Therapy of fungal infections of the pharynx involves solving three problems: the destruction of pathogens (if before the patient took antibacterial drugs, they are canceled); normalization of the balance of microorganisms in the intestine and indices of the interferon status.
Treatment of mycotic infections of the throat begins primarily with the use of local antiseptic or antimycotic drugs. The duration of the course of treatment of acute mycoses with local antifungal agents is usually from two to three weeks, antiseptic - more prolonged. Therapeutic measures are carried out until the visual symptomatology disappears and then another seven to ten days.
Antiseptic means lubricate the previously dried infected surface. In this case, aqueous solutions (1% or 2%) of conventional greens or methylene blue are used. These agents cause irritation of the mucous membrane, and the fungi quickly become resistant to them. Lugol's solution is more effective , they can be lubricated by the throat and tonsils. More convenient form of spray. This solution contains iodine, can cause burns, irritation, allergies. It is not recommended for pregnant women, children 0-4 years old, persons with hyperthyroidism.
For lubrication, a solution of borax in glycerine (10-15%) is also used, the old tested product, however, inferior in effectiveness to modern antifungal agents.
Antiseptic, a solution of Manganese-potassium hydroxide or Boric acid (1%) is used for rinsing. The throat is rinsed every time after a meal, for greater effectiveness antiseptic drugs are used alternately, changing them in a week.
Modern antiseptics are more effective. For rinses, a solution of Hexetidine (0.1%) is used. The throat is rinsed for about half a minute in the morning and at night after a meal. The solution is also available in aerosol form. Irrigation of the throat is performed for one or two seconds twice a day.
Antifungal topical preparations belong to the group of polyene antibiotics (nystatin, amphotericin, levorin and others) or to imidazole derivatives (nizoral, clotrimazole, fluconazole). They are produced in various forms - solutions, sprays, tablets. When using any form of the drug, the main condition for treatment is the need to delay the drug as much as possible in the mouth. For example, Nystatin tablets with oropharyngeal lesions slowly resolve to the cheek and try to hold in the mouth as long as possible. This drug has activity against yeast fungi and aspergillas, it is low in toxicity, but can cause allergic reactions.
If the local therapy is ineffective, systemic treatment is connected, for example, with Nizoral. It has the ability to destroy yeast fungi that cause candidiasis, destroying the membranes of their cells. It can cause side effects from the nervous system, digestive organs, the genital area, disrupt blood coagulability. The daily dosage is 0.2 g and can be increased to 0.4 g. Taking the drug is desirable during meals for two or three weeks. Sometimes the treatment is repeated.
Correction of the balance of the intestinal microbiocenosis is multitasking. Reduction of the number of pathogenic and conditionally pathogenic microorganisms is carried out with the help of antibacterial drugs, such as Intestopan, and also by the inclusion of products with bactericidal properties in the diet.
Intestopan is active against bacteria and protozoa. Contraindicated in case of sensitization to oxyquinoline derivatives, nervous disorders, severe hepatic and renal pathologies. May cause side effects - digestive disorders, peripheral nerve damage, tachycardia and headache. Adults take one or two tablets three times a day for not more than a decade. To children - the doctor appoints, proceeding from a status and weight of a body.
Required reconstitution microbiocenosis via microbial preparations such kolibakterin - lyophilizate live bacteria E. Coli or Lactobacterin, containing Lactobacillus acidophilus. Live bacteria, entering the intestines, multiply, creating a favorable environment for digestion, metabolism, strengthening immunity and displacing representatives of pathogenic microorganisms. Side effects and contraindications for probiotics are not fixed. Treatment lasts from three weeks to three months, it is recommended to be carried out against a background of vitamin therapy.
Substitution therapy, for example, Viferon, is performed with the aim of correcting the indices of the interferon status. This drug contains reaferon (artificial α-2b-interferon, identical to human), antitumor and cell membrane stabilizing ingredients. In the form of rectal suppositories is administered per unit twice a day every 12 hours for a month. Then, within two or three months, the suppository is applied thrice a week (for example, Tuesday, Thursday, Saturday). The dosage remains the same. After the end of therapy, a control immunoassay is given.
