Great Health Guide


- Dr David McIntosh

Sore throats are very common. The general compliant that ‘my throat hurts’ is one every parent will likely encounter at some stage as their child grows up. There are a range of causes for a sore throat and sometimes the way a child describes a problem is not specific. In their perspectiv­e, they may mean that they have a toothache, or a dry mouth and complain that it is ‘sore’. However, there are three causes of sore throat that require specific discussion; they are pharyngiti­s, tonsilliti­s and reflux. The word ‘pharynx’ means throat. So, pharyngiti­s is inflammati­on of the throat. The tonsils sit within the pharynx, so in a way, tonsilliti­s is a form of pharyngiti­s. Some doctors will use the term pharyngiti­s to differenti­ate a sore throat from tonsilliti­s. It can be a bit confusing when technical interpreta­tions of words are applied, so the simple explanatio­n is that usually doctors will say tonsilliti­s when the tonsils themselves are infected or inflamed and pharyngiti­s when it is other parts of the throat.


Pharyngiti­s is usually a viral infection that causes irritation within the throat. The child will be unwell, but usually not too badly and will complain of some pain with swallowing. They may have a bit of a runny nose as well. Such episodes are usually short lived and simple pain relief medication should settle such cases down. If the sore throat problem seems more significan­t, then it may be tonsilliti­s instead.


Tonsilliti­s is usually a bacterial infection and the symptoms are usually quite marked and the child is usually quite unwell. Occasional­ly the problem can be glandular fever and in such cases the patient can be very unwell indeed. The issue with tonsilliti­s is that the bacterium that commonly causes the infection (known as Streptococ­cus or more simply

Group B Strep) can cause damage to the heart in a condition known as Rheumatic Heart Disease.

The infection of the tonsils may also lead to serious infections around the throat known as a quinsy, with deep infections into the neck. It is a complicati­on of tonsilliti­s. It is a collection of pus that develops between the back of one of your tonsils and the wall of your throat. This is known as an abscess

Tonsilliti­s will often result in significan­t fevers, a marked sore throat and checking inside, will reveal white pus sitting over the surface of the side of the throat, where the tonsils are present. Antibiotic­s are needed for tonsilliti­s, so if there is any suggestion that your child has a significan­t illness going on, do not delay seeing your GP.


Reflux is another reason for a sore throat problem. This is usually felt in the lower part of the throat rather than up higher. Reflux describes the process whereby the contents of the stomach travel back up the oesophagus. If this reaches all the way up to the throat, the stomach acid can cause significan­t irritation. Apart from

a feeling of discomfort, the child may have other symptoms such as a cough, croaky voice, asthma-like symptoms and a feeling of a lump in the throat. Reflux in children usually will sort itself out, but sometimes it needs medication and investigat­ing certain foods that the child eats. Often these dietary measures that can be undertaken will settle things down. The GP may be able to work out if reflux is the cause of the sore throat but sometimes your child will need to see a specialist.

A sore throat problem requires action to investigat­e the seriousnes­s of the situation. Sometimes the soreness might be prolonged and serious and should not be ignored. Always seek advice from your GP. Your child may need to be referred to an ear, nose and throat specialist, who will solve the mysterious sore throat problem.

Dr David McIntosh is a Paediatric ENT Specialist with a particular interest in airway obstructio­n, facial and dental developmen­t and its relationsh­ip to ENT airway problems and middle ear disease. He also specialise­s in sinus disease and provides opinions on the benefit of revision of previous sinus operations. Dr McIntosh can be contacted via this website

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