Pharyngitis (sore throat)

Published by Bupa's Health Information Team, May 2011.

This factsheet is for people who have pharyngitis, or who would like information about it.

Pharyngitis is inflammation of your throat (pharynx). The most common symptom is a sore throat. It’s often caused by an infection.

About pharyngitis

Your throat starts at the back of your mouth and nose and connects to your oesophagus (the pipe that goes from your mouth to your stomach), windpipe (trachea) and voice box (larynx).

Pharyngitis can be an acute or chronic inflammation of your throat. When describing an illness, the terms ‘acute’ and ‘chronic’ refer to how long a person has had it, not to how serious the condition is.

• Acute pharyngitis is typically over quite quickly. It usually lasts about a week and is a common condition, particularly in children and young adults.
• Chronic pharyngitis (or a persistent sore throat) lasts for longer – sometimes for several weeks or months.

What is pharyngitis?

Pharyngitis is inflammation of your throat, usually caused by an infection. The infection can sometimes cause inflammation of your tonsils as well.

Pharyngitis is a common condition, particularly in children and young adults.

Types of pharyngitis

There are two types of pharyngitis - chronic and acute.

Acute pharyngitis is common and is usually caused by a viral infection. It's often caused by the same viral infection that causes the common cold. The symptoms of acute pharyngitis usually last for a week or less.

Chronic pharyngitis is a persistent sore throat. The symptoms of chronic pharyngitis last for longer than those of acute pharyngitis.

Symptoms of pharyngitis

The symptoms of pharyngitis vary, depending on how inflamed your throat is. Symptoms can include:

• a sore throat – pain at the back of your mouth, which may be mild or severe
• difficulty and pain when swallowing
• earache
• a fever – a temperature higher than 37.5°C
• feeling generally unwell
• muscle aches
• cough
• enlarged and tender glands in your neck
• enlarged and tender tonsils (tonsillitis)

You don’t always need to see a doctor for these symptoms if they are not very severe and you can manage them at home. However, if your symptoms don’t improve or get worse, or you have a constant high temperature that isn’t helped by painkillers such as paracetamol, see your GP.

Complications of pharyngitis

Most people with pharyngitis won’t have any complications. However, if you have had pharyngitis caused by a bacterial infection, there is a small chance that you may develop:

• an ear infection (otitis media)
• a sinus infection (sinusitis)
• a throat abscess (retropharyngeal abscess) – this is most common in young children
• an abscess behind your tonsils (peritonsillar abscess or quinsy)
• an inflammation of the flap of tissue that covers your windpipe (epiglottis), which can make it difficult to breathe – this is very rare nowadays

If you have an abscess, you may have severe pain, drool, and find it very hard to swallow. You should see your GP if you have these symptoms, or seek urgent medical attention if you are finding it hard to breathe.

You are more likely to develop complications if you have a weakened immune system, for instance if you have HIV/AIDS, or if you are taking medicines that suppress the immune system.

Causes of pharyngitis

Pharyngitis is usually caused by an infection with a virus or bacterium. Most people with acute pharyngitis have a viral infection such as the common cold. The most common type of bacterial infection is Streptococcus (known as strep throat). Strep throat occurs most often in children. There is no evidence that sore throats caused by a bacterial infection are more severe than those caused by a virus, or that they last any longer.

Irritants and allergens can also inflame the linings of your throat and cause a persistent sore throat (chronic pharyngitis). Some examples of irritants include:

• airborne allergens such as grass and tree pollen
• smoke and air pollution
• sprays containing chemicals (eg household detergents)
• alcohol

You may be more likely to have a persistent sore throat if you smoke or have a medical condition affecting your mouth, nose or upper respiratory system (such as hay fever, sinusitis or a chronic cough).

Diagnosis of pharyngitis

Pharyngitis doesn't usually need to be diagnosed by a doctor if your symptoms are mild and resolve on their own. However, if you visit your GP with symptoms of pharyngitis, he or she will examine you and may ask you about your medical history. Your GP will look at the inside of your throat. If you have pharyngitis, the lining of your throat will appear red. Your tonsils may also be red and inflamed. There may be some white discharge or pus at the back of your throat. Your GP may also feel your neck to check for any swelling.

Your GP will assess your sore throat looking for symptoms and signs that may indicate a risk of complications. He or she may also make an assessment of whether you're more likely to have a bacterial or a viral infection, based on all of your symptoms.

You won't usually need to have any specific tests for a sore throat, such as a throat swab. However, if you have had a sore throat for a long time, or you keep getting severe sore throats, your GP may take a swab sample from the back of your throat to help confirm whether you're likely to have a bacterial infection. Your GP may also ask you to have a blood test to check for glandular fever if you have a persistent sore throat (it has lasted for longer than a week).

If you have had a sore throat for longer than a month with no obvious cause, your GP may refer you to a doctor who specialises in ear, nose and throat conditions.

Treatment of pharyngitis

Self-help

Pharyngitis will usually get better on its own. Gargling with salt water, drinking warm liquids and sucking on throat lozenges can help to reduce the pain. Most people feel better within a week.

Medicines

You can take over-the-counter painkillers such as ibuprofen or paracetamol to relieve pain and bring your temperature down if you have a fever. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

If you have pharyngitis and an allergy then you may find that controlling your allergy helps to reduce the symptoms of your pharyngitis. Antihistamine tablets such as loratadine (eg Clarityn) may help to do this.

Your GP won't usually prescribe antibiotics, even if your sore throat is thought to be caused by a bacterial infection, as antibiotics won't usually help to relieve your symptoms or help you to recover any sooner. Your GP may prescribe you antibiotics if you have a severe infection or if he or she thinks you're at risk of complications. You may also be given antibiotics if you're admitted to hospital because of a complication, such as an abscess (quinsy).

If you're prescribed antibiotics, make sure that you take the full course. Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.