What Is Pharyngitis?

Pharyngitis (pharyngitis) is a non-specific inflammation of the pharynx. It is a collective term for inflammation of the pharynx caused by various microorganisms. It can exist alone, coexist with rhinitis, tonsillitis, and laryngitis, or it is a precursor symptom of certain diseases. Can be divided into acute pharyngitis and chronic pharyngitis. Acute pharyngitis is an acute inflammation of the pharyngeal mucosa and submucosal tissues. Pharyngeal lymphoid tissues are often involved. Inflammation can be limited in the early stage. As the disease progresses, the entire pharyngeal cavity can often be involved. It is more common in autumn and winter and winter and spring. Mainly manifested as dry throat, burning, pain, obvious swallowing pain, congestion and swelling of the throat. Chronic pharyngitis can be divided into chronic simple pharyngitis, chronic hypertrophic pharyngitis, and atrophic pharyngitis. Of these, chronic simple pharyngitis is more common. The lesions are mainly in the mucosal layer, which is manifested by chronic congestion of the pharyngeal mucosa, mucosal and submucosal connective tissue proliferation , Mucus glands can be hypertrophic, hypersecretory function, increased mucus secretion. Patients often sputum sticky phlegm, or feel foreign body sensation in the pharynx, can not spit out, can not swallow. More common in adults, long course, easy to relapse, stubborn symptoms, difficult to cure.

Basic Information

English name: pharyngitis
Visiting department: ENT

Multiple groups: Adults
Common causes: Can be caused by infections such as bacteria and viruses
Common symptoms: Pharyngeal dryness and congestion, burning, soreness, swallowing pain, sticky sputum

Causes of pharyngitis

Mainly viral and bacterial infections. Mostly transmitted by droplets or direct contact. The pharyngeal part of the human body is the nasal cavity and the back of the mouth, which can be divided into three components: nasopharynx, oropharynx, and laryngo-pharynx. The pharynx is rich in lymphoid tissue, and they aggregate into clusters called tonsils. Because the pharynx is rich in lymphoid tissue, the pharynx is one of the main gateways for the body to block pathogens, especially germs. However, because the structure of the pharynx is complicated and foreign matter such as food debris is easy to deposit, bacteria are more likely to stop, reproduce and cause inflammation in the human pharynx.

In addition, weakened body resistance, such as fatigue, cold, excessive alcohol and tobacco, are often the causes of the disease. The disease can also be secondary to a cold or acute tonsillitis. Acute pharyngitis recurrent or incomplete treatment, and stimulation of nearby organ lesions such as sinusitis, tonsillitis, nasopharyngitis, and bronchitis can develop into chronic pharyngitis. Excessive tobacco and alcohol, spicy food, smoke, dust and harmful gas irritation are also common causes.

Pharyngitis clinical manifestations

Chronic hypertrophic pharyngitis

(1) Pharyngeal discomfort, pain, itching, or dryness, sometimes burning, smoky, foreign body sensation, etc .; irritating cough, coughing up secretions in the morning, even nausea.

(2) The pharyngeal mucosa is thickened, dark red, with small blood vessels dilated, and granular lymphoid follicle hyperplasia is scattered in the posterior pharyngeal wall, and even fused into pieces. The pharyngeal cord is thickened, and both sides are in the shape of a cord protruding toward the pharyngeal cavity. The posterior pharyngeal wall may have sticky or purulent discharge.

2. Streptococcal pharyngitis

It is the most severe type of acute pharyngitis and is caused by group A streptococcal infection. It can cause pyogenic lesions in distant organs, also known as acute septic pharyngitis. Sudden onset, dry throat and burning at the beginning, followed by sore throat, sore throat is more obvious when emptying than when eating, and severe cases are accompanied by chills, high fever, headache, general malaise, loss of appetite, back and limbs Soreness. Sore throat is gradually aggravated, and the symptoms can be caused by the site of inflammation. Inflammation of the pharyngeal cord causes swallowing difficulties and pain, accompanied by ear pain, and inflammation of the lymphoid tissues of the tongue base causes severe burning or tingling and radiates to both ears. When it spread to the eustachian tube, there were ear tightness, tinnitus and hard of hearing. If the lesion invades the throat, there are symptoms such as cough, hoarseness, and dyspnea. Pediatric illness is severe and convulsions can occur.

