Causes and risk factors
Pharyngitis can be acute or chronic. Acute pharyngitis can be caused by underlying chronic pharyngitis, viral infection, and bacteria like Streptococcus pyogenes. Exanthemata may be accompanied by pharyngitis. There is congestion of lymphoid tissue as well as mucosa and its glands. Chronic pharyngitis affects people above the age of 15 years. Hyperplasia and inflammatory changes are seen in mucosa and submucosa. Mucus glands are hypertrophied and may become cystic. There is marked lymphoid hyperplasia. Predisposing factors include endogenous – nasal and paranasal infections: DNS, hypertrophied turbinates, polyps, allergic rhinitis, chronic sinusitis; throat – chronic tonsillitis, tonsillectomy; respiratory tract – chronic bronchitis, bronchiectasis; GIT – acid reflux, hiatus hernia, hyperacidity, intestinal parasites; faulty voice production and overuse of voice. Exogenous – tobacco smoking, tobacco chewing, smoker’s throat, atmospheric pollution, alcohol, etc. Functional factors include stress, emotions, fear of malignancy, etc. These patients have tendency to hawk frequently.
Clinical presentation
In acute pharyngitis, patient presents with congestion in throat. Irritation of throat is experienced. Hoarseness of voice can occur. Vocal fatigue is experienced by the patient. Uvula becomes edematous. Pharyngeal wall may be coated with mucopurulent discharge. In extreme cases, ulcerations with membrane formation may be present. In chronic pharyngitis, there is irritation in throat and foreign body sensation in throat. Patient is continuously hawking for clearing the throat. Dry irritating and cough is often present. Pain is present. Vocal fatigue is experienced by the patient. There may be spitting of blood stained sputum. There is marked congestion. The posterior wall appears to be studded with granules, which is pink to deep red in color. Dilated blood vessels are seen. Cystic growths may be present.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Routine hemogram is required. Radiographs of paranasal sinuses and chest is recommended. Throat swab is obtained for smear, culture, and antibiotic sensitivity.
Treatment
Treatment depends upon the underlying cause. For acute pharyngitis, bedrest and soft diet is advised. Antibiotics and analgesics are prescribed. Warm saline gargles are recommended. For chronic pharyngitis, underlying cause must be treated first. Hawking should be avoided. Surgery is recommended which includes electrocautery. Steam inhalation is advised.
Other Modes of treatment
The other modes of treatment can also be effective in treating pharyngitis. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating pharyngitis.
