Pharyngitis is an inflammatory process in the mucous membrane and lymphoid tissues of the pharynx. Infection with pharyngitis from a sick person is only possible if the disease is caused by a specific pathogen (for example, diphtheria bacillus). In other cases, the disease is considered not contagious. There are two forms of the disease: acute and chronic.

Reasons for the development of the disease:

• inhalation of cold air;
• exposure of the pharyngeal mucosa to irritating chemicals ( tobacco smoke, tar contained in cigarettes, alcohol, polluted air);
• infections (streptococcal, staphylococcal, pneumococcal);
• viruses (, parainfluenza, adenoviruses);
• mushrooms of the genus Candida;
• entry of an infectious agent from other inflammatory foci (rhinitis, sinusitis, caries).

Acute pharyngitis

Symptoms of acute pharyngitis include a sore and sore throat, especially when swallowing.

Most often, acute pharyngitis is combined with acute inflammatory processes in the respiratory tract (flu, infectious diseases).

Patients complain of a sore throat and pain when swallowing. Body temperature may remain normal or rise slightly to 37.50C. The general condition of the patients is assessed as satisfactory.

In children under 2 years of age, pharyngitis is more severe than in adults, since it is often combined with inflammatory processes in the nasopharynx, accompanied by impaired nasal breathing.

Chronic pharyngitis

There are atrophic and hypertrophic forms of the disease, which have a similar clinical but completely different pharyngoscopy picture.

For any shape chronic pharyngitis An increase in temperature and deterioration in the well-being of patients is not typical.

The disease is manifested by dryness, itching and sensation foreign body in the throat. Patients complain of a persistent cough with scanty discharge. Accumulates in the throat large number viscous mucus, which patients are forced to constantly swallow. This can lead to increased irritability of patients, and even sleep disturbances.

Diagnostics

Diagnosis of pharyngitis usually does not cause difficulties for a doctor. The diagnosis is made based on an assessment of the patient's complaints, anamnesis (history) of the disease and the results of pharyngoscopy. Subject to change clinical analysis blood, but they are not specific for of this disease, and only indicate the presence of an inflammatory process in the body.

The pharyngoscopy picture differs in different forms of the disease.
At acute pharyngitis The mucous membrane of the pharynx is hyperemic (bright red), in some places deposits of pus and mucus are visible on it, and the uvula is swollen.

With atrophic pharyngitis, you can see a shiny, dry, thinned mucous membrane of the pharynx, covered with dried mucus.

The hypertrophic form of the disease is characterized by the presence of foci of hyperplastic lymphoid tissue in the pharynx, an increase in tubopharyngeal ridges localized behind the posterior palatine arches.
During exacerbation of chronic forms of pharyngitis these changes accompanied by swelling and hyperemia of the pharyngeal mucosa.

Treatment

Relieve discomfort Drinking plenty of warm fluids will help your throat.

Therapeutic measures are aimed at eliminating the factor that caused the development of pharyngitis, treating local manifestations of the disease, as well as restoring the normal immune status of the body.
Bed rest during an exacerbation of the chronic form of the disease or the development of acute pharyngitis is not necessary, however, you should not endure the disease “on your feet.” Warm (but not hot), soft, non-irritating food and warm drink are recommended for the inflamed mucous membrane of the pharynx.
It is necessary to eliminate the factors that caused the disease, as well as other irritating agents, such as cold air, tobacco smoke, and alcohol.

Local impact on the inflammatory process is the most effective method of treating pharyngitis. Medicines used for these purposes have anti-inflammatory, antibacterial and analgesic effects.

Drugs local action are issued in the form of several dosage forms: sprays (hexoral, inhalipt), lozenges and lozenges (spetolete, strepsils, grammidin, faringosept), solutions for rinsing and lubricating the pharyngeal mucosa. Effective gargling herbal decoctions from chamomile, sage and oak bark, as well as solutions table salt and furatsilin.

Application antibacterial drugs local action significantly increases the effectiveness of treatment of pharyngitis in adults, but the question of the advisability of their prescription must be decided by the doctor. Despite the fact that antibacterial therapy is carried out locally, the rules of antibiotic treatment should be followed. It is unacceptable to change the frequency and time of use of drugs, as well as their unauthorized cancellation before the end of the course of treatment, even if you feel better.

