What is Pharyngitis and How to Treat It

Pharyngitis is the inflammation of the pharynx and can be:

• Acute, the most common form, which usually resolves in 5-7 days;
• Chronic, meaning prolonged over time.

The pharynx, divided into three anatomical sections (nasopharynx, oropharynx, and hypopharynx), is a muscular-membranous tube located behind the nasal cavities, mouth, and larynx. It is part of both the respiratory and digestive tracts and is approximately 13-15 centimeters long.

Pharyngitis presents with multiple symptoms, the most common being a sore throat, often associated with difficulty swallowing. However, it can sometimes be limited to a burning sensation or itching at the back of the mouth.

Other collateral conditions can include:

• Postnasal drip;
• Enlarged and painful submandibular lymph nodes;
• Enlarged and/or reddened palatine tonsils;
• Headache;
• Cough;
• Chills;
• Fever.

Pharyngitis can be viral or bacterial in origin. In the latter case, for those who still have their tonsils, pus plaques may appear on them, which would suggest a clinical picture of pharyngotonsillitis. However, in most cases, pharyngitis is of viral origin.

In both cases, it is important to note that pharyngitis is highly contagious. It can spread through nasal secretions, saliva, breathing, or contact, for example, through kissing or even simply unwashed hands.

Other causes of pharyngitis

In some cases, the appearance of pharyngitis is neither viral nor bacterial. This clinical condition, often chronic, can be found in:

• Individuals who have undergone tonsil surgery;
• People with allergies;
• Smokers;
• Those who abuse alcohol;
• Individuals exposed to work environments filled with smoke or toxic substances.

A particular case is the nighttime reflux of stomach acid (gastroesophageal reflux), which causes inflammation not only of the pharynx but often also the trachea (cough) and vocal cords (hoarseness). In all these situations, it is necessary to address the triggering causes.

It is difficult to distinguish bacterial pharyngitis from viral pharyngitis based solely on a clinical examination, as the symptoms are often overlapping.

Bacterial forms can be identified by culturing the material obtained through a throat swab in a laboratory (although it typically takes a couple of days to get results).

Rapid tests based on monoclonal antibodies, commonly used in pediatrics, are also available. These tests detect bacterial pharyngitis caused by the presence of Group A Beta-hemolytic Streptococcus. A flexible swab is rubbed on the back of the throat and tonsils, collecting mucus that is placed in a test tube containing a reagent that changes color in the presence of the microorganism.

It is important to remember that some individuals may carry this bacteria in their tonsils without showing any symptoms. These are known as "healthy carriers." In these cases, especially if the bacterial load is low, often no treatment is necessary.

There are also rapid tests for certain viral diseases, the typical example being the rapid test for diagnosing COVID-19.

Viral pharyngitis primarily requires symptomatic therapy (antipyretics and anti-inflammatories, either systemic or local), along with rest, plenty of fluids, and avoiding smoking and cold exposure.

In bacterial forms, in addition to the measures mentioned for viral pharyngitis, antibiotics are necessary to prevent serious complications, such as tonsillar abscess, or the onset of systemic diseases like rheumatic fever and glomerulonephritis (inflammatory kidney disease).

Acute pharyngitis affects both adults and children. Those at higher risk for developing pharyngitis include:

• Children;
• Smokers;
• People with allergies;
• Individuals with a weakened immune system due to illnesses or medical treatments (e.g., those undergoing chemotherapy or radiotherapy for cancers).

It is more common during the winter months when people spend more time in closed environments, and viruses (Rhinovirus, Adenovirus, Herpesvirus) spread more easily, especially in communities. Additionally, temperature fluctuations during this season can weaken the immune system.

In chronic pharyngitis, in addition to using symptomatic medications, it is important to eliminate, where possible, the underlying causes of the disease, perhaps by changing lifestyle habits.