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Soothing the pain of sore throats

Georgia Merton gmerton@pharmacytoday.co.nzFriday 09 June 2017, 11:08AM
Soothing the pain of sore throats

We're all familiar with that painful swallow that heralds a sore throat, whether it be from the beginnings of a cold, a serious infection or just overdoing it on a night out.  

The most common cause for throat pain, according to laryngologist Jacqui Allen, is acute laryngitis, which is inflammation of the voice box.  

This may be caused by a bacterial, viral or sometimes fungal infection, or from overuse or irritation. According to Dr Allen, low-level laryngitis can be easily treated over the counter, but pharmacists need to be aware of the signs of an acute infection.  

"Normally, it's a bacterial thing so there are high fevers, muscle and joint aches and pain, nausea and sometimes swollen glands," says Dr Allen, who established the first Centre for Voice and Swallowing in Auckland.  

A common and potentially serious bacterial infection is strep throat, which Dr Allen emphasises is important to keep an eye out for.  

Caused byStreptococcus­bacteria, strep throat is a contagious bacterial infection, which, if left untreated can cause rheumatic fever, kidney problems and other complications.  

Pharmacist Carol Han says she always asks her patients whether anyone around them has had a sore throat and what their living situation is like, as strep throat thrives in close-quarter living conditions.  

"Maori and Pacific people are more prone, so if they have a sore throat with significant pain, we send them to the doctor to get a swab," says Miss Han, a newly graduated pharmacist at Milford Unichem.  

"We always ask how bad the pain is. If they can't talk or swallow, they probably need a swab just in case," she says.  

According to the Ministry of Health guidelines, the patient should see a doctor if they have had a sore throat for more than a few days, are having trouble swallowing, have a high fever, enlarged tonsils, swollen neck or ear or joint pain.  

SoreThroatBoxFor a sore throat that presents as part of the "classic" cold, Miss Han says to treat symptomatically, until the virus has run its course.  

She advises antibacterial lozenges, gargles or sprays, which are anti-inflammatory and can contain an analgesic, depending what the customer wants.  

Her co-worker and pharmacy assistant at Milford Unichem, Michelle Nawisielski, says she always recommends a gargle that is both antiviral and antibacterial.  

For a natural solution for less severe cases, or for those who are opposed to antibiotics, Ms Nawisielski says colloidal silver solution is great, as it is antibacterial, antiviral and antimicrobial.   

According to Miss Han, ear pain can be a classic symptom of the cold or flu, but she always asks about the severity as intense pain can be indicative of a more serious infection.  

A less common source of infection for the throat isCandida, a fungal infection. According to Dr Allen, this can occur after a course of antibiotics, especially after surgery, or for those on long-term medication such as asthma steroids.  

Dr Allen says she has also seenCandidainfection in diabetics and immunosuppressed patients, but it is easily treatable by Fungalin lozenges or Nilstat.  

Aside from infection, the vocal cords are sensitive to irritation from a multitude of factors, according to Dr Allen. She says overuse is common, and can be made worse by air-conditioning or snoring, which further dries out the throat.  

"Lubrication is vital for the vocal cords and throat at all times," says Dr Allen, and says there are over-the-counter products available to soothe. She says a persistent cough or reflux can also be to blame for pain.  

Ms Nawisielski says to soothe a sore throat, she can't go past honey, which has known antiseptic properties. "Fresh lemon and honey drinks, if the person isn't diabetic, or honey lozenges," she says.  

As for tonsillitis, Dr Allen explains, it's the aggravation of the tonsils rather than the voice box, and she says patients will often only get a mild voice change those with laryngitis - will often come in rasping or with no voice at all.  

She says a trip to the doctor is advisable if you suspect tonsillitis, as multiple severe cases will probably lead to a tonsillectomy. "Four or more a year or three consecutive years with two to three infections, then they'll generally come out," she says.  

Whereas most of us think of bowls of icecream when it comes to tonsillectomy recovery, Dr Allen says that normal food should be encouraged from day one, as it reduces swelling.  

"Plenty of fluid, regular pain relief and sometimes overlapping analgesia for the first seven to 10 days, so paracetamol and an NSAID," she says. She says iceblocks and topical analgesic sprays can help, too.  

According to Dr Allen, throat cancer is quite rare, with 300 new cases per year in New Zealand, and is usually seen in patients who smoke or have a high alcohol intake.  

She says warning signs include a persistent voice change or deterioration, combined with weight loss, ear ache, difficulty swallowing, a neck lump or mass or coughing up blood.  

"Anyone with these symptoms should see an ENT specialist urgently, and they can do an endoscopic exam," says Dr Allen. 

She says smokers, in general, shouldn't suffer from a sore throat, and if they do have pain, they should see a specialist.  

As for keeping a sore throat at bay over winter, Dr Allen advises good sleep, good hydration, the flu shot and Vitamin C.  

"And cough into your elbow!

 
 
 
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