Besides drug therapy For the treatment of pharyngitis, physiotherapeutic methods are used, such as UV irradiation, electrophoresis with medicinal substances, darsonvalization, etc.
To strengthen the immune system, you should take vitamin-mineral complexes and biologically active food supplements.

Prevention of pharyngitis

Preventive measures should be aimed at strengthening protective forces the body and eliminating factors that provoke the development of the disease. It is also necessary to treat diseases of other organs and systems that can cause the development of secondary inflammation in the pharyngeal mucosa.

Which doctor should I contact?

If signs of pharyngitis appear, you should consult an ENT doctor. In addition, a physiotherapist is involved in the treatment. It will also be useful to visit the dentist and treat teeth affected by caries - the center chronic infection in the body.

About the treatment of pharyngitis - broadcast of the magazine "Otolaryngologist"

The Moscow Doctor clinic talks about the disease:

Pharyngitis is an acute or chronic inflammation mucous membrane of the pharynx, which is accompanied by sore throat, foreign body sensation, and discomfort. In acute pharyngitis, the pathogen penetrates the respiratory tract and then into the underlying sections. The infection enters the pharynx from the outside or from existing foci of infection in the body (caries, tonsillitis, etc.). In chronic pharyngitis, morphological changes occur predominantly in one area; neighboring parts of the respiratory tract are not involved in the process.

Before nominating correct treatment pharyngitis in adults, medications, antibiotics and give recommendations on what folk remedies can help fight the disease; the doctor needs to find out the causes of the disease.

The main causes of acute pharyngitis include the following:

• Viruses
• Bacteria
• Allergens
• Fungi
• Injuries to the pharyngeal mucosa
• Irritants (eg chemicals).

Redness of the back wall of the throat and palatine arches is the first sign of pharyngitis.

Inhalation of cold or polluted air can trigger the disease.
Chronic pharyngitis can be caused by opportunistic oral flora, which is activated by hypothermia, serious illnesses and other unfavorable conditions. The causes of this disease may be gastrointestinal diseases. Chronic pharyngitis is often caused by frequent or constant exposure to a room with a high content of dust in the air. Associated factors that contribute to the development of the disease are the following:

• Smoking
• Alcohol abuse
• Somatic diseases
• Endocrine disorders
• Allergy
• Difficulty breathing through the nose.

Treatment of acute pharyngitis in adults should begin immediately when the first symptoms appear.

Symptoms of pharyngitis

The main symptoms of acute pharyngitis include the following:

• Sore throat, dryness, discomfort and pain
• Enlarged anterior cervical lymph nodes, pain on palpation
• Sore throat radiates to ears
• Cough
• General weakness
• Fever.

Sore, dry, and sore throat are the first symptoms of pharyngitis.

With chronic pharyngitis, the patient feels normal, the temperature does not rise. Symptoms include:

• Sore and dry throat
• Feeling lumpy or foreign object in the throat that makes you want to cough
• Dry cough or coughing.

To combat the disease, various medications and antibiotics are prescribed.

Diagnosis of the disease

To diagnose the disease, the doctor listens to the client’s complaints, examines the throat and performs pharyngoscopy. In doing so, pay attention to the following points:

• Redness of the posterior wall of the pharynx and palatine arches, inflamed lymphoid granules - characteristic of acute pharyngitis
• Hyperplasia of lymphoid tissue - with hypertrophic form diseases
• The mucous membrane is thinned, dry, covered with dry mucus - characteristic of the atrophic form of chronic pharyngitis.

To determine the nature of the pathogen, the doctor takes a swab from the throat, and subsequently bacteriological or virological studies are carried out. Medicines for pharyngitis in adults are prescribed after receiving the results.

Treatment of pharyngitis in adults: drugs, antibiotics, general recommendations

When treating pharyngitis, you should adhere to the following recommendations.

• Stay at home for several days and try to avoid contact with other people. It is not necessary to adhere to bed rest; it is enough to just get a good rest at night.
• You should adhere to a certain diet. It is worth including warm foods rich in microelements and vitamins in your diet. Avoid salty, fried and spicy foods.
• It is recommended to drink warm milk with honey and butter, ginger tea with honey green tea with lemon, alkaline water still, fruit and vegetable fruit drinks for dry throat mucosa.
• It is necessary to refrain from smoking and alcohol.
• You should regularly carry out wet cleaning, ventilate the room, use individual dishes and towels.

