Pharyngitis - Treatment

Treatment of pharyngitis has two main goals - to achieve relief of unpleasant subjective sensations in the throat and normalization of the pharyngoscopic picture.

Treatment of pharyngitis consists of using medications and performing a set of procedures. Pharyngitis is a sore throat caused by inflammation in the mucous membrane and lymphoid tissue of the pharynx. Often accompanied by a sore throat, tickling in the throat, dry cough.

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Indications for hospitalization

Patients with pharyngitis are usually treated on an outpatient basis. Patients whose work involves exposure to various unfavorable factors that aggravate the course of the disease may be advised to leave work during the treatment period. Hospitalization may be required only in the case of a severe respiratory infection, as well as in cases where an acute infectious disease, one of the manifestations of which is an inflammatory process in the throat, is contagious and poses a danger to others (diphtheria, measles, scarlet fever).

Treatment of pharyngitis with non-drug methods

Treatment of acute pharyngitis should begin with the exclusion of irritating (hot, cold, sour, spicy, salty, etc.) food, carbonated drinks. Among the first-priority prescriptions are also a ban on smoking, alcohol, and a recommendation to observe a voice regime.

The chronic form may be the result of problems with the gastrointestinal tract, and is also associated with frequent nasal congestion, forced breathing through the mouth. Treatment of pharyngitis includes a balanced diet, thermal procedures - for example, foot baths, warming compresses (if the body temperature is not elevated). The influence of negative factors that provoke the development of the disease should be excluded if possible. Inhalations and regular gargling are indicated for pharyngitis. Various lozenges do not have a high enough activity, so they will be most effective in mild forms of the disease.

Treatment of pharyngitis with medication

Local treatment of pharyngitis consists of prescribing drugs with antiseptic, anti-inflammatory, and analgesic effects. Sage and chamomile infusions, a combination of calendula officinalis flower extracts, chamomile flowers, and yarrow herb extracts are widely used for gargling: hexetidine, benzyldimethyl, myristoylaminopropylamine, eucalyptus rod-shaped preparation, etc. Spraying the throat with various aerosols is effective in the case of an infectious nature of the disease: fusafungin, propolis, dexamethasone + neomycin + polymyxin B, povidone-iodine + allantoin, biclotymol, stopangin, benzydamine. Various local antiseptics are used in the form of tablets (antiangin, amylmetacresol + dichlorobenzyl alcohol, ambazon, etc.), lozenges (diclonine), candies or dragees (strepsils, acetylaminonitropropocenbenzene) for resorption in the mouth. Usually, tablets, lozenges or lozenges for resorption have a relatively low activity, they are prescribed for mild forms of the disease.

Preparations containing iodine (povidone-iodine, povidone-iodine + allantoin), as well as those containing plant antiseptics and essential oils (rotokan, septolete), although effective, are contraindicated for those suffering from allergies. The number of such patients in some geographic areas is up to 20% or more. The choice of the optimal local antibacterial agent is determined by the spectrum of its antimicrobial activity, the absence of an allergenic and toxic effect. However, in some cases, even the most effective local preparations do not completely replace the need for systemic antibacterial therapy, especially with a combination of pharyngitis and tonsillitis caused by beta-hemolytic streptococcus. Systemic antibiotic therapy is indicated to prevent purulent complications, descending infection in cases of severe general reaction with high temperature. The drugs of choice in such cases are antibiotics of the penidillin group, macrolides, cephalosporins.

On the other hand, due to the non-bacterial nature of many forms of the disease, the emergence of an increasing number of resistant strains of bacteria, as well as the undesirable effects of general antibiotic therapy, local administration of drugs with a broad spectrum of antimicrobial activity is in many cases the method of choice.

In the treatment of acute pharyngitis, immunomodulators are also used: bacterial lysates, mixtures, etc. They activate phagocytosis, promote the attraction of immunocompetent cells to the inflammation site, increase the content of lysozyme and secretory IgA in saliva. If necessary, immunomodulators combine well with local or systemic antibiotics, helping to reduce the recovery time and maintain local immune protection, which is especially important in antibiotic therapy; in case of allergic pharyngitis, antihistamines are prescribed.

Treatment of chronic pharyngitis often begins with the treatment of chronic foci of infection and the upper respiratory tract.

Local therapeutic effects on the mucous membrane of the pharynx are effective in order to cleanse it of mucus and crusts. Inhalation therapy has become widespread: warm inhalations are prescribed in the form of a coarse aerosol of chamomile flowers, sage leaves, eucalyptus, alkaline mineral water in combination with rosehip, sea buckthorn, etc. oils. In hypertrophic forms, gargling with warm 0.9-1% sodium chloride is used. The same solution can be used for inhalations and spraying of the pharynx. In recent years, sea water preparations have been successfully used for this purpose.

Reduces swelling of the mucous membrane by lubricating the back wall of the pharynx with 3-5% silver nitrate, 3-5% silver proteinate, 5-10% tannin-glycerin. Large granules on the back and side walls of the pharynx are effectively removed by exposure to cold, laser evaporation, ultrasonic disintegration, cauterization with concentrated 30-40% silver nitrate, polycresulene.

Preparations containing plant antiseptics and essential oils are considered effective. It should be noted that such preparations are contraindicated for people with an allergic reaction to pollen.

