With pharyngitis, a virus or bacterium irritates your throat, or pharynx. Both viral and bacterial forms of pharyngitis can make your throat sore and make swallowing difficult. If you have a severe case, you may find it hard to breathe. Most cases of acute pharyngitis last a few days with treatment. If you smoke, face regular exposure to environmental irritants, or have a continuing infection in your sinuses, lungs, or mouth, you may develop chronic pharyngitis, in which your symptoms will come back from time to time. The viral form of pharyngitis usually accompanies a cold, flu, or mononucleosis. Strep throat is the best-known example of a bacterial form of pharyngitis.

The symptoms of pharyngitis include the following:

• Sore throat
• Pain when swallowing
• In rare cases, difficulty breathing
• Inflammation of the membrane lining your throat
• An extra membrane or the appearance of pus in your throat (can appear as white patches on tonsils or back of throat)
• Fever
• Enlarged lymph nodes in your neck

Viruses or bacteria infect the pharynx—your throat—and cause it to swell. That accounts for the soreness and difficulties in swallowing. Viruses that cause pharyngitis usually come into your body with a cold, the flu, or a similar infection. Bacteria that cause the disease can enter the body through open wounds, skin infections, and common routes of sexually transmitted diseases.

Your health care provider will examine your throat and take a swab from it to test whether a virus or bacteria have caused the infection. The provider may also take a blood sample to check your white blood cell count, which can determine the cause of your pharyngitis.

If your healthcare provider suspects that you have the bacterial form of pharyngitis, he or she will prescribe an antibiotic. Pharyngitis that stems from a viral cause has no specific treatment beyond bed rest and simple forms of self-treatment, such as gargling and aspirin. Avoid any irritants that might affect your throat, such as smoke from cigarettes, cigars, or pipes, and cold air. Avoid drinking alcohol. Gargling several times a day with a � tsp. of salt in a glass of warm water will also help reduce your discomfort, as will throat lozenges.

If you have a bacterial form of pharyngitis, your health care provider will prescribe an antibiotic. Penicillin, 250 mg 3 times a day, taken by mouth for 6 to 10 days is the most commonly prescribed. Occasionally an intravenous form may be used. If you have an allergy to penicillin, your provider may prescribe erythromycin 300 to 400 mg 3 times a day.

If you have the viral form of pharyngitis, your health care provider will probably advise you to treat yourself at home. Aspirin or other over-the-counter pain medicines will help relieve the pain and soreness in your throat. However, aspirin should not be given to children under 18.

Strep infection should be treated with antibiotics. Alternative treatments can be effective in cases of acute, chronic, or recurrent pharyngitis.

• Zinc (30 mg per day or lozenges) boosts the immune system and relieves soreness.
• Vitamin C (250 to 500 mg two times per day) isr needed for proper immune function and to strengthen mucous membranes.
• Beta-carotene (50,000 to 100,000 IU per day) may help restore the integrity of mucous membranes and supports immune function.

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

• Slippery elm (Ulmus fulva): Soothes irritated tissues and promotes healing. Use as lozenge or tea.
• Licorice (Glycyrrhiza glabra): Antiviral and soothing to the throat. Use as lozenge or tea. Do not take licorice if you have high blood pressure.
• Garlic/ginger tea (Allium sativum/Zingiber officinale): Antimicrobial and warming herbs. Use two cloves of garlic and two to three slices of fresh ginger root. Simmer in 1 cup of water for 10 minutes. Drink warm. May add lemon and honey for flavor.
• Tincture of two parts coneflower (Echinacea purpurea), two parts goldenseal (Hydrastis canadensis), and one part propolis should be taken every three to four hours. Place 30 drops in ¹/4 cup water. Gargle and swallow.

There have been few studies examining the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for sore throat based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

• Aconitum — for sore throats that come on suddenly after exposure to cold and are accompanied by a high fever and thirst; this remedy works best if given immediately after symptoms begin�
• Apis mellifica — for shiny red, swollen throats with stinging, burning, and dry pains; this remedy is most appropriate for individuals who feel better with cold drinks but have little thirst; they may also have difficulty swallowing and may have the sensation of a fishbone being stuck in the throat; they also tend to be bothered by anything around the neck
• Arsenicum album — for a burning sensation in the throat accompanied by thirst, chills, and restlessness; symptoms are relieved by warm liquids; nasal discharge often occurs before the development of a sore throat
• Belladonna — this is usually the first homeopathic remedy considered for sore throats, particularly if there is sudden onset of intense pain on the right side of the throat along with redness, swelling, and a feeling of constriction; individuals also generally have a fever, may experience pain when swallowing (although the individual wants to drink despite the pain), and often describe a hot sensation in the throat; this remedy works best if used during the first 24 hours of throat soreness�
• Hepar sulphuricum — for stinging throat pain that is often described as a stick in the throat; throat pain is often accompanied by enlarged tonsils; pain may extend to the ears and is generally better from warm drinks; individuals for whom this remedy is appropriate are often very irritable and sensitive to cold, touch, motion, noise, and light
• Lachesis — for throat pain with swelling that is initially worse on the left side but may spread to the right; symptoms are worsened by warmth, warm liquids, swallowing (including saliva), and constrictive clothing
• Lycopodium — for throat pain with a choking sensation, as if having a ball stuck in the throat; individuals for whom this remedy is appropriate often have pain that begins on the right side and may spread to the left; symptoms are relieved by warm drinks
• Mercurius — for throat pain accompanied by fever, weakness, red spots on the tonsils as well as possible pus, and bad breath; Mercurius is most appropriate for individuals who may be sensitive to both heat and cold and tend to salivate, drool, or perspire, particularly at night
• Phytolacca — for a dark red, purple, or bluish swollen throat accompanied by excessive aching, fever, and pain with swallowing; individuals for whom this remedy is appropriate may also have a shooting pain that extends to the ears, and an acute pain at the base of the tongue when protruded; these symptoms are worsened by warm drinks and motion�
• Rhus toxicodendron — for throat pain accompanied by restlessness that is worse with initial swallowing, but is relieved by subsequent swallows as well as warm liquids; symptoms may be initiated by cold air or straining the voice
• Sulphur�—for a burning, lingering sore throat; symptoms are worsened by warm drinks and food; tonsils tend to be swollen, breath may be foul, and gums and nasal passages are dry

Chiropractic treatment may be a helpful addition to conventional medicine, especially in children.

Acupuncture may be helpful in improving immune function.

Massage can reduce the effects of stress.

Acute pharyngitis usually goes away within a week or two. Check with your health care provider if you still have symptoms after that time.

Do not use goldenseal during pregnancy.

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