Sore Throat

When to call the doctor

• When these conditions point to the possibility of a bacterial infection, you should see the doctor.
  • Severe sore throat without much of a cough
  • Fever   over 101°F
  • Associated headache  , abdominal pain  , or vomiting
  • Another family member recently diagnosed with a strep throat
• If you seem to be dehydrated (dry mouth, sunken eyes, severe weakness, or decreased urine output), an urgent doctor's appointment is indicated. Symptoms of dehydration in adults   may be different from symptoms of dehydration in children  .
• If you can't get good pain relief from over-the-counter medications or you can't get to sleep because of pain, you should see the doctor.

When to go to the hospital

If swallowing hurts enough that drooling occurs, you should go to a hospital's emergency department. Difficulty breathing from a sore throat can also be a symptom of a more serious illness. Significant dehydration associated with inability to drink fluids is often best treated at the hospital.

Because doctor's offices vary in their ability to treat serious conditions in the office or see people on an urgent basis, you might want to call your doctor to get advice on whether you should come to the office or go to the emergency department. Keep in mind that urgent care centers are generally poorly equipped for treatment of serious conditions.

Self-Care at Home

Treatment of pain is often the number 1 priority if you have a sore throat.

• Throat lozenges often prove inadequate for all but the most minor cases.
• Gargling with salt water is sometimes helpful. (You may try mixing table salt with warm water and gargling.)
• Although they may be rough on the stomach, NSAIDs (nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen) are often more effective pain relievers than acetaminophen (Tylenol).
• Drinking enough fluids is very important.
  • A fever can increase fluid requirements, and painful swallowing can decrease fluid intake.
  • When it is hard for you to drink, it is important to decrease your body's requirements for fluid through rest and lowering any fever.
  • Pain treatment can help increase fluid intake.
  • Choose high-quality fluids such as soup broth (replaces both salt and water losses) and sugar-containing solutions (they help your body absorb the fluids more rapidly).
  • Avoid caffeine because it can cause water loss.
• Getting extra sleep can promote more rapid recovery, especially if a virus is the cause. Malaise (a general feeling of illness) is the body's cry for rest.

Follow-up

As with other illness, you should contact your doctor if you become more ill despite treatment. Sometimes, determining whether a condition became worse because of the natural course of the illness or because of a side effect of the medication you are taking can be difficult. (For example, both the infection causing a sore throat and a reaction to medication can cause nausea.)

Prevention

Avoiding close contact with ill people can help you from getting a throat infection. Cold viruses appear to be more readily transmitted than streptococcal infections. Only about 25% of family members exposed to strep develop strep throat. Usually a person with strep throat becomes noninfectious within 24 hours after the first antibiotic dose. The incubation period (the time between exposure to strep germs and onset of illness) is usually 2-5 days. Children should stay home from school and day care during infectious periods.

Outlook

Most sore throats go away with or without treatment. Although rare, complications of strep throat such as rheumatic fever, poststreptococcal glomerulonephritis, and epiglottitis can cause serious illness or death. When you dread every swallow, however, any treatment that gives relief is looked upon with great favor