Sore throat: what you need to know

Sore throat is very common and is usually caused by infection with any one of a large number of viruses or less commonly bacteria.

Occasionally, sore throat can have other causes such as allergies, excessively dry air (e.g. from air conditioning), irritants (e.g. tobacco smoke, pollution), voice strain or gastro-oesophageal reflux disease (where acid from the stomach rises into the gullet).

Many illnesses ranging from the common cold to glandular fever cause sore throat as a symptom.
Symptoms

A sore throat may be accompanied by sniffles, a cough and feeling weak and feverish.

If bacteria or viruses infect the tissues at the back and sides of the throat, the body produces antibodies to fight off the infection. This process may cause the lymph nodes (‘glands’) in the neck to swell and become tender.

Most people are over the infection within 7 days; many people find that their sore throat goes away much sooner than this.
Sore throat treatments

Give your body a hand to heal itself by trying the following.

  • Resting as much as you can. Take time off work and do not send your child to school or pre-school if they have a sore throat.
  • Drinking plenty of fluids (don’t worry if you don’t not feel like eating much for a couple of days). Children and adults may find ice-blocks refreshing.
  • Drinking warm water with honey and lemon can be soothing for a sore throat.
  • Gargling with a glass of warm water with a teaspoon of salt in it at least twice a day (older children and adults only).
  • Taking medicines to control the pain and fever.

Pain relief for sore throat

Pain relief for sore throats should be considered. Pain relief will allow you to eat and drink more comfortably and has the added benefit of reducing fever if this is a problem.

Paracetamol, paracetamol combined with codeine, or codeine combined with aspirin, or aspirin alone can help relieve the pain of a sore throat. Medicines containing aspirin must not be used by children under 16 years who have a fever, especially if the child also has symptoms of influenza or chicken pox. This is because aspirin can cause a serious condition called Reye syndrome in children.

Your doctor may also recommend ibuprofen, a non steroidal anti-inflammatory drug (NSAID). People with peptic or duodenal ulcers, bleeding conditions or who are taking anti-coagulant medicine should not take ibuprofen or aspirin.
Antibiotics and sore throat

Most people do not need antibiotics for sore throats, as the majority are caused by viruses (which are not affected by antibiotics).

Antibiotics can help shorten the duration of symptoms in certain cases, for example if it’s suspected that you have a specific bacterial infection. However, antibiotics are associated with side effects such as nausea, diarrhoea and rash. Your doctor will weigh up the pros and cons of antibiotics in your particular case.

If your doctor does prescribe antibiotics, make sure you complete the whole course, even if your symptoms clear up before you have finished the antibiotics. This reduces the risk in the community of bacteria becoming resistant to the antibiotics.
When to see your doctor

Seek immediate medical attention if you or your child have any of the following symptoms, which could indicate a life-threatening condition:

  • difficulty breathing or noisy breathing;
  • neck stiffness rather than throat pain;
  • a lot of difficulty swallowing water or saliva;
  • a muffled voice;
  • drooling;
  • a rash or bruising; or
  • signs and symptoms of dehydration, such as sunken eyes or passing less urine than usual.
  • You should also see a doctor if you or your child have any of the following:

    • a high fever for 48 hours or longer;
    • no easing of the sore throat after 7 days (adults) or 2 days (children);
    • ear pain; or
    • other medical problems which affect how your body can heal itself, such as diabetes or immune disorders.

    In these circumstances, your doctor will examine you and may do blood tests or a throat swab (a cotton swab is brushed over the back of your throat and examined for bacteria in the laboratory) to establish whether antibiotics may be necessary.

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