Pharyngitis: What It Is, Its Causes, Symptoms, and Treatment

In the winter months, we often encounter respiratory tract illnesses.

​​​​​One of the most well-known of these illnesses is pharyngitis. Often referred to as the "teacher's disease," pharyngitis is a condition that everyone is familiar with.

What is Pharyngitis?

Pharyngitis is a disease caused by inflammation of the pharynx (throat), located at the back of the throat, which plays an important role in both the respiratory and gastrointestinal systems. This condition is usually viral in origin, but bacteria can sometimes cause it as well. Tonsillitis, or infection of the tonsils, may also accompany pharyngitis. There are two types of pharyngitis, which differ in terms of symptoms.

The two types of pharyngitis are acute pharyngitis and chronic pharyngitis.

Chronic Pharyngitis: It is more commonly seen in children aged 4-7, with a much lower likelihood in children under the age of 1. This disease can also be work-related or environmental, particularly in dusty environments or for those exposed to chemical vapors. It is also commonly seen in individuals with conditions such as allergic rhinitis or acid reflux.

Symptoms of Pharyngitis: Like many diseases, the symptoms can vary depending on the individual, the cause of the illness, and the environment. Pharyngitis symptoms can also be divided into acute and chronic categories.

Acute Pharyngitis Symptoms:

• Sore throat
• Difficulty swallowing or talking due to pain
• Swelling of the lymph nodes in the neck or throat
• Swelling and redness of the tonsils
• Hoarseness
• White or gray spots at the back of the throat

Chronic Pharyngitis Symptoms:

• Worsening of throat discomfort, pain, or soreness
• Severe coughing
• Itching or tickling sensation in the throat
• Sensation of something being stuck in the throat
• Difficulty swallowing
• High fever
• Headache due to throat pain and discomfort
• Voice fatigue

In infants, pharyngitis symptoms may appear differently. Babies with pharyngitis often experience sudden fever, abdominal pain, and vomiting, leading to restlessness and crying. In such cases, it is necessary to consult a doctor.

What are the Causes of Pharyngitis?

Causes of Acute Pharyngitis:

Acute pharyngitis is often seen after illnesses like the flu or common cold, which are caused by viruses. Some diseases, such as herpes simplex virus (which causes cold sores), shingles, sexually transmitted gonorrhea (also known as "the clap"), and diphtheria, which are less commonly encountered, can also lead to acute pharyngitis.

Streptococcus bacteria are also among the common causes of pharyngitis. Since it is a bacterial form of pharyngitis, antibiotic treatment may be applied to ensure rapid recovery and eliminate symptoms. Most bacterial cases of pharyngitis are caused by Group A beta-hemolytic streptococci. Symptoms of this type of pharyngitis often include fever, sore throat, and swelling of the lymph nodes in the neck.

Candida Albicans fungi can also cause pharyngitis.

Causes of Chronic Pharyngitis:

• Nasal congestion resulting from upper respiratory infections
• Consumption of food that is either too hot or too cold
• Spending time in dry or polluted environments
• Infections in the teeth or gums
• Excessive smoking
• Prolonged exposure to environments with heavy air conditioning
• Postnasal drip caused by sinusitis
• The habit of frequently clearing the throat, which becomes a repetitive action for some people

How is Pharyngitis Diagnosed?

When diagnosing pharyngitis, it does not matter whether it is acute or chronic. For both acute and chronic pharyngitis, the doctor should take the patient's medical history and conduct a physical examination. Usually, no additional tests are needed, but if the doctor deems necessary, certain tests may be requested after the examination. If pharyngitis is suspected to be caused by an underlying disease, these tests may reveal the cause. If sinusitis is suspected, imaging tests, or rarely, blood tests or cultures may be requested.

How is Pharyngitis Treated?

The majority of pharyngitis cases heal on their own with rest, proper diet, and adequate sleep, without the need for treatment. It is crucial to consult a doctor when symptoms of pharyngitis appear. The treatment will vary depending on the underlying cause. For example, viral pharyngitis does not require antibiotic treatment, as antibiotics are effective against bacteria, not viruses. In cases of bacterial pharyngitis, antibiotics may be prescribed. However, doctors do not frequently use antibiotics for pharyngitis unless necessary. In mild cases, over-the-counter medications may be used for treatment.

If the pharyngitis is caused by a virus, there are ways to alleviate the symptoms at home without consulting a doctor.

Home Remedies:

• Drink plenty of fluids, especially water, to prevent dehydration.
• Gargle with a mixture of 1 teaspoon of salt in 8 cups of water.
• Use a humidifier to keep the air moist if necessary.
• Rest as much as needed until feeling better.
• Consult a pharmacist to use over-the-counter medications to manage pain and fever.

Medical Treatment for Pharyngitis:

Medical treatment for pharyngitis is usually not necessary, but antibiotics may be used when required. The decision to use antibiotics should be made by a doctor because antibiotics are ineffective against viral pharyngitis and could lead to antibiotic resistance if used unnecessarily. This is an important issue, and doctors are generally reluctant to prescribe antibiotics unless absolutely necessary.

Some doctors may use a test called the “Centor criteria” to decide whether antibiotics are needed. This test evaluates:

• The presence of inflammation in the tonsils
• The presence of painful or swollen lymph nodes in the neck
• The patient’s cough status
• The patient’s fever status

If three or four of these symptoms are present, the doctor may prescribe antibiotics. According to some studies, amoxicillin and penicillin are the most frequently prescribed antibiotics for streptococcal throat infections.

Recommendations for Pharyngitis Patients:

• Avoid consuming very hot or cold foods, as they can irritate the throat and prolong the healing process.
• Sage, which has antiseptic properties, should be consumed regularly but in moderation.
• Drink plenty of water to prevent dehydration. Warm broths made with meat stock are also recommended.
• Speaking loudly can irritate the throat and contribute to the condition; it is advisable to speak softly during the recovery period.
• To relieve dryness, pain, and discomfort in the throat, and to sleep better, drink warm water before bed.
• Smoking or being in environments with smoke can hinder recovery.
• Ensure the environment is clean and free of dust. The air should also be kept moist.
• Engage in moderate exercise regularly, without overexertion.
• Maintaining a healthy, balanced diet is crucial during the recovery period.
• Follow the doctor’s prescribed treatment and do not skip any recommended steps.