Pharyngitis: treatment

Treatment of pharyngitis has 2 main goals - to achieve relief of unpleasant subjective sensations in the pharynx and normalization of the pharyngoscopic picture.

The treatment of pharyngitis consists in the use of medications and a complex of procedures. Pharyngitis is a sore throat caused by inflammation in the mucous membrane and pharyngeal lymphoid tissue. Often accompanied by a tickling, tickling in the throat, dry cough.

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Indications for hospitalization

Patients who have pharyngitis treatment are usually performed on an outpatient basis. Patients whose work is associated with exposure to a variety of adverse factors, aggravating the course, may be recommended exemption from work during the treatment period. Hospitalization may be required only with a severe course of respiratory infection, and also in those cases when an acute infectious disease, one of the manifestations of which was the inflammatory process in the pharynx, is contagious and poses a danger to others (diphtheria, measles, scarlet fever).

Treatment of pharyngitis by non-medicamentous methods

Treatment of acute pharyngitis should begin with the exclusion of irritating (hot, cold, acidic, spicy, salty, etc.) food, carbonated drinks. Among the top-priority appointments is also a ban on smoking, alcohol, a recommendation to follow the voice regime.

Chronic form can be the result of gastrointestinal malfunction, also has a connection with frequent nasal congestion, forced breathing through the mouth. Treatment of pharyngitis includes a balanced diet, thermal procedures - for example, foot baths, warming compresses (if not increased body temperature). The influence of negative factors that provoke the development of the disease should be deleted as far as possible. With pharyngitis, inhalations and regular rinses are indicated. A variety of tablets for resorption have insufficiently high activity, so they will be most effective for mild forms of the disease.

Treatment of pharyngitis by medicamental methods

Local treatment of pharyngitis consists in the appointment of drugs that have antiseptic, anti-inflammatory, analgesic effect. For rinses, sage infusion, chamomile, a combination of extracts of flowers of calendula officinalis, chamomile flowers and yarrow grass are common: hexiethidine, benzyldimethyl, myristoylamino-propyllamionium, eucalyptus rodent drug, etc. Effective in the infectious nature of the disease is the pulverization of the pharynx by various aerosols: fusafungin, propolis , dexamethasone + neomycin + polymyxin B, povidone-iodine + allantoin, biclotimol, stopangin, benzidamine. Various local antiseptics are used in the form of tablets (antiangin, amylmetacresol + dichlorobenzyl alcohol, ambazone, etc.), pastilles (diclonin), lozenges or dragees (strepsils, acetylaminonitro-propokenbenzene) for resorption in the mouth. Usually, tablets, lozenges or lozenges for absorption have relatively low activity, they are prescribed for mild forms of the disease.

Preparations that include iodine (povidone-iodine, povidone-iodine + allantoin), as well as containing plant antiseptics and essential oils (rotokan, septothete), although effective, but their use is contraindicated in allergic patients. The number of such patients in some geographical areas is up to 20% or more. The choice of the optimal local antibacterial agent is determined by the spectrum of its antimicrobial activity, the absence of an allergenic and toxic effect. However, in some cases even the most effective local drugs do not completely replace the need for systemic antibacterial therapy, especially when pharyngitis and angina are associated with beta-hemolytic streptococcus. Systemic antibiotic therapy is indicated to prevent purulent complications, descending infection in cases of pronounced general reaction with a high temperature. The drugs of choice in such cases are antibiotics of the penidylline group, macrolides, cephalosporins.

On the other hand, in connection with the non-bacterial nature of many forms of disease, the emergence of an increasing number of resistant strains of bacteria, as well as the undesirable effects of general antibiotic therapy, the local administration of drugs that have a broad spectrum of antimicrobial activity is in many cases a method of choice.

In the treatment of acute pharyngitis, immunomodulators are also used: bacterial lysates mixture, etc. They activate phagocytosis, promote immunocompetent cells in the inflammatory focus, increase the lysozyme content and secretory IgA in saliva. If necessary, immunomodulators work well with local or systemic antibiotics, helping to shorten the periods of recovery and maintain local immune defense, which is especially important in antibiotic therapy, with the allergic nature of pharyngitis prescribed antihistamines.

Treatment of chronic pharyngitis often begins with the sanation of chronic foci of infection and the area of the upper respiratory tract.

Effectively local therapeutic effect on the mucous membrane of the pharynx for the purpose of purification from mucus and crusts. Dissolved inhalation therapy: prescribed warm inhalation in the form of a large-dispersed aerosol broth chamomile flowers, sage leaves, eucalyptus, alkaline mineral water in combination with rosehip oil, sea buckthorn, etc. In hypertrophic forms, rinse with warm 0.9-1% sodium chloride. The same solution can be produced by inhalation and pulverization of the pharynx. In recent years, seawater preparations have been used successfully for this purpose.

Reduces the swelling of the mucosa, lubrication of the posterior pharyngeal wall 3-5% silver nitrate, 3-5% silver protein, 5-10% tannin-glycerin. Large granules on the posterior and lateral walls of the pharynx can be effectively removed by cold exposure, laser evaporation, ultrasonic disintegration, cauterization of concentrated 30-40% silver nitrate, polycrezulene.

Effective drugs are considered to have in their composition plant antiseptics and essential oils. It should be noted that such drugs are contraindicated to people who have an allergic reaction to pollen.