Treatment of pharyngitis in adults: drugs

Spray ingalipt

Today there are many safe medicines, which can be purchased at a pharmacy without a prescription. At the first sign viral infection accept antiviral drugs, such as Amizon, Isoprinosine, Groprinosine and others.

Used for gargling antiseptic solutions(Chlorophyllipt alcohol, Chlorhexidine, Furacilin). It is advisable to carry out the procedure 1-2 times every hour. Lozenges and sprays are also used for treatment, which have an anti-inflammatory and analgesic effect. The most commonly prescribed sprays are Ingalipt, Givalex, Kameton, Tera-flu, Isla-moos lozenges, Faringosept, Lizobakt, Strepsilis and others.

Syrups are used to combat coughs. plant based(Eucabal, Herbion, Bronchipret), they have an expectorant effect. They also use drugs containing synthetic medicinal substances sputum thinners - Lazolvan, ACC, Bromhexine.

To moisturize the mucous membrane, inhalations are performed. Use as a solution saline solution, products containing ambroxol, herbal decoctions.

First aid for pharyngitis: gargling with infusions of herbs that have antiseptic properties(chamomile, sage, calendula, eucalyptus).

Treatment folk remedies cannot replace treatment with medications, it is additional method to fight the disease. Use of funds exclusively alternative medicine may lead to the development of complications. Treatment of pharyngitis at home in adults should only be carried out after consultation with your doctor.

Among the most popular means traditional medicine the following:

• The mouth is rinsed with infusions of herbs that have antiseptic properties (chamomile, sage, calendula, eucalyptus). 10 grams of the plant are infused in 1 glass of boiling water. Gargle with warm solution for at least 5 minutes every hour.

• Inhalations with medicinal herbs (chamomile, eucalyptus, sage) using a nebulizer.
• To treat pharyngitis, use propolis tincture. In 100 ml warm water dilute 30 drops of 30% tincture. Gargle with this solution 3-4 times a day.
• For inhalation, use an infusion of pine buds (20 g of raw material is needed for 1 glass of boiling water).
• To relieve inflammation, you will need blackberry leaves. A decoction of them is used for inhalation and rinsing.
• Cocoa butter is great for coughs. Add half a teaspoon of butter to a glass. warm milk. This solution is taken 3-4 times a day.

Treatment of pharyngitis with folk remedies in adults possible with mild form diseases. Otherwise it is necessary drug treatment which is prescribed by the doctor. You should not self-medicate, as some medications may cause allergic reaction. Among traditional medicines, you need to be careful with those containing iodine.

Pharyngitis is an inflammatory process in the pharyngeal mucosa, which is accompanied by unpleasant sensations in the form of a sore throat and discomfort when swallowing.

Table of contents:

There are three sections of the pharynx - the lower, called the laryngopharynx, the middle (oropharynx), and the uppermost (the so-called nasopharynx). Certain manifestations and types of pharyngitis depend on the location of the inflammation. However, if the disease begins with acute period, then it is difficult to make a specific division of symptoms, since all three departments are affected almost simultaneously.

The infection (regardless of its nature - viral or bacterial) is migratory in nature, but more often it is descending: it descends from the nasopharynx to the hypopharynx. This process is clearly visible from the morphological changes in the mucosa, so an otolaryngologist with a high degree of probability can determine the current localization of inflammation.

There are two main types of pharyngitis - acute and chronic.

Acute pharyngitis

In the acute form, the disease develops rapidly. It is provoked by infection, as well as contributing factors: smoking, exposure to cold, irritation of the throat, drinking alcohol. You can also observe acute pharyngitis in the form of concomitant disease for various respiratory infectious diseases or gastrointestinal disorders.

The most common viral etiology of acute pharyngitis. About a third of all cases occur in bacterial infection. The patient's pharynx swells in one or two areas, infiltration of the mucous membrane occurs, and desquamation of the epithelium occurs. It is important to prevent complications of the process, since inflammation can spread to the auditory tubes.