3. Chronic simple pharyngitis

Systemic symptoms were not obvious, but local symptoms were the main symptoms. The symptoms of various types of chronic pharyngitis are roughly similar, and there are many kinds, such as pharyngeal discomfort, foreign body sensation, itching, burning sensation, dryness or irritation, but also slight pain. It is mainly caused by its secretions and hypertrophic lymphoid follicle stimulation, which causes patients to have frequent irritating coughs in the morning with nausea. Generally no sputum or only granular powdery cough-like secretions.

4. Acute pharyngitis

Onset is more acute and often occurs simultaneously with acute rhinitis. First-time feeling of dry throat, itching, slight pain, burning sensation and foreign body sensation, followed by sore throat, mostly burning pain, especially when swallowing. The pain can radiate to the ears. These local symptoms are more common in adults, while systemic symptoms are mild or absent. Young children and adults with severe illness may be accompanied by severe systemic symptoms such as chills, high fever, headache, general malaise, loss of appetite, thirst and constipation, and even nausea and vomiting.

Pharyngitis examination

1. Oropharyngeal and nasopharyngeal examination

Examination of patients with acute pharyngitis showed diffuse congestion and swelling of the mucosa; edema of the sacroiliac arch and drape, lymph follicles in the posterior wall of the pharynx and redness and swelling of the lateral pharyngeal cord; yellow and white spotted exudates on the surface, enlarged mandibular lymph nodes and tenderness.

Patients with chronic pharyngitis can see mucosal hyperemia, vasodilatation, scattered lymph follicles in the posterior pharyngeal wall, and a small amount of viscous secretions attached to the mucosal surface. If there is a significant proliferation of lymphatic follicles in the posterior pharyngeal wall and hypertrophy of the lateral pharyngeal cord, hypertrophic pharyngitis is considered. If the mucous membrane is dry and atrophic and pale, with yellow-brown tan skin with odor, it is considered atrophic pharyngitis.

2. Laboratory inspection

Pharyngeal swab culture and bacterial drug sensitivity tests are often used.

Pharyngitis diagnosis

According to the history, symptoms and signs, the diagnosis of this disease is not difficult. It should be noted that acute pharyngitis needs to be distinguished from some acute infectious diseases (such as measles, scarlet fever, influenza, etc.); chronic pharyngitis needs to be excluded from early malignant tumors.

Pharyngitis Treatment

Remove the cause

Eliminate various pathogenic factors, such as quit smoking and alcohol, improve the working environment, and actively treat chronic nasal and nasopharyngeal inflammatory lesions and related systemic diseases. Enhance physical fitness, improve immunity, and prevent acute upper respiratory tract infections. Pay attention to rest, drink plenty of water, and eat light digestible food.

Symptomatic treatment

If fever and sore throat, physical cooling (such as warm water or 75% alcohol rubbing bath, ice pack on the head, etc.) and antipyretic measures should be used in time. Commonly used drugs are oral APC or intramuscular injection of analdin, etc., to keep the mouth clean, and alkaline gargles can appropriately dissolve the viscous secretions in the throat, and often use compound borax gargle.

3. Anti-inflammatory treatment

In the early stage of the onset, 1% iodine glycerol or 2% silver nitrate can be used to rub the throat wall, which can promote the inflammation to fade. If inflammation affects the larynx or trachea, appropriate antibiotics or hormone nebulization inhalation can be used. In severe cases, intramuscular injection or intravenous drip of penicillin is preferred, and antibiotics with high efficacy are replaced at any time. If it is caused by a viral infection, antiviral drugs should be used.

4. Local treatment

Chronic pharyngitis is mainly treated locally. Chronic simple pharyngitis often uses compound borax solution, furacicillin solution, and 2% boric acid solution. When gargle, tilt your head back and make an "ah" sound, so that the gargle can clean the posterior wall of the pharynx. In addition to the above drugs, chronic hypertrophic pharyngitis can be treated with laser. Atrophic pharyngitis can be applied to the throat with 2% iodine glycerol, which can improve local blood circulation and promote glandular secretion.

5. Chinese medicine treatment

Chronic pharyngitis is visceral and yin deficiency, disturbance of deficiency fire, remedy yin and clearing heat, and can be used to increase or decrease soup. Chinese patent medicine tablets are also often used in clinical applications.