Pharyngitis - Information Overview

Pharyngitis (Latin pharyngitis) (catarrh of the pharynx) is an acute or chronic inflammation of the lymphoid tissues and mucous membrane of the pharynx, occurring in a chronic or acute form. Pharyngitis is accompanied by a sore throat, acute discomfort and pain when swallowing. Pharyngitis - treatment is carried out by both traditional and folk medicine.

ICD-10 code

• J00 Acute pharyngitis.
• J31.2 Chronic pharyngitis

According to the international classification of diseases, pharyngitis is distinguished separately from tonsillitis, however, in the literature the unifying term “tonsillopharyngitis” is often used, taking into account the combination of these two pathological conditions.

Epidemiology of pharyngitis

Pharyngitis is quite common in middle-aged and elderly people. Children, as a rule, rarely suffer from chronic pharyngitis. Pharyngitis is observed more often in men. However, subatrophic forms of the disease predominate in women.

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Screening

Identification of individuals with this disease is carried out taking into account characteristic complaints, the patient's medical history and the results of pharyngoscopy.

What causes pharyngitis?

The main factor that provokes the appearance of pharyngitis is polluted and cold air, nicotine, and other harmful substances. Pharyngitis often occurs along with tonsillitis (simply put, sore throat) and can be caused by the penetration of various infections into the throat.

Common causes of the disease are cold or dirty air, aggressive influence of such irritants as tobacco or alcoholic drinks, pathogenic bacteria: staphylococci, streptococci, flu virus and Candida fungus. Often, inflammation of the mucous membrane develops in the presence of an infection in the oral cavity and nasopharynx: caries, rhinitis.

Often, chronic inflammation is not a separate disease, it is a pathology of other internal diseases: pancreatitis, gastritis, cholecystitis.

Chronic inflammation also often occurs with difficulty breathing through the nose. The reason for this may be frequent and irrational use of nasal drops.

The development of chronic pharyngitis is facilitated by:

• Frequent exposure of the mucous membrane to factors such as hot or smoky air, dust, chemical substances
• Frequent use of decongestants, regular nasal congestion.
• Allergic manifestations
• Vitamin A deficiency in the body
• Smoking and alcohol
• Diseases of the endocrine system
• Heart, kidney and lung diseases, diabetes

Diagnosis of pharyngitis is made by examination and, if necessary, a smear of the mucous membrane is taken.

Acute pharyngitis is divided into:

• Traumatic
• Viral-bacterial
• Allergic (due to exposure to an irritant)
• Chronic pharyngitis:
• Atrophic
• Catarrhal
• Granular

One of the most common forms of pharyngitis is catarrhal, caused by colds. The causative agents of the disease in 70% are rhinoviruses, adenoviruses, parainfluenza viruses and others. According to medical research, the most active causative agent of inflammation is rhinovirus, which is especially evident during autumn and spring epidemics.

Pharyngitis - Causes and Pathogenesis

Symptoms of pharyngitis

The clinical form of acute inflammation is increased dryness in the throat, irritation, soreness in the pharynx. There may be malaise, fatigue, and fever. The cervical lymph nodes are enlarged, which can be determined by palpation.

It is worth considering that acute inflammation can be the cause of other, more serious infectious diseases: rubella, measles, scarlet fever.

The symptoms of chronic pharyngitis are somewhat different from the early form of the disease. There is no general malaise, and the body temperature usually remains normal. The disease manifests itself as a sore throat, dryness and a feeling of a lump in the throat, which causes a desire to cough. A dry, persistent cough occurs. Chronic pharyngitis disrupts restful sleep, since mucus in the back of the throat requires constant swallowing.

In acute pharyngitis and exacerbation of chronic pharyngitis, the patient notes unpleasant sensations in the nasopharynx: burning, dryness, often accumulation of viscous mucus, irritation and sometimes mild pain in the throat (especially with an "empty throat"). When the inflammation spreads to the mucous membrane of the auditory tubes, congestion and pain in the ears appear. Headaches localized in the occipital regions are often disturbing, difficulty in nasal breathing and nasal voice arise, especially in children. General symptoms, as a rule, are expressed insignificantly. The patient may be bothered by weakness, headache; a slight increase in temperature is possible. Sometimes an increase in regional lymph nodes is noted, moderately painful on palpation.