In the treatment of pharyngitis, drugs such as strepsils, septotheca, lysobakt, decatilen, etc. Can be used. A powerful antiseptic action is the herbal spray anginal (also available in the form of tablets for resorption).

In the process of treatment a balanced diet is recommended to avoid irritation of the mucous throat. As with other types of respiratory diseases, abundant drinking, taking vitamin complexes, regular rinses, tea with jam, honey, etc. Are recommended.

In most cases, local antiseptic drugs are used to treat pharyngitis, and only if the disease is provoked by a bacterial infection, oral antibiotics can be prescribed by the doctor.

Rinse solutions should be warm, not hot. For these purposes, you can use furatsilin, soda, salt, sage sprays, chamomile, eucalyptus, rotokan, chlorophyllipt, etc. Apply with pharyngitis also alcohol compresses on the neck (should not be above 40 degrees, so as not to burn the skin). Gauze or a diaper can be moistened, for example, with vodka, you need to tie a warm scarf on top. During the treatment period, smoking is contraindicated, it is also necessary to avoid hypothermia.

The pharyngitis of a chronic form has a somewhat different character of treatment. In addition to rinses and a plentiful warm drink, physiotherapy (phonophoresis, inhalation, UHF) is practiced, and Lugol is treated with a throat.

Treatment of atrophic pharyngitis includes daily removal from the surface of the mucous membrane of the pharynx of the mucopurulent discharge and crusts. For this purpose, rinse 0.9-1% sodium chloride with the addition of 4-5 drops of 5% alcohol solution of iodine per 200 ml of liquid. It is also effective to use sea water preparations. Systematic and prolonged irrigation of the pharynx with these solutions removes irritation of the mucosa, reduces the severity of symptoms. With an abundance of dry crusts, inhalations of proteolytic enzymes (6-10 days) are carried out, followed by inhalations of vegetable oils containing retinol, tocopherol acetate, ascorbic acid. With subatrophic pharyngitis, a good effect is obtained by rinsing the pharynx with a solution of B.S. Preobrazhensky (70% ethyl alcohol, glycerin and mint water evenly, 1 tsp, mixture for 1/2 cup boiled water) after eating 3-4 times a day.

Periodically conduct courses lubricating the pharyngeal mucosa 0.5% Lugol with glycerin. Other compositions are also possible for application to the mucous membrane of the pharynx - olive, peach, rosehip oil. However, with atrophic pharyngitis, you should avoid drying, suppressing the secretion of glands. In particular, it is inappropriate to use sodium bicarbonate, because it lowers the activity of gland secretion, as well as eucalyptus, sea-buckthorn and menthol oils, since they have a drying effect. The positive effect is the use of Novocain blockades in the lateral sections of the posterior pharyngeal wall.

Patients who have gastroesophageal reflux and chronic pharyngitis, the treatment is carried out under the supervision of a gastroenterologist.

One of the possible causes of persistent chronic pharyngitis may be dysbacteriosis of the intestine, so it is advisable to recommend the patient to study the intestinal microflora and, if necessary, to conduct treatment (hilak forte, bactisubtil, etc.).

Given the fact that the endocrine and hormonal disorders, cardiovascular, lung, and renal failure may be the cause of the development of chronic pharyngitis, it may be necessary to participate in the treatment of the patient with appropriate specialists (endocrinologist, cardiologist, pulmonologist, nephrologist, etc.).

Among the methods of physiotherapy, electrophoresis is applied to the submandibular region with 3-5% potassium iodide, exposure to the infra-red laser to the mucosa of the posterior pharyngeal wall and submandibular lymph nodes, mud or paraffin applications to the submandibular region. In the treatment of chronic atrophic pharyngitis, 0.5% of nicotinic acid is electrophoresed on the submandibular region (duration of the procedure is 15-10 min, for the treatment of 20 procedures).

Treatment of pharyngitis by surgical methods

In chronic pharyngitis, medical measures are taken to restore nasal breathing (adenotomy, treatment of sinusitis and hypertrophic rhinitis, polypotomy, septoplasty, etc.). When combined with chronic pharyngitis and chronic tonsillitis, the question of the advisability of surgical treatment of tonsillitis in each specific case is solved individually. The pathological secretion of the lumen of the tonsillar lacuna causes constant irritation of the pharyngeal mucosa and supports its chronic inflammation. Therefore, tonsilelectomy is indicated, but it should be taken into account that in some patients in the next months and even years after the operation, subatrophic changes in the mucous membrane of the pharynx are noted in different degrees in the postoperative period.

Further management

In chronic pharyngitis, climatic treatment is shown in areas with high aerial and hydroaeroion concentrations in the air: the seashore, mountainous areas. Sanatorium-and-spa treatment is conducted in conditions of a warm wet climate with the presence of mud and hydrogen sulphide resources.

The complex of medical measures with pharyngitis must first of all be directed at eliminating the causes that provoked it. In acute and chronic form of pharyngitis, symptomatic treatment prescribed by an otolaryngologist is indicated.

Treatment of pharyngitis may not be needed if the disease is preventive, which includes hardening of the body, pouring and sports loads. It is also necessary to give up harmful habits, restore and treat internal organs. Also, restoration and maintenance of body immunity will not prevent.