Pharyngitis may be caused by a viral infection (90% of cases) or by a bacterium (10%). If caused by the group A streptococcus, it is called "strep throat". The chronic form can be caused by a continuing infection of the sinuses, lungs or mouth, or by constant irritation from smoking, breathing heavily polluted air, food allergies or consuming too much alcohol, or by swallowing substances that scald, corrode or scratch the throat. Pharyngitis is a common illness.
Epidemiological surveys demonstrate a correlation between vitamin C deficiency and the development of post-streptococcal consequences. Rheumatic fever is virtually nonexistent in the tropics where vitamin C intake is higher; 18% of children in high risk groups have subnormal serum vitamin C levels.
Even strep throat is usually a self-limiting disease. Controlled trials show that clinical recovery is similar in cases with and without the use of antibiotics.
Rheumatic fever, which can cause permanent damage to the heart, is a rare but potentially serious complication of untreated strep throat.
Post-streptococcal glomerulonephritis is another possible serious complication that may develop a week or two after recovery from strep throat. It occurs when the immune system overreacts to the strep throat infection and produces excess antibodies that end up settling in the glomeruli (small blood vessels in the kidneys). This leads to inflammation and, potentially, kidney failure.
If your throat is sore, having a throat culture is usually a good idea for several reasons. First, the symptoms of mono and strep infection (including that caused by Strep-A, a particularly serious form of strep) are very similar. Second, strep throat or other throat infections can develop at any time during or shortly after infectious mononucleosis infection. In any case, it is important that throat infections be diagnosed as soon as possible and treated with antibiotics that can kill the organism responsible for the infection.
Propolis has proven effective in helping to deal with a wide variety of infections including sore throat. [Doroshenko, P. N. (1978, 1981, 1990) (U.S.S.R.)]
The berberine alkaloid found in goldenseal stops the growth of streptococcus, the organism most often associated with bacterial pharyngitis. It also promotes easier removal of the bacteria by inhibiting their ability to adhere to tissue surfaces.
To promote the spread of colonies, streptococci secrete large amounts of hyaluronidase. This enzyme is inhibited by echinacea and prevents tissue invasion by the bacteria. Echinacea also promotes increased phagocytosis and natural killer cell activity. Physical contact is required, so gargling or topical application is best.
For coating and soothing irritated or inflamed mucous membranes add 1 tablespoon of dried slippery elm per cup of hot water. Alternatively, mix 1 tablespoon of liquid extract in 8 ounces of hot water and drink up to 3 cups daily. Slippery elm lozenges are also available.
Sugars have a depressive effect on the immune system.
Avoid spicy foods or acidic foods such as orange juice.
Primary care physicians should avoid or delay prescribing antibiotics to patients with sore throats. Even when beta-hemolytic streptococcus has been cultured and thus shown to be present, antibiotic use may be no more effective than placebo. [Antibiotics are Ineffective for Sore Throat Treatment, Family Practice News, May 25, 1997; p.62, British Medical Journal, 1997;314: pp.722-27]
When antibiotics are required, a once-daily regimen of amoxicillin was found to be as effective as penicillin V administered tid to children with group A beta-hemolytic streptococcal pharyngitis. This reduces cost and inconvenience.
Zinc lozenges have been found to be effective when locally applied to an inflamed throat. Lower dosages of zinc (10mg) with more frequent application are best, and may help avoid any nausea which might result from higher doses.
Gargling with very warm salt water hourly can ease the pain and reduce the duration of a sore throat. Sometimes it works so well that people forget to continue gargling after the first couple of times and the sore throat returns. Use at least 1⁄2 teaspoon salt per cup of water. The water should be no hotter than your immersed finger is able to tolerate.
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