Swelling of the follicles of the posterior wall of the pharynx and their drainage provoke granulosa pharyngitis - a type acute illness. Except viral or bacterial pathogen, pharyngitis can provoke and fungal infection mucous membrane. In this case, fungal pharyngitis develops. Cases of allergic pharyngitis have also been described, a condition in which an allergic reaction takes the form of inflammation of the pharyngeal mucosa.

As a result of damage to the mucous membrane in any part of the throat, traumatic pharyngitis can develop. The inflammatory process is a response to prolonged or severe one-time mechanical irritation of the upper layer of the epithelium. It could be surgery or getting a foreign body into the throat.

A form of pharyngitis in which acute inflammation develops into constant process, is called chronic.

Chronic pharyngitis

Chronic pharyngitis, in turn, is divided into hypertrophic, atrophic and catarrhal.

In this case:

1. Hypertrophic pharyngitis is accompanied by a change in all layers of the pharyngeal mucosa; it thickens, increasing the amount of epithelium. Dense mucosa, on which the vessels with blood and lymph are dilated, is the main sign of hypertrophy in pharyngitis. Also during this process, expansion of lymphoid formations is observed, neighboring lymph granules merge with each other, and hypersecretion appears. All this occurs on the back or side walls of the pharynx.
2. Atrophic form, on the contrary, means thinning of the mucous membrane. It is dry and the glands become smaller.
3. Catarrhal pharyngitis characterized by diffuse venous hyperemia. At the same time, stasis of small-caliber veins, perivascular infiltration and pastosity of the pharyngeal mucosa can occur.

The main causes and factors of pharyngitis

The main reasons for the development of pharyngitis are considered to be prolonged inhalation of cold air (in severe frost), irritation of the pharynx chemicals(for example, alcohol when drinking alcohol), air pollution.

The infectious etiology of the disease is observed when the body is damaged by viruses, bacteria (microbes) and fungi.

Also considered contributing factors are:

• smoking;
• violation of nasal breathing;
• unfavorable climate;
• poor environment;
• gastrointestinal diseases;
• dental problems;
• alcohol abuse;
• hormonal imbalances;
• eating very cold or too hot food.

The chronic form of the disease occurs with improper treatment acute stage, and also when the real reason pharyngitis was never diagnosed.

Provokes chronic disease prolonged irritation of the throat. May occur repeated inflammations or expansion of process localization. The most obvious cause of this type of pharyngitis is various infectious diseases that occur in a chronic form, for example, tuberculosis.

Signs and symptoms of pharyngitis

Most pronounced symptom In acute pharyngitis, pain when swallowing is considered. This is especially felt when the throat is empty, when the dryness irritates the mucous membrane. There may also be an increase in temperature, general weakness, and soreness. Sometimes discomfort can spread to the ear area.

Important: the symptoms of pharyngitis are very similar to other serious infectious diseases, so it is important to establish the etiology of the disease in time, excluding , , .

In its chronic form, pharyngitis manifests itself as a lump in the throat, when there is often a desire to clear the larynx and cough. All this may be accompanied by malaise, and body temperature often rises. Among important symptoms– cough, it always has typical symptoms: dryness, tearing, with special emphasis on the throat area. A person is forced to constantly swallow mucus that forms on back wall larynx. This causes a lot of inconvenience, the quality of life and sleep is disrupted, irritability and nervousness appear.

Please note: Chronic pharyngitis rarely occurs as an independent disease. Basically this is just a consequence of more serious problems, for example, with the gastrointestinal tract.

It is necessary to examine the body for diseases such as pancreatitis and. If they are discovered, then full recovery it is vain to fight chronic pharyngitis. Its symptoms will persist as long as the affected area exists in the body.

The most obvious complication of acute pharyngitis is the flow into chronic form. This is possible with ineffective treatment or no treatment at all.

The list of complications also includes such diseases:

Diagnostics

To diagnose pharyngitis in a timely manner, you need to visit an otolaryngologist (ENT). He examines the patient’s pharynx, assesses the condition of the mucous membrane and oral cavity. You may also need a pharyngoscopy or a referral for a microbiological analysis, a blood test for antibodies to streptococcal bacteria.

When diagnosing pharyngitis, it is imperative to exclude acute tonsillitis, since the symptoms of these two diseases are very similar.

Treatment of pharyngitis

If the disease is local character, without significantly disrupting general well-being for the patient, symptomatic therapy is sufficient. It includes a diet, warm compresses on the neck and legs, drinking milk, steam inhalation, gargling and irrigating the throat.

