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Sore Throat & Tonsillitis

Pain or soreness in the throat: What is tonsillitis?

by Professor David Howard

Pain and soreness in the throat are very common symptoms all over the world. There are many different causes, and simple viral infections are the most common. The pain and soreness often get better in a few days and basic treatments including resting the voice, drinking plenty of water, and the regular use of a  mild painkiller such as paracetamol are all that is required. Viral infections do not require antibiotics, as these do not kill viruses.

Soreness of the throat lasting a few days can also be caused by shouting and straining the voice, especially against a noisy background (such as a party, musical event orsporting event) - in particular if this is combined with alcohol and smoking. This type of case requires the simple treatment outlined above.

What is tonsillitis?

Bacterial infections of the throat can rapidly cause pain which is severe enough to make swallowing difficult and can be associated with additional earache. This type of infection, known as tonsilitis and particularly common in children, is most often due to fact that the infection involves the tonsils in the throat. This type of infection often requires treatment with antibiotics which inhibit and kill the responsible bacteria. The most common bacteria to cause this problem are varieties of streptococcus which explains why people sometimes talk about a 'strep throat'.

Tonsillitis can become severe and the infection in the tonsil may lead to a collection of pus, known as an abscess, in the side of the throat. This is called a quinsy and requires the patient to go to a hospital. Fortunately this is a rare problem and can be treated by antibiotics given into the bloodstream of the patient via a fluid drip in the hospital and/or by drainage of the abscess by a simple operation on the throat under a short general anaesthetic.

If the pain and soreness in my throat comes quickly and is severe, what should I do?

If your symptoms or those of your child or children come along quickly over 24 hours and are increasing, you should first of all try to get an urgent appointment with your family doctor (GP). GPs are very used to seeing this common problem and can treat you effectively even when your symptoms are severe. If you really require referral to a hospital, the GP can arrange this.

Please do not go straight to an Accident & Emergency Department at a hospital if at all possible, as this department should be used for more serious and urgent problems. Only attend the hospital direcly if your symptoms are so severe that they are affecting your breathing (very rare) or preventing you from swallowing.

What should I do if I have had pain or soreness in my throat for more than ten days and it is not getting better?

The most common reasons for persistent and chronic sore throat pain are shouting and straining the voice, cigarette smoking, alcohol abuse or acid reflux from the stomach (this reflux often occurs at night and is particularly common in people who are overweight). There are other rarer causes.

If symptoms have lasted longer than ten days, an appointment with the family doctor (GP) is strongly advised.  If there is pain, soreness, persistent irritation, and/or altered sensation/feeling in the throat lasting longer than three weeks, is also advised to make an appointment with the family doctor particularly if the person concerned is or has ever been a smoker or heavy drinker. An urgent referral to an ENT hospital department may be needed.

For more advice about adult tonsil surgery, children's tonsil surgery and adenoid surgery, please visit the patient Information section of the ENT-UK website offering additional information on a wide variety of ear, nose and throat problems.