Sore Throat (Pharyngitis)

A new complaint of a sore throat is often a sign of infection from a virus or bacteria. Allergies, sinus infections or acid reflux can also cause sore throats. Pain from an infection is usually worse than discomfort from nasal or reflux problems. Boys Town Ear, Nose and Throat offers insight into different causes and care for your child's sore throat needs.

Common Causes

• Viruses: The most common cause of a sore throat is a viral infection, such as the common cold, croup or a respiratory flu. The sore throat from a virus will usually go away in 2-4 days although other symptoms may last longer. One viral infection, infectious mononucleosis will last significantly longer. Antibiotics are not used for viruses. Increasing fluids such as soups/warm tea and giving acetaminophen (Tylenol) or ibuprofen (Motrin/Advil) is helpful for managing sore throat pain.
• Bacteria: Streptococcus (strep throat) is the most common cause of bacterial sore throat. It causes about 15% of sore throats, although rates can be higher in winter. Symptoms of strep throat often include fever (greater than 101F), white patches on the throat and swollen neck glands. Headache and stomach pain can also happen. Strep throat is best evaluated with a throat swab test. Rapid strep test results are usually completed in 15-30 minutes, a 24-48 hour culture is often done if the rapid test is negative. Strep is treated with an antibiotic to shorten the illness and prevent complications. It is important to finish the entire antibiotic to keep the sore throat from coming back. Sore throats can also be caused by a bacterial sinus infection when mucus drains from the nose and irritates the throat.
• Tonsillitis: Tonsillitis is when the tonsils look inflamed or red. It can be caused by a viral or bacterial infection. Pharyngitis means the whole throat/mouth looks abnormal.
• Allergies: Allergies to molds, dust, pet dander, and pollens can cause a sore throat also, but the sore throat is usually mild and can come and go.  Other causes and symptoms include a stuffy nose from allergies, which can cause nighttime mouth breathing and a sore throat in the morning, post nasal drip from allergies, and the same meds that are used to treat allergies can cause mild sore throats.
• Gastroesophageal reflux disease (GERD): GERD is a digestive system disorder that causes stomach acid to back up into the esophagus and sometimes into the throat. It can have symptoms of heartburn, hoarseness, cough, soreness and the sensation of a lump in the throat.

Care Tips

• Increase fluid intake, warm fluids are helpful.
• Use a humidifier in the bedroom.
• Older children and adults can gargle with warm salt water (approx. ¼-1/2 teaspoon of salt per cup) helps with pain and swelling.
• Take over the counter pain/fever relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin/Advil) as needed.
• Never take leftover antibiotics for this symptom. Antibiotics will have no effect on viruses and may cause side effects or make it harder to find out what is wrong if an illness worsens.

Warning Signs to Seek Medical Attention Include

• Difficulty breathing
• Difficulty swallowing/drooling
• Significant swelling on one or both sides of throat or neck
• Difficulty opening the mouth
• Ear pain
• Fever (especially if prolonged or over 102F)
• Rash
• Joint pain
• Frequently recurring sore throat

When to Contact a Physician

Contact a physician if a sore throat is severe or lasts longer than the usual 5-7 days due to a cold or flu illness. Consult our Boys Town Ear, Nose and Throat clinic locations to talk to an otolaryngologist specialist.

• Transcript

  Sore Throats

  Most sore throats are caused by viruses, so everyone is pretty familiar with a doctor telling you that.

  Some sore throats are caused by bacteria and some people are familiar with strep throat that you get the test for. That’s the most important bacterial one to get diagnosed because it has some complications.

  Allergies can also cause sore throats. Reflux, which is acid coming back up your throat can cause sore throats. Then there are a variety of things that you have to worry about. If you’re a smoker, a tumor or growth can cause a sore throat, that’s pretty rare of course and not something we see in kids.

  When should you see a doctor?

  Fair amount of the time, it’s ok if you don’t go to the doctor for a sore throat. If it’s a mild sore throat, lasts a day or two, it’s probably not worth going to the doctor.

  Mostly you look at severity and duration. If you have a sore throat so bad that you can’t swallow, so bad that you can’t open your mouth, or if you have a fever associated with it, temp of 100 or 101 for a day or two is probably ok, 102 or 103 or a fever not going away in a day or two, those are all things you want to go see the doctor for.

  A sore throat, if its in the five to seven day range and it’s not getting any better, it’s a good time to see the doctor.  If you have a sore throat that’s not acute and ,kind of, more chronic and has been going on for a couple of weeks, you should definitely see the doctor in that time frame.

  How are sore throats treated?

  When you go in to the doctor and it’s more of an acute sore throat, you’re probably going to end up with a strep test. If you get a bacterial result from the test and you have strep then you’ll get some antibiotics otherwise you’re going to get told, it’s a virus, take some Tylenol or Motrin, gargle with some warm salt water and wait until it goes away.

  If it’s more complicated, if it’s something due to allergies or reflux, as determined by your physician, then you’re possibly going to get some treatment for your allergies, possibly some dietary changes to try to treat your reflux.

  Are over-the-counter medications a good idea?

  Over-the-counter things for sore throats should only be used on a temporary basis. The throat sprays and the sore throat cough meds type of things, if you read the labels it’s going to say to only use them for two or three days, but actually Tylenol or Motrin, and gargling with warm salt water is better than any of the over-the-counter stuff.