Please note: uncomplicated pharyngitis in adults and children does not require .

Actively used antimicrobial agents in the form of lozenges, lozenges, insufflations, solutions for inhalation and rinsing.

Medicines and preparations for the treatment of pharyngitis

The most commonly used tablets, lozenges and lozenges are “Neo-angin”, “Septolete”, “Strepsils”, “Hexaliz”, “Faringosept”. Iodine-containing drugs are also prescribed: “Iodinol”, “Vocadine”, “Yox”. Sulfonamides are also effective: Ingalipt, Bikarmint.

For occasions neglected form pharyngitis requires antibiotics, for example, from a number of natural or synthetic penicillins, as well as cephalosporins. The latter are used if pharyngitis is quite advanced, has caused complications and significantly affects the patient’s condition.

Tetracycline antibiotics are rarely used today, but they can be prescribed if the body is resistant to other types of antibacterial drugs.

A relatively new medicine, Imudon, is a polyvalent complex with lysates of fungi and bacteria that cause acute bacterial pharyngitis. For gargling, Hexoral is used, which has an antimicrobial and analgesic effect, which significantly reduces the degree of discomfort when swallowing.

Treatment of pharyngitis with folk remedies

You can prepare it at home herbal teas and rinses based on traditional medicine recipes. This treatment of pharyngitis will alleviate the patient’s condition and enhance the effect of traditional medications. All medications used should be previously discussed and agreed upon with your doctor.

Here are a few recipes that can be used to relieve symptoms of pharyngitis:

Diet

If you have symptoms of pharyngitis and during treatment of the disease, you should monitor the temperature of food. It shouldn't be hot or cold. It is also important to avoid hard foods that can mechanically irritate the pharynx. Food must be chewed thoroughly, because during a long stay in the mouth it will acquire a normal temperature and consistency for the body.

It is important to enrich the diet with foods containing calcium, magnesium, iodine, zinc.

Features of the course of the disease and treatment of pharyngitis in children

In young patients, pharyngitis is more complicated because its diagnosis is difficult. Often the symptoms of an inflammatory process in the pharynx are accompanied by a runny nose, wheezing, dry painful cough. Pharyngitis in children can often be confused with other diseases, e.g. bronchial asthma. It is very important to carry out correct and timely differential diagnosis.

Important: When treating the disease, it is worth taking into account the characteristics of the body up to 2 years of age. Such children should not be prescribed throat irrigation with a spray. This can lead to spasm, which, in turn, sometimes causes respiratory arrest.

Features of pharyngitis in pregnant women

Since the treatment of pharyngitis is predominantly local, that is, drugs that are not absorbed into the bloodstream are used, special instructions There is no treatment for pregnant women.

However, it is worth knowing that pharyngitis during pregnancy may require antibacterial therapy, which is contraindicated during this period. In this case, the appropriateness of using antibiotics is determined by the doctor, correlating the benefits and effects of taking the drugs with the potential risk for the mother and fetus.

Prevention

In order to prevent the body, you should take care of your immunity. You need to regularly consume vitamins and vitamin-containing vegetables and fruits, propolis preparations, and beekeeping products.

It is useful to be near the sea and breathe iodine vapor. It never hurts to carry out gentle hardening. However, it must be started strictly in the warm season.

Trofimova Yaroslava, medical observer

Pharyngitis is an inflammatory process of the pharyngeal mucosa of an acute or chronic nature. Pharyngitis is manifested by soreness, discomfort and pain in the throat.

Pharyngitis is an inflammation of the lymphoid tissue and mucous membrane of the pharynx. There are many methods of treating it, and below we will look at them in detail.

Let's start with general characteristics procedures for illness. Treatment measures designed to eliminate the factor that caused pharyngitis. The patient needs treatment of local manifestations of the disease and restoration of immunity. Observe bed rest It’s not important, but you shouldn’t endure pharyngitis “on your feet.”

Local exposure is the most effective method of treating pharyngitis. The medications used must have an anti-inflammatory, analgesic and antibacterial effect - these can be sprays (for example, Bioparox), lozenges, tablets (for example, Miramistin), etc. Throat diseases can also be treated using herbal decoctions and propolis.