In the case of extensive involvement of the pharynx with Candida fungi, operations on the lymphatic pharyngeal ring, heat and steam procedures, washing of the lacunae of the tonsils are counter-indicative, penicillin and tetracycline antibacterial drugs are not recommended.
With leptotrichosis infection, removal operations are performed, laser or cryodestruction of sites with pathological changes of exclusively palatine tonsils.
Treatment of actinomycosis involves a complex of antibacterial and antifungal measures; oral intake of funds containing iodine. Operative treatment, including a wide opening of the suppuration area, ensuring a constant outflow of pus and washing antiseptics of inflammatory infiltrates.
Immunotherapy consists in intramuscular injection of 20-25 injections of Actinolizate (stimulant phagocytic process). The drug is not used to administer sensitized patients, with acute viral infections and cancerous tumors. It is not prescribed to lactating women. In extreme cases, it is used to treat pregnant women and people with autoimmune diseases. At the initial stage of treatment is very likely an exacerbation of the underlying disease.
In severe forms of actinomycosis, treatment with X-rays is indicated.
In the treatment of chronic tonsillitis various methods are used. Therapeutic regimens are used for compensated (local) form of the disease, when signs of systemic reactions of the organism are not yet observed; when decompensated, manifestations of which consist in repeated angina, and in cases of patient's contraindications to the conduct of surgical treatment.
The patient is guided by the observance of the correct daily routine, which includes moderate exercise, walking outdoors, balanced nutrition, containing the necessary amount of natural vitamins and trace elements.
The drugs that reduce the hypersensitivity of the body - containing calcium, hypo-sensitizing agents: calcium preparations, vitamin C, antiallergic drugs and minimum dosages of allergens, aminocaproic acid and others for symptomatology.
Immunocorrective medications are prescribed, for example, Broncho-munal. It is an oral combined stimulant of immunity, lyophilizate of eight bacteria - the most common pathogens of diseases of the upper respiratory tract. Has a vaccine-like effect. The effect of the application is a decrease in the frequency and severity of the course of infectious diseases of the respiratory tract. Accordingly, drug therapy, especially antibacterial therapy, is minimized. With the introduction of destroyed cells of bacilli, the body responds by producing antibodies to them, which leads to the development of resistance of the organism to these pathogens, preventing exacerbation or greatly facilitating its course. The drug activates the activity of phagocytes, the cleavage of oxygen, its metabolites, superoxide and nitric oxide, have a destructive effect on pathogenic microorganisms found in the body. Increased production of immune cytokines and stimulated their functional qualities, immunoglobulins in plasma, saliva, gastric juice, secretion of the lungs and bronchi, thereby increasing the humoral immunity.
Contraindicated in infants up to six months, pregnant in the first three months and lactating women, as well as with allergies.
Side effects are extremely rare, however, there are allergic reactions, dyspeptic disorders and increased fatigue.
Capsules are taken in the morning on an empty stomach one piece per day. The preventive course consists of three ten-day receptions with intals in 20 days.
Broncho-munal is not recommended to be taken concomitantly with immunosuppressors, combinations with antibiotics are possible.
Manipulations are carried out for the sanation of the tonsils and the pharyngeal cavity by washing or sucking off the lacunar contents and introducing medicines into the lacunae. Solutions for these manipulations of rinsing are selected by the doctor. It can be: antiseptic and antibacterial, enzymatic, anhistamine and other drugs. Properly performed procedures contribute to reducing the inflammatory process and the size of the tonsils themselves.
With these manipulations enough often used Ekteritsid - antibacterial natural product based on fish oil. Antagonist of pyogenic microflora. Has no contraindications and side effects.
Drugs are injected directly into the tonsils, sometimes using a nozzle with multiple thin needles for a quality penetration of the amygdala tissue.
As before, lubrication of the tonsils with Lugol solution, chlorophyllipt (oil solution), collargol and other means is practiced.
Patients are prescribed rinsing with medicine or herbal infusions, prepared at home, vitamins and vitamin-mineral complexes.
Physiotherapy is widely used. The most common application of ultrasound, laser, micro- and magnetic waves, induction currents, microwave radiation, UHF-therapy, ultraviolet irradiation, mud therapy. Practice and other methods.
For example, reflexotherapy - acupuncture, novocain blockades and manual therapy, since it is established that chronic tonsillitis is often combined with blocking mobility in the occipital region (it is localized most often between the occiput and the atlas).
