Throat pain causes and infection

Throat  pain is a very distressing symptom especially when you are not able to eat or drink or swallow  saliva. The cause for throat pain can be various like infection, inflammation, ulcers inside the mouth or any lesions.

Infective causes are  viral, bacterial and fungal .Viral pharyngitis  usually accompanied by cold or coryza symptoms, body pain, chills, fever ( always need not be in this order).Those with long standing  tonsillitis issue may come with flare up of tonsillitis or membrane  over the tonsils. Viral pharyngitis need to be treated symptomatically.

Bacterial pharyngitis and tonsillitis usually caused by gram positive cocci  like streptococcus. Antibiotics are needed to control bacterial tonsillitis to prevent abscess formation ( collection of pus).

Fungal Infection  seen more in those with low immunity like Diabetes or those on immunosuppressive medication. 

Other causes are allergic reaction to food or drinks, it can cause  pain , itchy throat, swelling of pharynx especially uvula .

Chronic conditions like acid reflux or Sinusitis with post nasal discharge leads to throat pain which will be of long standing duration.

 Preventive measures 

Viral and bacterial Infection usually spread through nasal or oral route. Those with illness should wear mask while going out . Avoid overcrowded areas as it leads to rapid spread of upper respiratory Infections.

Eat healthy food,  adequate hydration ,maintain oral hygiene.

TREATMENT 

Depends on the findings, comorbidities . Analgesics to relieve the pain, gargling with salt water and betadine. Drink warm fluids. Antibiotics only if symptoms point towards bacterial infection. Don't self medicate, visit a nearby doctor.

Red flag signs 

Any choking sensation or breathing difficulties change in voice ( like hot potato voice) high fever with chills need immediate hospital visit.

If mouth ulcers or blister like lesions are the causes for throat pain, topical  cream   should be added according to the findings.

Eat healthy, adequate hydration, take rest, avoid travelling if you are sick .

Oral health day

 World Oral health day is  on 20 th March .Theme this year (2024 )is "A HAPPY MOUTH   is ......a HAPPY BODY".

Mouth  extends from the lips and cheeks and it's divided into oral cavity and oropharynx. Infections from the mouth can spread to involve nose, ear, jaw joint and throat. Salivary gland ducts open into the mouth, hence infection can spread on to the salivary glands.Tissue spaces  associated with the mouth hasten the spread of infection.

Dental infection 

Carries teeth  or tooth decay is the  common cause of infection and if untreated dental  abscess can spread rapidly to adjacent areas, if patient is having uncontrolled Diabetes  or any low immunity. conditions. Lower dental abscess spread to spaces below the jaw and upper  dental Infection into maxillary sinus area ( cheek ).Gum infection,ulcer, swelling it can be due to local pathology or secondary to  certain medications and systemic disease manifestations.

Oral mucosa  ( lining the cheek, palate, floor  of the mouth) can present with ulcer, swelling, redness , fungal infection .Premalignant and malignant lesions to be kept in mind. Any nonhealing ulcer needs to be examined . Certain immunological conditions affect oral cavity and oropharynx like Lichen planus.

Dehydration, obstruction to salivary duct leads to stone formation. Multivitamin deficiency  has oral manifestations like cheilitis, glossitis, stomatitis.

Smoking and smokeless tobacco  as in paan  with betel leaves, arecanut, lime leads to mucositis, submucous fibrosis,cancer.

Oral health is  necessary to prevent various infections. Maintain oral hygiene by brushing teeth, rinsing mouth after eating, drink adequate water to prevent dehydration  and other problems.Those with Diabetes Mellitus  and other immunodeficiency diseases need to take special care, any carries teeth needs to be examined by a dentist. Various systemic conditions have oral manifestations,needs to be evaluated.

MAINTAIN ORAL HEALTH  TO IMPROVE QUALITY OF LIFE .

SMOKING AND IT'S HARMFUL EFFECTS

Smoking can affect  the body thereby our health in various ways. It depends on the duration, number of cigarettes  and associated comorbidities which smoking can contribute or  worsen.

Every year March second Wednesday  is considered as NO SMOKING DAY. Smoking can lead on  Cardiovascular diseases, lung diseases or can aggravate existing lung conditions and can  cause Cancer.

SMOKING  AND IT'S  MANIFESTATIONS IN ENT 

Tobacco contains certain substances which are carcinogens like polycyclic aromatic hydrocarbons and nitrosamines. Use of  unfiltered cigarette, pipe will increase the carcinogenic effect ,:along with alcohol intake synergistic effect occurs as alcohol increases absorption of carcinogens contained in the tobacco. Duration of smoking, amount of cigarettes daily increase the carcinogenic effect.

Head and neck cancers like oral cavity and oropharynx  , Larynx, hypopharynx  majority of the patients give history of smoking and alcohol intake.

Chewing tobacco or smokeless tobacco  lead on to cancers of  oral cavity and oropharynx. Paan mixed with  lime ,where lime lowers the pH thereby increasing the release of alkaloids from tobacco and  arecanut  making more prone to cancer . It can lead on to fibrosis, oral submucous fibrosis where patient will have difficulty in opening the mouth due to  fibrous bands.

Smoking can worsen laryngitis,cause polypoid chan ges in the larynx. Bronchitis and exacerbation of asthma have been observed.

Ear infections and hearing loss

Smoking is a risk factor for ear Infections like middle ear Infections especially in children due to parental smoking. Age related hearing loss and noise induced hearing loss aggravated by smoking. its also related to tinnitus ( sound in the ear ). Smoking  causes Ventilating or Eustachian tube dysfunction and causes  increased mucus build up in the middle ear.

Nose and paranasal sinuses

Smoking  affects the inner lining of nose and PNS, decrease the number of cilia , change the viscosity thereby alter the mucociliary  pathway,  causing mucus build up. It can lead on to Rhinitis due to the irritating effect, worsening  of occupational rhinitis or prolongation of rhinosinusitis. Tobacco smoke will irritate the nerves related to smell resulting in decrease in smell sensation, which will reverse once smoking is stopped.

Certain lesions like polyp,  inverted papilloma  has history of active or passive smoking.

To summarise smoking leads to various diseases, interfere with the quality of life. Stopping smoking will improve mucociliary function. Active and passive smoking  is a health hazard, parents should be careful if they have small kids and avoid smoking in front of them or try to quit the habit.