Chronic pharyngitis is not characterized by an increase in temperature and a significant deterioration in the general condition. Catarrhal and hypertrophic forms of inflammation are characterized by a feeling of irritation, tickling, soreness, awkwardness in the throat when swallowing, a sensation of a foreign body that does not interfere with food intake, but forces frequent swallowing movements. With hypertrophic pharyngitis, all these phenomena are expressed to a greater extent than with the catarrhal form of the disease. Sometimes there are complaints of blocked ears, which disappears after several swallowing movements,

The main complaints of atrophic pharyngitis are a feeling of dryness in the throat, often difficulty swallowing, especially with the so-called empty throat, and often unpleasant odors from the mouth. Patients often have a desire to drink a sip of water, especially during a long conversation. It should be noted that the patient's complaints do not always correspond to the severity of the process: in some, with minor pathological changes and even in their apparent absence, a number of unpleasant side effects arise, which force the patient to undergo long-term and persistent treatment, while in others, on the contrary, pronounced changes in the mucous membrane proceed almost unnoticed.

Lateral pharyngitis, or acute inflammation of the lateral pharyngeal ridges

Lateral pharyngitis is often combined with inflammation of the lymphadenoid granules of the posterior pharyngeal wall (angina pharyngis granulosa). Usually these lymphoid formations hypertrophy compensatorily after removal of the palatine tonsils, and if pathogenic microbiota nests in them, then under certain risk factors and provoking causes its virulence increases, and inflammation of these formations occurs, "serving, - in the words of B.S. Preobrazhensky, - as if an equivalent of tonsillitis of the palatine tonsils in those not operated on."

Most often, the inflammation is unilateral or predominantly unilateral, when the lateral ridge is involved in the process secondarily.

During pharyngoscopy, the lateral ridges appear enlarged, hyperemic, and may be covered with a pseudo-film, which is easily removed with a cotton swab. The overall clinical picture resembles that of catarrhal angina.

Treatment: sulfonamides, antiseptic rinses, bed rest for 3-5 days, depending on the severity of the clinical picture.

Pharyngitis - Symptoms

Pharyngitis classification

From an anatomical point of view, the pharynx is divided into three sections - the upper (nasopharynx), the middle (oropharynx) and the lower (larynx). Morphological changes in the mucous membrane in chronic pharyngitis usually have a predominant localization in one of the anatomical sections of the pharynx, therefore the inflammatory process developing here can be subdivided into nasopharyngitis, mesopharyngitis, hypopharyngitis. This division can be conditional, because the inflammatory process often affects the mucous membrane diffusely and is migratory in nature.

Acute pharyngitis is divided into viral, bacterial, fungal and allergic. Viral pharyngitis is often a companion of some acute respiratory viral infection. Upon examination, redness, a loose surface of the pharynx are clearly visible, sometimes an increase in the palatine tonsils is observed. Symptoms: dry cough, sore throat, enlarged lymph nodes, and a fever may also occur. In rarer cases, bacterial pharyngitis may occur, which is caused by strepto-, staphylo- and pneumococci. Fungal pharyngitis, or pharyngomycosis, occurs when the mucous membrane of the pharynx is affected by fungal pathogens. The impetus for the appearance of pharyngomycosis can be such pathologies as diabetes mellitus, blood diseases, as well as intestinal disorders, etc. Allergic pharyngitis is characterized by frequent sneezing and lacrimation.

Acute pharyngitis can cause discomfort in the ears, and the cervical lymph nodes are often enlarged.

Chronic pharyngitis can occur without an increase in temperature; the general condition is often normal.

Chronic pharyngitis is usually classified according to the nature of the morphological changes developing in the mucous membrane of the pharynx, in connection with which catarrhal (simple), hypertrophic and atrophic (subatrophic) pharyngitis are distinguished.

The above forms of chronic inflammation are often combined. Thus, the presence of diffuse atrophic changes in the mucous membrane can be combined with focal hyperplasia of the lymphoid tissue of the posterior pharyngeal wall.