It is impossible to rely entirely on alternative medicine, these pathologies of the throat should not be underestimated. However, physicians themselves often resort to alternative means in a complex of medical measures. The lights of alternative medicine can significantly alleviate the condition of both children and adults, but necessarily after a medical consultation, since independence in this matter should not be shown. It can slow down recovery and complicate the course of the disease. Especially orofaringomycosis, as the fungi are quite persistent and resistant pathogens, especially their spores.
The simplest advice - every time after a meal is recommended to eat one small slice of garlic, thoroughly chewing and holding the gruel in your mouth. The therapeutic effect of eating garlic appears in a week. The smell can be repulsed by chewing the leaves of parsley, which is also used as an alternative remedy for the fungus - fresh parsley, finely chopped, measure two tablespoons, pour a glass of cold water and make a broth, boiling for five minutes. Insist for an hour, gargle each time after eating.
The root of horseradish has antifungal activity, rub it with ½ cup and mix with three lemons juice. After meals, eat one teaspoon of this mixture.
It is recommended to treat the throat and tonsils right after rinsing with sea buckthorn oil twice a day, in the morning and in the evening. It should be noted that after lubrication you can not eat or drink anything for two hours.
Rinse is prepared from herbs that have antifungal properties. These are marigolds, sage, oak bark, chamomile. Such treatment with herbs should be performed no less than three times a day, or better - after each meal.
Infusions for rinsing with mycosis of the throat:
- flowers of marigold and leaves of peppermint (one tablespoon) brew with boiling water 200ml, insist 30 minutes;
- shoots of a birch and flowers of a bird cherry (on one table spoon) to make boiled water 200мл, to insist 30 minutes.
Alternative treatment of chronic tosillitis mainly consists of active rinsing of the throat with herbal infusions and the use of herbal teas.
Infusions are prepared from marigold, chamomile, peppermint, sage, oak bark (as with mycosis), you can use the leaves of blackberries, plantain, raspberries, burdock, as well as its roots, herb wormwood and thyme.
You can rinse yourself with "sea water" of your own preparation - in 200ml of water (≈37 ° C) add ½ teaspoon of soda and salt, stir and drip five drops of iodine;
- juice of red beet with apple cider vinegar in the proportion of a teaspoon of vinegar to 200ml juice;
- garlic infusions: cut three-four slices and brew with boiling water (200ml), insist 2/3 hours.
Herbal teas are brewed with leaves, dried berries and young shoots of currants, raspberries, blackberries, dog rose, chamomile, elecampane. You can add a teaspoon of honey, a slice of lemon, a half teaspoon of turmeric or cloves. In general, you need to drink a lot of warm drinks.
At night, it is recommended to drink a glass of hot milk with the addition of a pinch of pepper and turmeric. To relieve exacerbations, this procedure is done three times in succession.
Healing tea: for 500ml of water add a piece (≈5cm) of ground ginger root, two crushed lemons and cloves of garlic. This mixture is boiled for 20 minutes. When the mixture cools down halfway, you can add a little honey. Drink such tea three times a day in the intervals between meals, after eating must pass at least an hour.
Yoga is recommended for the treatment of chronic tonsillitis to practice asanas: the pose of a lion (simhasana) and a stand on the shoulders (sarvangasana). They cause blood flow to the head and neck. At the beginning of training it is not necessary to perform both poses at once, one by one, better - one at a time. Before performing asanas, you need to clear the tonsils from the plugs and rinse your throat, otherwise there may be an exacerbation.
This direction of medicine can give good results in the treatment of chronic inflammation of the tonsils and help to avoid their removal. Homeopathic treatment should appoint a qualified homeopath, the choice of means for treating this pathology is extensive.
At first glance, sore throat without pain in the throat should be cured by Baptisia or Mercurius solubilis, which is more suitable for female patients, however, other factors besides these will be taken into account when appointing a doctor. At the initial stages of the disease, Ferrum phosphoricum is recommended, with purulent plugs Potassium muratikum. Correctly and individually selected means faster and more effective will help get rid of frequent exacerbations of the disease, and perhaps achieve a complete cure.
