other tests include:
    • Rapid strep test or throat culture—using a cotton swab to touch the back of the throat to check for strep throat
    • Blood tests —to identify conditions that may be causing the sore throat
    • Mono spot test (if mononucleosis is suspected)

Treatment
Treatment depends on the cause of the sore throat. Treatment options include:

Medications
  • Antibiotics for strep throat
  • Drugs to reduce sore throat pain; these drugs include:
    • Ibuprofen (Motrin, Advil)
    • Acetaminophen (Tylenol)
    • Aspirin
      • Note : Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.
  • Numbing throat spray for pain control
  • Decongestants and antihistamines to relieve nasal congestion and runny nose
  • Throat lozenges
  • Corticosteroids (used in combination with antibiotics for severe cases)
Home Care
  • Get plenty of rest.
  • Drink plenty of water.
  • Gargle with warm salt water several times a day.
  • Drink warm liquids (tea or broth) or cool liquids.
  • Avoid irritants that might affect your throat, such as smoke from cigarettes, cigars, or pipes, and cold air.
  • Avoid drinking alcohol.
If you have been diagnosed with pharyngitis, be sure to follow your doctor's instructions .

Prevention
Here are ways to reduce your chance of getting a sore throat:
  • Wash your hands frequently, especially after blowing your nose or after caring for a child with a sore throat.
  • If someone in your home has a sore throat, keep his eating utensils and drinking glasses separate from those of other family members. Wash these objects in hot, soapy water.
  • If a toddler with a sore throat has been sucking on toys, wash the toys in soap and water.
  • Immediately get rid of used tissues, and then wash your hands.
  • If you have hay fever or another respiratory allergy, see your doctor. Avoid the substance that causes your allergy.




RESOURCES:
American Academy of Pediatrics

National Institute of Allergy and Infectious Diseases

CANADIAN RESOURCES:
Canadian Society of Otolaryngology


References:
Brink AJ, Cotton MF, Feldman C, et al. Guideline for the management of upper respiratory tract infections. S Afr Med J . 2004;94:475-483.

DynaMed Editorial Team. Streptococcal pharyngitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated October 12, 2010. Accessed November 10, 2010.

Family Doctor.org. Sore throat. Family Doctor.org website. Available at: http://familydoctor.org/online/famdocen/home/common/infections/cold-flu/163.html . Updated March 2009. Accessed November 10, 2010.

Mayo Clinic. Sore throat. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00526 . Updated October 1, 2007. Accessed June 15, 2008.

Patient UK. Sore throat. Patient UK website. Available at: http://www.patient.co.uk/health/Sore-Throat.htm . Accessed November 10, 2010.

Perkins A. An approach to diagnosing the acute sore throat. Am Fam Physician . 1997;55:131-138,141-142.

Vincent MT, Celestin N, Hussain AN. Pharyngitis. Am Fam Physician . 2004;69:1465-1470.

11/10/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P. Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. BMJ. 2009;339.

Last Reviewed September 2011