Pharyngitis (sore throat)

Pharyngitis is the medical term used to describe an infection or inflammation of your throat.

Your throat starts at the back of your mouth and nose and connects to your oesophagus (the pipe that goes from your mouth to your stomach), windpipe (trachea) and voice box (larynx).

Pharyngitis can be an acute or chronic inflammation of your throat. When describing an illness, the terms ‘acute’ and ‘chronic’ refer to how long a person has had it, not to how serious the condition is.

• Acute pharyngitis is typically over within three to seven days. It’s a common condition, particularly in children aged five to 15 years old during winter and early spring.
• Chronic pharyngitis (or a persistent sore throat) lasts for longer, sometimes for several weeks.

The symptoms of pharyngitis vary depending on how inflamed your throat is. The most common symptom is a sore throat, which may be mild or severe. Other symptoms that you may also have at the same time include:

• difficulty and pain when swallowing
• a fever (a temperature higher than 37.5°C)
• a runny or blocked nose
• a cough
• a headache
• enlarged and tender glands in your neck
• pain or discomfort in your abdomen (tummy)
• feeling sick or vomiting
• enlarged and painful tonsils (tonsillitis)

You probably won’t need to see your GP if you have these symptoms as you can usually manage them at home. Speak to your pharmacist for advice about what medicines to take. However, if your symptoms get worse, for example you have difficulty swallowing fluids, are vomiting or painkillers aren't helping, contact your GP for advice. You should always see your GP if you have a persistent sore throat that lasts for several weeks.

Pharyngitis is usually caused by an infection with a virus and, less commonly, by bacteria. Most people with acute pharyngitis have a viral infection such as the common cold virus. The most common type of bacterial infection is group A Streptococcus (known as strep throat). Strep throat occurs most often in children. There is no evidence that sore throats caused by a bacterial infection are more severe than those caused by a virus, or that they last any longer.

Other, rarer causes of an acute sore throat may include:

• a thrush infection of your throat
• a sexually transmitted infection passed on through oral sex
• a blood disorder, such as leukaemia or anaemia
• certain medicines such as carbimazole, clozapine and sulfasalazine

Irritants and allergens can also inflame the linings of your throat and cause chronic pharyngitis. For example, you may be more likely to have a persistent sore throat if you smoke, drink alcohol to excess or have a medical condition affecting your mouth, nose or upper respiratory system (such as hay fever, sinusitis or a chronic cough).

You probably won’t need to see your GP if you or your child has a sore throat. However, if you’re worried that your symptoms are more severe or not getting better, contact your GP – he or she may be able to advise you.

Your GP will usually be able to diagnose pharyngitis by asking about your symptoms and possibly also examining you. He or she may look inside your throat to check for signs of infection and feel your neck to check for any swelling. You won't usually need any other tests but if your GP suspects you have a bacterial infection and you’re at risk of complications, he or she may take a swab sample from the back of your throat to help confirm this. However, this isn't usually necessary.

Your GP may also ask you to have a blood test to check for glandular fever if you have a sore throat that lasts for longer than a week.

If you have had a sore throat for longer than three weeks with no obvious cause, your GP may refer you to a doctor who specialises in ear, nose and throat conditions.

Further information

• ENT UK - 020 7404 8373 - www.entuk.org

Sources

• Acute pharyngitis. BMJ Best Practice.www.bestpractice.bmj.com, published 19 October 2012
• Sore throat – acute. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published October 2012
• Viral pharyngitis. eMedicine. www.emedicine.medscape.com, published 26 September 2011
• Pediatric pharyngitis. eMedicine. www.emedicine.medscape.com, published 15 June 2012
• Management of sore throat and indications for tonsillectomy. Scottish Intercollegiate Guidelines Network (SIGN), April 2010. www.sign.ac.uk
• Vincent MT, Celestin N, Hussain AN. Pharyngitis. Am Fam Physician 2004; 69(6):1465–70
• Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database of Systematic Reviews 2006, Issue 4. doi:10.1002/14651858.CD000023.pub3
• Sore throat (treatment). ENT UK. www.entuk.org, published 23 January 2012
• Tonsillitis. BMJ Clinical Evidence. www.clinicalevidence.bmj.com, published 26 October 2009
• WHO guidelines on hand hygiene in healthcare. World Health Organization. www.who.int, published 2009