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Throat pain Pain in the throat
contents
definition
Symptoms in throat pain
Causes of throat pain
diagnosis
Therapy for throatache
Naturopathy for throatache
definition
Pharyngeal pain describes complaints that are limited to the area of the pharynx or upper respiratory tract. Mostly colloquially a synonymous use of the terms "pharyngeal pain" and "sore throat". However, pharyngeal pain is defined here as part of the wide range of sore throats, which includes ailments that are not related to the throat.
Symptoms in throat pain
Throat pain is characterized by a stinging, burning, sometimes also pressure-like pain in the throat area. Typical concomitant symptoms are difficulty swallowing and a generally thick neck, but can be added according to the possible causes of pharyngeal pain also numerous other complaints. The cause of pharyngeal pain also determines the intensity of the symptoms and their temporal manifestations. Here, the spectrum ranges from relatively sudden onset, quickly receding throat pain, for example, when swallowing, to permanent pain in the throat area.
Inflammation of the epiglottis causes massive pharyngeal pain. (Image: joshya / fotolia.com) Causes of throat pain
Possible causes of pharyngeal pain are acute and chronic pharyngeal inflammations, diseases such as epiglottis, glossopharyngeal neuralgia or pharyngeal cancer. Other illnesses such as tonsillitis or the rather rare acute inflammations of the thyroid gland (thyroiditis), although known as causes of sore throats, are not attributed here to the triggers of the narrower concept of pharyngeal pain.
Inflammation of the pharyngeal mucosa
The most common cause of throat pain is acute pharyngitis (inflammation of the pharyngeal mucosa). This is usually due to a viral or bacterial infection, with the bacterial mucosal inflammation usually associated with wider health risks than the viral infections. Viruses that cause pharyngitis include, for example, influenza viruses (so-called parainfluenza viruses and human adenoviruses), but also viruses of the genus Herpes simplex and special forms of enterovirus (coxsackievirus) are known to cause pharyngeal inflammation. Furthermore, viral diseases such as rubella or measles are sometimes accompanied by inflammation of the pharyngeal mucosa. Frequently, flu-like symptoms such as fever, headache and body aches can be observed in addition to pharyngeal pain in the case of mucosal inflammation caused by the virus. In addition, significantly more serious health problems can be added. For example, an infection with the Coxsackievirus usually manifests itself first as a cold, with symptoms such as coughing, runny nose and hoarseness, but it can also lead in rare cases to a life-threatening meningitis or inflammation of the heart muscle.
Pharyngeal mucosal inflammation as a result of bacterial infection is much less common than viral infections. They cause a similar symptoms, especially in children, however, are often added abdominal pain and nausea. Complaints that may well occur in the viral infection, but there form a less typical feature. Bacterial pharyngitis is usually triggered by specific streptococci, but sometimes it is also a result of infection with Corynebacterium diphtheriae (trigger of diphtheria), Treponema pallidum (syphilis) or other bacterial species.
Occasionally, the pharyngeal inflammations also take a chronic course, the cause here are often persistent irritation, for example, by tobacco or alcohol consumption. Also, special environmental toxins and allergies are considered in the chronic inflammation of the pharyngeal mucosa as a possible trigger of the symptoms.
Epiglottis inflammation
Pharyngeal pain, especially when swallowing, may be a sign of potentially life-threatening epiglottitis. This inflammation of the epiglottis is due to a bacterial infection with Haemophilus influenzae type B in the majority of cases. The affected have the feeling of a lump in the throat, suffer from respiratory distress and produce clearly audible breath sounds. In the course of inflammation, the epiglottis can swell to such an extent that the airways are extremely narrowed and those affected die asphyxiation in the worst case. Due to the lack of oxygen supply, sometimes bluish discoloration of the lips, skin and fingernails can be observed.
glossopharyngeal
Neuralgia causes discomfort and pain in the supply area of the affected nerve tracts. If the neuralgia in the area of the tongue and throat nerve shows, patients often suffer from a sudden onset pain in the throat area, which mainly begins when swallowing, chewing or speaking. The pain can also radiate into the area of the tongue base, tonsils or ears. Sometimes the neuralgia of the ninth cranial nerve (glossopharyngeal nerve) also has an influence on the autonomic functions or the autonomic nervous system, leading to a slowing of the heartbeat (bradycardia), a fall in blood pressure or even short-term circulatory collapse (syncope) and life-threatening heartbeat (asystole ) can lead.
pharyngeal cancer
On the pharyngeal mucosa, malignant tissue growths in the form of a pharyngeal carcinoma can also arise from a hitherto unknown cause. Depending on the location and size of the ulcer, various symptoms can be observed, ranging from nasal breathing, the sensation of a lump in the throat and discomfort during swallowing to massive pharyngeal pain. Also more unspecific symptoms such as an unpleasant bad breath, repeated nosebleeds or pharyngeal haemorrhage are sometimes the result of pharyngeal carcinoma. Particularly dangerous in the case of pharyngeal cancer is the often relatively early onset of metastases, which initially manifest themselves mostly in the cervical lymph nodes.