Treatment does not allow changes in the time and frequency of use of medications, or their unauthorized withdrawal until the end of the course of treatment for pharyngitis. In addition to drug therapy, pharyngitis can be treated using physiotherapeutic methods.

Eucalyptus-M tablets

Hexaliz tablets

Grammidin tablets

Falimint tablets

Broncho-munal tablets

Travisil tablets

Efizol tablets

Causes of pharyngitis

The main cause of pharyngitis is inhalation of cold or polluted air, the influence of chemical irritants (alcohol, tobacco). Infectious pharyngitis can be triggered by various microbes (strepto-, staphylo-, pneumococci), as well as viruses (influenza, adenoviruses) and fungi (candida). Pharyngitis often develops as a result of the spread of infection from any source of inflammation adjacent to the pharynx. This is how pharyngitis develops with sinusitis, rhinitis, and dental caries.

Types of pharyngitis

There are acute and chronic pharyngitis.

Acute pharyngitis develops immediately after exposure of the pharyngeal mucosa to an aggressive factor (infection, irritant gas, etc.). The course of acute pharyngitis is favorable.

Chronic pharyngitis can be a consequence of untreated acute pharyngitis, as well as independent disease, which occurs with prolonged irritation of the pharyngeal mucosa. In the development of chronic pharyngitis, phases of exacerbation and remission are noted.

Classification of pharyngitis

• Viral
• Bacterial
• Fungal
• Allergic
• Traumatic
• Caused by exposure to irritants
• Chronic

Simple (catarrhal):

• Hypertrophic (granular)
• Atrophic
• Mixed form

The most common form acute inflammation the mucous membrane of the pharynx is catarrhal pharyngitis during ARVI. It is known that approximately 70% of pharyngitis is caused by viruses, including rhinoviruses, coronaviruses, respiratory syncytial virus, adenovirus, influenza and parainfluenza viruses. Most typical pathogen acute pharyngitis are rhinoviruses.

Research recent years show that their importance is rapidly growing, and now rhinoviruses are responsible for more than 80% of acute respiratory viral infections during autumn epidemics. Viral infection is often only the first phase of the disease, and it “paves the way” for subsequent bacterial infection.

Viruses that cause acute pharyngitis (in descending order of frequency):

Basic:

• Rhinoviruses
• Coronaviruses
• Adenoviruses
• Influenza virus
• Parainfluenza virus

• Respiratory syncytial virus
• Viruses herpes simplex(types 1 and 2)
• Enteroviruses
• Coxsackie virus
• Epstein–Barr virus
• Cytomegalovirus
• Human immunodeficiency virus

These generalized data taken from foreign guidelines on otorhinolaryngology and infectious diseases, are very conditional, since the concept of “sore throat”, used in English(the Russian-language analogue is acute pharyngitis or pharyngotonsillitis), is not a definition of a specific nosological form, but rather a collective term for several diseases. In addition to the nonspecific form, there are other types of pharyngitis associated with specific pathogens, for example, Epstein-Barr virus with infectious mononucleosis, Yersinia enterocolitica for yersenial and gonococcus for gonorrheal pharyngitis, as well as Leptotrix buccalis for leptotrichosis of the pharynx.

Symptoms of pharyngitis

Acute pharyngitis is characterized by soreness, dryness, discomfort and pain in the throat when swallowing (especially with an empty throat), less often - general malaise, a rise in temperature (usually 37.5-38°C). When the tubopharyngeal ridges become inflamed, the pain usually radiates to the ears. On palpation, there may be pain and enlargement of the upper cervical lymph nodes. Pharyngoscopy reveals hyperemia of the posterior wall of the pharynx and palatine arches, individual inflamed lymphoid granules, but there are no signs of inflammation of the tonsils characteristic of angina. It should be remembered that acute pharyngitis may be the first manifestation of some infectious diseases: measles, scarlet fever, measles rubella. In some cases it is necessary to carry out differential diagnosis with Kawasaki disease and Stevens-Johnson syndrome.

Chronic pharyngitis is not characterized by fever and significant deterioration. general condition. The sensations are characterized by patients as dryness, soreness and a feeling of a lump in the throat, which causes a desire to cough or “clear the throat”. The cough is usually persistent, dry and easily distinguishable from the cough that accompanies the course of tracheobronchitis. Discomfort in the throat is often associated with the forced need to constantly swallow mucus in the back of the throat, which makes patients irritable, interferes with their normal activities and disrupts sleep.