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Diagnosis of pharyngitis

During pharyngoscopy in a patient with acute pharyngitis and exacerbation of chronic inflammation, the mucous membrane of the pharynx is hyperemic and edematous.

The process can spread to the palatine arches, tonsils: the soft palate and uvula can be edematous, increased in volume. Often, individual lymphadenoid follicles in the form of bright red rounded elevations (granules) are visible on the back and side walls of the pharynx - granular pharyngitis.

Pharyngitis - Diagnosis

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Treatment of pharyngitis

If the disease pharyngitis does not have pronounced manifestations, then symptomatic treatment is prescribed, which includes a light diet, warming compresses, inhalations, rinses, foot baths. Any aggressive impact on the mucous membrane must be stopped. The list of taboos includes smoking, dry, cold food. Pharyngitis treatment is carried out without antibiotics if the inflammation has no complications.

The list of antibiotics prescribed for treatment includes several antiseptic drugs: ambazone, chlorhexidine, thymol, iodine preparations, etc. Anesthetics are used: lidocaine and tetracaine. Natural antiseptics, ascorbic acid, interferon can also be prescribed.

Antimicrobial drugs are rinses, inhalations, tablets and lozenges. Requirements for this category of drugs:

• No toxic effects, low allergenicity
• Broad antimicrobial action that has antiviral activity
• Absence of mucous membrane irritants

Most tablets and lozenges have low potency and are prescribed for mild forms of mucosal disease. In addition, many drugs contain toxic chlorhexidine, so the use of these drugs should be limited, especially in children.

Some medications are highly allergenic and cannot be prescribed to patients with allergies. Such medications include propolis, as well as plant antiseptics and essential oils.

Traditional treatment of pharyngitis

If you are not allergic to propolis, you can undergo the following treatment:

Lubricate the mucous membrane of the throat and nose for 2 weeks. It is necessary to lubricate only the cavity cleared of mucus with propolis infused in alcohol. This medicinal recipe has gained wide popularity due to the following data: 75% of patients recovered, the rest felt a significant improvement.

For treatment you will need a 10% propolis solution, 35 drops of which are diluted in a quarter of a glass and dripped into the nose 4 drops at a time, deeply inhaling. It should be noted that with such treatment there is pain, but it quickly goes away.

The effectiveness of this treatment is that by lubricating the throat and dripping the nose with this solution, the gastrointestinal tract is also cured.

Collect a medicinal bouquet: eucalyptus, calendula, sage - a teaspoon of each. You need to pour 300 ml of boiling water over the herbs and leave for 25 minutes. Add half a spoon of honey to the hot herbal tea and gargle. After 4-5 rinses, the patient notes a significant improvement.

If you have a dry, painful cough, garlic and honey will help you. Chop half a cup of garlic, pour honey over it and put it on low heat. Simmer, stirring, for about 30 minutes. Take a dessert spoon after meals.

Pharyngitis - Treatment

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How to prevent pharyngitis?

Acute pharyngitis can be prevented if prophylaxis is carried out taking into account the main pathogenetic factors. It is necessary to exclude hypothermia and exposure to drafts, as well as irritation of the mucous membrane of the pharynx by agents of an alimentary nature. Preventive measures are represented by general and local hardening of the body with cold, timely treatment of purulent-inflammatory diseases of the nasal cavity, paranasal sinuses and nasopharynx. Sanitation of the oral cavity is of no small importance.

Prevention of chronic pharyngitis, first of all, the elimination of local and general causes of the disease. It is necessary to exclude the impact of possible irritating factors, such as smoking, dust and gas pollution of the air, irritating food, etc. It is necessary to conduct appropriate treatment of general chronic diseases, including diseases of the internal organs (heart, liver, kidneys, gastrointestinal tract, urinary tract), metabolic disorders, since the development and course of chronic pharyngitis is associated with the general condition of the body.

What is the prognosis for pharyngitis?

Pharyngitis has a favorable prognosis, but chronic atrophic pharyngitis requires systematic symptomatic therapy.