Dr Sarah Jarvis
Everyone gets them and to most they’re just a bore that passes in a few days. But sometimes sore throats can signal a serious infection that needs antibiotic treatment – and they might have a most unlikely cause.
By far the most common cause of sore throat is a virus infection, often accompanied by typical symptoms of a cold – coughing, sneezing, feeling tired and a bit achy. Your pharmacist can advise on over-the-counter remedies to help you feel better while your immune system fights it off. These include painkillers like paracetamol or ibuprofen. There’s not much evidence that gargling with soluble paracetamol before swallowing it is more effective, but some people swear by it. There’s definitely no evidence for the popular option of gargling salt water.
Tonsillitis, or inflammation of the tonsils at the back of the throat, is also most often down to a virus infection. The sore throat is at its peak for 2-3 days, then gradually settles over the course of a week or so. However, it can be caused by a bacterial infection (usually streptococcus). It’s most common in children, teenagers and young adults, although it can affect older adults too.
There are certain key features that can help you decide if you need to see a doctor: If you have at least 3 of these symptoms – sore throat with no cough, a temperature, swollen tender glands on the front of your neck, and white pus on the back of your throat when you shine a torch into your mouth – then see your GP. An abscess on the tonsils is more serious still. Watch out for difficulty in breathing, problems
swallowing even saliva or opening your mouth properly, and very severe pain on one side of your throat.
Glandular fever is also more common in young adults and teenagers. Although you may have only a mild sore throat, it’s likely to look very red and inflamed and it’s usually accompanied by swollen, tender glands. It’s caused by a virus and can leave you tired and washed out for weeks, even months. If your GP suspects glandular fever, they’ll do a blood test to confirm.
Some non-infectious conditions can leave you with a sore throat. Hay fever is one of them, although sneezing, itchy watery eyes and blocked nose are usually a give-away.
Throat cancer occasionally starts with pain in the throat that doesn’t settle, although other causes are much more likely. If you’ve been a smoker and pain doesn’t settle, do see your doctor.
You may think of stomach reflux as an unlikely culprit for a sore throat. In reflux, stomach acid leaks back up into your gullet, leading to burning pain behind your breastbone, or heartburn. It can also leave a nasty taste in your throat, as acid can rise right up into your mouth, especially when you lie down and it doesn’t have to battle against gravity. This acid can lead to soreness and sometimes an irritating cough.
A rare cause of sudden onset sore throat is low levels of white blood cells, which help fight off infection. This is most likely if you’re taking medicines that interfere with your immune system, like carbimazole (for overactive thyroid), chemotherapy for cancer, or so-called “disease modifying drugs” for conditions like rheumatoid arthritis, psoriasis or Crohn’s disease.
If you’re unlucky enough to succumb to a sore throat in spite of a healthy lifetsyle, make your pharmacist your first port of call. Next Week: Protect yourself from breast cancer