From drugstore homeopathic preparations can be appointed Tonsilotren. The drug intake helps to eliminate purulent plugs, relieves inflammation and reduces the size of the tonsils, restores the structure of their tissues and impaired activity. Contraindicated in case of sensitization to chromium. Pregnant women and people with high thyroid function should only take the doctor's prescription.
In chronic tonsillitis and hyperplasia of tonsils, individuals over 12 years of age can resolve one or two tablets under the tongue, at the age of 1-12 years - one tablet. The number of receptions for all age categories of patients is three per day. The medication is taken at an interval of 30 minutes before or after a meal.
Fungal diseases of the throat are also treatable by homeopathy, however, in this case the treatment is prescribed by a doctor. With candidiasis of the throat, Apis, Lahiesis, Belladonna can be selected, there is information about the successful treatment with Kali Carboconum.
At present, indications for tonsillectomy are:
- frequent exacerbations (at least seven registered appeals for exacerbations throughout the year, or five for each year for two years, or at least three every year for three years);
- decompensated chronic inflammation of the tonsils;
- toxic-allergic phenomena accompanying this disease and increasing the likelihood of complications from the heart, joints, urinary or other organs, or already developed pathologies;
- stopping breathing in a dream, a breathing disorder and swallowing, which are a consequence of an increase in the volume of palatine tonsils;
- relapsing inflammations of the peripendritive cellulose.
Usually tonsillectomy is performed in the remission stage, but with purulent complications the operation is performed urgently in the acute stage under the barrier of antibacterial drugs in high doses.
In pediatrics indications for tonsillectomy are most often decompensated, non-conservative therapy, a form of chronic tonsillitis, or any form of the disease, accompanied by a violation of the function of breathing during sleep. Also indications for surgery for the removal of tonsils is the presence of serious diseases that have developed against their chronic inflammation. Nowadays, age is no longer a contraindication to this operative intervention, it can be carried out to children from the age of two and to older people as needed.
Removal of palatine tonsils is contraindicated in patients with the following pathologies:
- severe forms of nervous and mental disorders, diabetes;
- blood diseases;
- vascular anomalies in the pharynx;
- decompensated diseases of vital organs (heart, kidney, liver, lungs);
- open tubercular process in the lungs.
Tonsillectomy is not performed during the period:
- acute inflammatory, infectious and exacerbations of chronic diseases;
- with the symptomatology preceding the disease;
- menstruation in women;
- caries lesions of the teeth (mandatory sanation before the operation);
- presence of pustular skin lesions;
- intoxication, bronchoadenitis of tuberculous etiology;
- epidemics of influenza and poliomyelitis.
Preparation for surgery includes blood tests (clinical, biochemical, for clotting), a general urine test.
Currently, various methods are used to remove palatine tonsils, characterized by removal technology, bleeding intensity and pain syndrome after surgery. The duration of the recovery period also differs somewhat for different types of surgical interventions.
Extracapsular tonsillectomy (removal with surgical scissors and a wire loop) is the most common method performed under local and under general anesthesia. With this method it is possible to perform a resection of the amygdala together with its capsule and to open the infiltrates (abscesses) of the peripendritive cellulose.
Electrocoagulation method (use of high-frequency current) - a small loss of blood is a plus, but postoperative complications are possible in connection with the exposure of thermal radiation to the near-modal tissues.
The use of an ultrasonic scalpel minimizes damage to the paramagnetic fiber and bleeding.
Laser methods - used infrared, which allows not only to dissect, but also to "weld" tissues, or a carbon dioxide laser, which performs evaporation of the tonsil tissue and the elimination of foci of infection. Carried out under local anesthesia. In both cases, bleeding, puffiness are minimized, and postoperative soreness is practically absent. A short recovery period is typical.
Radiofrequency ablation (the use of radio waves) - most often used for tonsillotomy. Anesthesia is local, the removal of tonsils with the help of radio wave energy causes minimal postoperative discomfort. A short recovery period is typical.
Coblation (bipolar radiofrequency ablation) - complete or partial resection of the tonsils by disengaging molecular bonds in an ionized layer created by radio frequency vibrations. Anesthesia is common, bleeding is minimized, post-operation pains, complications and time for rehabilitation are minimized. It is considered a promising direction in surgery.