With atrophic pharyngitis, the mucous membrane of the pharynx looks thinned, dry, and often covered with dried mucus. Injected vessels may be visible on the shiny surface of the mucous membrane. In the hypertrophic form, pharyngoscopy reveals foci of hyperplastic lymphoid tissue randomly scattered on the posterior wall of the pharynx or enlarged tubopharyngeal ridges located behind the posterior palatine arches. At the time of exacerbation, these changes are accompanied by hyperemia and swelling of the mucous membrane, but usually the paucity of objective findings does not correspond to the severity of the symptoms that bother patients.

Chronic pharyngitis is often not an independent disease, but a manifestation of the pathology of the entire gastrointestinal tract: chronic atrophic gastritis, cholecystitis, pancreatitis. Entry of acidic gastric contents into the pharynx during sleep with gastroesophageal reflux disease and hernias hiatus diaphragm is often hidden reason development of chronic catarrhal pharyngitis, and in this case, without eliminating the main cause of the disease, any methods local treatment give insufficient and short-lived effect. Smoking and tonsillectomy lead to the development atrophic changes in the mucous membrane of the pharynx.

Pharyngitis often develops with constantly difficult nasal breathing. It can be caused not only by switching to mouth breathing, but also by abuse vasoconstrictor drops, which flow from the nasal cavity into the pharynx and have an unnecessary anemic effect there. Symptoms of pharyngitis may be present with the so-called postnasal drip (postnasal drip). In this case, discomfort in the throat is associated with the flow of pathological secretions from the nasal cavity or paranasal sinuses along the back wall of the pharynx. Besides constant coughing this state may cause wheezing in children, which requires differential diagnosis with bronchial asthma.

The main factors contributing to the development of chronic pharyngitis:

• constitutional features of the structure of the mucous membrane of the pharynx and the entire gastrointestinal tract;
• long-term exposure exogenous factors(dust, hot dry or smoky air, chemicals);
• difficulty breathing through the nose (breathing through the mouth, abuse of decongestants);
• smoking and alcohol abuse;
• allergy;
• endocrine disorders (menopause, hypothyroidism, etc.);
• vitamin deficiency A;
• diabetes mellitus, heart, pulmonary and kidney failure.

For persistent sore throat that is not amenable to conventional therapy, differential diagnosis is required with a number of syndromes that develop in some cases. systemic diseases and diseases nervous system. Plummer–Vinson syndrome occurs in women aged 40 to 70 years against the background iron deficiency anemia. Sjögren's syndrome – autoimmune disease accompanied, in addition to severe dryness of the mucous membrane of the gastrointestinal tract, diffuse increase salivary glands. Eagle syndrome (stilalgia) is characterized by severe persistent, often unilateral, pain in the throat caused by elongation of the styloid process, which is located on the lower surface of the temporal bone and can be palpated above the upper pole tonsil. A number of neuralgias (glossopharyngeal or vagus nerve) can also cause sore throat, especially in older people.

Treatment of pharyngitis

Treatment of pharyngitis involves, first of all, eliminating the factor that provoked the disease. In the case of bacterial pharyngitis, this is achieved with the help of antibiotics, and in the case of pharyngitis caused by prolonged inhalation of smoke or irritants, job changes or the use of personal protection methods.

Important!!! Treatment for all cases of pharyngitis requires smoking cessation.

Any drug treatment for pharyngitis should be carried out under the supervision of the attending physician.

In case of acute and exacerbation of chronic pharyngitis, not accompanied by severe disorders of the general condition, it is enough symptomatic treatment, including a gentle diet, hot foot baths, warm compresses on the front of the neck, milk with honey, steam inhalations and gargling. Smoking should be stopped. Uncomplicated pharyngitis usually does not require systemic antibiotics. In this situation, it becomes justified to conduct not a systemic, but a local antimicrobial therapy, which can also be prescribed as monotherapy. However, a survey conducted in Belgium showed that in general, 36% of doctors resort to prescribing antibiotics for acute respiratory viral infections and pharyngitis.

