Sore throat can lead to complications

Donya Betancourt, Pediatrician, Sanur, Bali, drdonya@hotmail.com

A sore throat may often be the first symptom of a cold or flu, but it can occur as an ailment in itself. Most frequently, the cause is a virus, but in a minority of cases, the cause is bacterial.

Three common reasons for a sore throat is infection, allergy, and dry air. If the air is dry, your throat can dry out with your breathing and become sore. Sometimes it's hard to figure out which one you have, but in most cases, there are clues as to the origin.

When it comes to infection, people tend to be most concerned about what is called a strep throat.

A strep throat is caused by bacteria, a type of germ. It is very common in children under three years old and much less common in adults.

Strep sore throat is of primary concern because it can occasionally lead to complications. Strep throat often comes with a fever for a few days as well as a headache and stomach pains. The tonsils become red and swollen, and after a day or two, white spots, a white patch, green exudate or pus may appear on the tonsils.

Usually a person with strep throat will have swollen and tender lymph nodes at the front sides of the neck and the throat will hurt so much that even swallowing liquid is painful.

Unlike in viral or dryness-related soreness, coughing, however, is rare with strep throat. Strep throat is not likely if the sore throat is a minor part of a typical cold with runny nose, stuffy ears and cough.

Keep in mind that strep throat is less common than the other infectious causes of a sore throat, which is a virus.

There are many viruses that can give you a sore throat and upper respiratory symptoms. The clues that it might be a virus are lots of different symptoms like a cough, nasal congestion and runny nose. Both strep and viruses can cause fatigue and headache.

The general rule of thumb is; antibiotics for strep, no antibiotics for viral infection. A doctor can make an educated guess as to the likelihood of strep based on clinical judgment, or a throat culture (or rapid strep) can be done. Most sore throats are viral, so this prescribing method leads to many antibiotic-treated viral infections.

The downside to taking antibiotics is antibiotic resistance. People who take antibiotics frequently increase the likelihood of an antibiotic losing its effectiveness against certain bacteria in their own bodies. There is also the issue of antibiotic resistance to bacteria in the community. In the long run, we come across what are known as super bugs, which could potentially be resistant to all antibiotics.

Ibuprofen or acetaminophen are the standard pain relief pills. If post nasal drip is causing the sore throat you may benefit from an antihistamine or decongestant. Liquids such as tea, water, electrolyte drinks, or broth can be soothing as well. Staying well hydrated is always beneficial, especially if you have a fever, which can dehydrate you quickly.

For strep sore throat, original studies reveal that a ten-day course of penicillin or erythromycin decreases the incidence of rheumatic fever (an illness associated with prior strep infection) from 5 percent to less than 1 percent.

Some people get relief with lozenges. Menthol lozenges have some local anesthetic properties but can make your tongue and whole mouth feel numb. Zinc lozenges remain controversial, as far as their usefulness is concerned.

Both viral and bacterial upper respiratory infections are considered contagious. You are probably most contagious in the early stages of your illness and even shortly before you start exhibiting symptoms. Avoid touching, sharing drinks and close contact with people. Wash hands frequently if you're trying to avoid getting sick.

Frequent and recurrent sore throats are common, especially in children between the ages of five and 10. There are other things that can happen with strep throat, which we will talk about next week.