In the treatment of pharyngitis, such drugs as strepsils, septolete, lisobact, decatilene, etc. can be used. The herbal spray anginal (also available in the form of lozenges) has a powerful antiseptic effect.

During the treatment, a balanced diet is recommended to avoid irritation of the mucous membrane of the throat. As with other types of respiratory diseases, it is recommended to drink plenty of fluids, take vitamin complexes, regularly rinse, drink tea with jam, honey, etc.

In most cases, topical antiseptics are used to treat pharyngitis, and only if the disease is caused by a bacterial infection, oral antibiotics may be prescribed by a doctor.

Rinsing solutions should be warm, not hot. For these purposes, you can use furacilin, soda, salt, decoctions of sage, chamomile, eucalyptus, rotokan, chlorophyllipt, etc. Alcohol compresses on the neck area are also used for pharyngitis (it should not be higher than 40 degrees, so as not to burn the skin). Gauze or a diaper can be moistened, for example, with vodka, a warm scarf should be tied on top. Smoking is contraindicated during treatment, and hypothermia should also be avoided.

Chronic pharyngitis has a slightly different treatment. In addition to gargling and drinking plenty of warm fluids, physiotherapy is practiced (phonophoresis, inhalations, UHF), the throat is treated with Lugol.

Treatment of atrophic pharyngitis includes daily removal of mucopurulent discharge and crusts from the surface of the mucous membrane of the pharynx. For this purpose, gargle with 0.9-1% sodium chloride with the addition of 4-5 drops of a 5% alcohol solution of iodine per 200 ml of liquid. The use of sea water preparations is also effective here. Systematic and long-term irrigation of the pharynx with these solutions relieves irritation of the mucous membrane, reduces the severity of symptoms. With an abundance of dry crusts, inhalations of proteolytic enzymes are carried out (6-10 days), subsequently inhalations of vegetable oils containing retinol, tocopherol acetate, ascorbic acid are prescribed. With subatrophic pharyngitis, gargling with a solution of B.S. gives a good effect. Preobrazhensky (70% ethyl alcohol, glycerin and mint water in equal parts; 1 teaspoon of the mixture per 1/2 glass of boiled water) after meals 3-4 times a day.

Periodically, courses of lubrication of the mucous membrane of the pharynx with 0.5% Lugol with glycerin are carried out. Other compositions for application to the mucous membrane of the pharynx are also possible - olive, peach, rosehip oils. However, with atrophic pharyngitis, drying agents that inhibit gland secretion should be avoided. In particular, it is inappropriate to use sodium bicarbonate, since it reduces the activity of gland secretion, as well as eucalyptus, sea buckthorn and menthol oils, since they have a drying effect. A positive effect is achieved by using novocaine blockades in the lateral sections of the back wall of the pharynx.

Patients with gastroesophageal reflux and chronic pharyngitis are treated under the supervision of a gastroenterologist.

One of the probable causes of persistent chronic pharyngitis may be intestinal dysbacteriosis, as a result of which it is advisable to recommend the patient to have the intestinal microflora examined and, if necessary, undergo treatment (hilak forte, baktisubtil, etc.).

Considering the fact that the cause of chronic pharyngitis may be endocrine and hormonal disorders, diseases of the cardiovascular system, lungs, renal failure, the participation of relevant specialists (endocrinologist, cardiologist, pulmonologist, nephrologist, etc.) in the treatment of the patient may be required.

Among the methods of physiotherapy, electrophoresis of the submandibular region with 3-5% potassium iodide, infrared laser exposure to the mucous membrane of the back wall of the pharynx and submandibular lymph nodes, mud or paraffin applications to the submandibular region are used. In the treatment of chronic atrophic pharyngitis, electrophoresis of 0.5% nicotinic acid to the submandibular region is indicated (procedure duration 15-10 minutes, 20 procedures per course of treatment).

Treatment of pharyngitis by surgical methods

In chronic pharyngitis, treatment measures are taken to restore nasal breathing (adenotomy, treatment of sinusitis and hypertrophic rhinitis, polypotomy, septoplasty, etc.). In the case of a combination of chronic pharyngitis and chronic tonsillitis, the question of the advisability of surgical treatment of tonsillitis in each specific case is decided individually. The pathological secretion flowing out of the lumen of the tonsillar lacunae causes constant irritation of the mucous membrane of the pharynx and maintains its chronic inflammation. Therefore, tonsillectomy is indicated, but it should be taken into account that in the postoperative period, some patients experience subatrophic changes in the mucous membrane of the pharynx to varying degrees in the coming months and even years after the operation.

Further management

In chronic pharyngitis, climatic treatment is indicated in areas with high levels of aero- and hydroaeroions in the air: sea coast, mountainous areas. Sanatorium and resort treatment is carried out in warm, humid climates with mud and hydrogen sulphide resources.

The complex of medical measures for pharyngitis should first of all be aimed at eliminating the causes that provoked it. In acute and chronic forms of pharyngitis, symptomatic treatment prescribed by an otolaryngologist is indicated.

Treatment of pharyngitis may not be necessary if disease prevention is carried out, which includes hardening the body, dousing and sports activities. It is also necessary to give up bad habits, restore and treat internal organs. Restoring and maintaining the body's immunity will also not hurt.