diagnosis
After a detailed survey of the patients to the occurrence of pharyngeal pain, possible concomitant symptoms, pre-existing conditions and potential risk factors such as smoking or alcohol consumption, followed by a visual inspection of the mouth and throat using a so-called wooden spatula. The cleft is used to push the tongue down a little and thus to be able to look into the pharynx. Possibly present inflammations of the pharyngeal mucosa or the epiglottis can usually be clearly recognized in this way. However, in the case of epiglottis, there is a risk that the already narrowed airways are completely closed by the pressure with the wooden spatula, which is why a corresponding examination should only be carried out if the air supply is ensured by a tube inserted into the trachea.
If pain is felt on the almonds during examination or pressure with the spatula and no inflammation of the pharyngeal mucosa can be detected, this may indicate a possibly existing glossopharyngeal neuralgia.
If a pharyngeal inflammation is detected, a smear followed by a laboratory examination serves to identify the pathogens. Blood tests provide evidence of possible inflammation and may help identify other conditions such as rubella or measles.
Also, pharyngeal cancer can often already be clearly recognized during the examination of the pharynx. The examination by means of a so-called endoscope, which is introduced into the nasopharynx and allows a view into the inside of the body, takes place in more difficult cases of the diagnosis. A biopsy (removal of a tissue sample) can be performed simultaneously with the endoscope in order to definitively secure the diagnosis. But not all forms of pharyngeal cancer can be detected with the endoscope. In case of doubt, modern imaging techniques such as ultrasound, computed tomography or magnetic resonance tomography help to detect malignant ulcers. For the final confirmation of the diagnosis, however, it is necessary to examine a tissue sample.
Therapy for throatache
If the diagnosis is confirmed, a cause-oriented therapy of the pharyngeal pain takes place. For example, is used against viral inflammation of the pharynx usually with various anti-inflammatory and pain-relieving drugs, disinfectant mouthwashes and analgesic and disinfectant lozenges. The use is usually aimed at alleviating the symptoms and avoiding secondary bacterial infections. A medicamentous control of the viruses is hardly possible, but in most cases not necessary, since the viral pharyngitis can usually be successfully controlled by the immune system alone.
If the pharynx pain is due to a bacterial pharyngitis, the use of antibiotics promises a successful treatment. Also against the life-threatening epiglottis inflammation, which are caused in most cases by bacteria of the genus Haemophilus influenzae type B, special antibiotics are used. First, however, it is important here to ensure the air supply. In case of doubt, this requires artificial respiration via a hose. In acute emergency situations in the event of imminent suffocation, a so-called tracheotomy may also be performed. It is not uncommon to treat swelling of the epiglottis during cortisone therapy.
In the case of glossopharyngeal neuralgia, first of all a drug treatment based on special antiepileptic drugs is planned. However, if this does not show the desired success, the possibility of surgical intervention remains. The purpose of the microsurgical operation is to eliminate possible compressions of the nerve tracts, as in the case of glossopharyngeal neuralgia, for example more frequently in the form of pulsating vascular loops.
In many cases, pharyngeal cancer can be completely eliminated in the course of a surgical procedure if diagnosed early enough. Today, the so-called transoral laser surgery is often used here, which allows removal of the tumor with the help of an endoscope and a special CO2 laser. More serious illnesses are usually treated with a combination of radiotherapy and surgery. Not infrequently, at the time of diagnosis already surrounding tissue structures are affected, so they are also removed in the context of operations. This also applies to the cervical lymph nodes, as metastasis often occurs here. If the pharyngeal cancer is already well advanced, a combination of radiotherapy and chemotherapy will be used. In the case of pharyngeal cancers with metastasis, however, the therapy often focuses on a palliative care of the patients, since a cure is no longer possible.
Naturopathy for throatache
Naturopathy focuses on inflammation of the pharyngeal mucosa and associated pharyngeal pain mainly on herbal ingredients. According to the German Central Association of Homeopathic Doctors (DZVhÄ), for example, preparations made from sage leaves or chamomile flowers have proven effective against pharyngeal mucosal inflammations. Prepared as a medicinal tea, these are also suitable for gargling several times a day after cooling down. Furthermore, mouthwashes with tinctures of myrrh are recommended by the DZVhÄ as they have a "disinfecting and mucous membrane" effect. In the case of inflammation of the pharyngeal mucosa, herbal medicine also focuses on the effects of tinctures from the root of the Ratanhia shrub, which are used for gargling.
Against the inflammation of the pharyngeal mucosa are also numerous homeopathic remedies such as Hepar sulfuris, Mercurius solubilis or potassium bichromicum available. The selection should, however, be made in close dependence on the symptoms and only be left to experienced therapists. From the area of the Schüssler salts the Schüssler salt No. 9 (sodium phosphoricum) against pharyngeal mucosal inflammation has proven itself especially. (Fp)