Antibacterial drugs for the treatment of pharyngitis usually include one or more antiseptics(chlorhexidine, hexetidine, benzydamine, ambazone, thymol and its derivatives, alcohols, iodine preparations, etc.), essential oils, local anesthetics(lidocaine, tetracaine, menthol), less often - antibiotics (fusafyungin, framycetin) or sulfonamides, deodorizing agents. Preparations may also contain bacterial lysates (Imudon), natural antiseptics (plant extracts, bee products), synthesized factors nonspecific protection mucous membranes, which also have an antiviral effect (lysozyme, interferon), vitamins (ascorbic acid).

Antimicrobial drugs can be prescribed in the form of rinses, insufflations, inhalations, as well as tablets and lozenges. The main requirements for drugs applied to the mucous membrane are:

• wide range antimicrobial action, preferably including antiviral and antimicrobial activity;
• no toxic effect and low speed absorption from mucous membranes;
• low allergenicity;
• no irritating effect on the mucous membrane.

Most drugs (Hexalize, Drill, Septolete, Faringosept, Neo-angin, Strepsils, etc.) are available in the form of tablets, lozenges or lozenges. This form of medicine has relatively low activity and its use is limited. light forms diseases. In addition, the doctor should remember the toxicity of chlorhexidine, which is part of many drugs (Antiangin, Drill, Sebidine, Eludril) and should not allow them unlimited uncontrolled intake patients (especially children).

The prescription of a number of drugs is limited by their high allergenicity and irritating effect. This includes drugs containing iodine derivatives (iodinol, iox, vocadine, povidone-iodine), propolis (proposol), sulfonamides (bicarmint, ingalipt). Preparations containing herbal antiseptics and essential oils are effective and harmless, but their use is contraindicated in patients suffering from allergies to pollen, and the number of people with this disease in some geographic areas is up to 20% of the population.

Inhalation antibiotic "Fyuzafyungin" (Bioparox) - a drug that combines antibacterial properties with anti-inflammatory properties and is produced in the form of a dosed aerosol, has been used in the treatment of respiratory tract infections for more than 20 years. Due to the very small size of aerosol particles, fusafyungin is able to penetrate into the most inaccessible parts of the respiratory tract and exert its effect there. healing effect. The high antimicrobial effectiveness of fusafyungin in acute pharyngitis, laryngitis and tracheobronchitis has been confirmed a large number observations. The spectrum of antimicrobial activity of fusafyungin is adapted to microorganisms that are most often the causative agents of upper respiratory tract infections; it is also active against mycoplasma infections. Unique quality This drug is stable in its spectrum of action: during its use, no new strains of bacteria resistant to it have emerged. In addition to its antibacterial properties, fusafungin has its own anti-inflammatory effect, which has been demonstrated in experimental studies. It enhances phagocytosis of macrophages and inhibits the formation of inflammatory mediators. This explains the effectiveness of the drug for viral pharyngitis, although the drug does not have a direct inhibitory effect on viruses. When fusafyungine was prescribed, a smoother course after tonsillectomy was noted.

"Imudon" is fundamentally different from all drugs used for local treatment of pharyngitis. It is a multivalent antigenic complex, which includes lysates of 10 bacteria, as well as two causative agents of fungal infections (Candida albicans and Fusiformis fusiformis), most often causing inflammatory processes in the oral cavity and pharynx. Imudon activates phagocytosis, helps increase the number of immunocompetent cells, increases the content of lysozyme and secretory IgA in saliva. Data have been obtained indicating that the administration of imudon for acute, as well as catarrhal, hypertrophic and subatrophic forms of chronic pharyngitis is more effective than traditional methods treatments, such as inhalation of alkaline and antibacterial drugs, cauterization of granules with a solution of silver nitrate and the use of other anti-inflammatory and analgesic drugs. If necessary, imudon combines well with local or systemic antibiotics, helping to reduce recovery time and maintain local immune defense, which is especially important during antibiotic therapy. Imudon is available in the form of lozenges.

Hexetidine (Hexoral) is available both as a rinse solution and as an aerosol. Unlike chlorhexidine, the drug is low-toxic. It is active against most bacteria - the causative agents of pharyngitis and tonsillitis, as well as fungi. In addition to being antimicrobial, hexetidine has a hemostatic and analgesic effect, which justifies its use not only after tonsillectomy and opening of a paratonsillar abscess, but also after extensive operations in the pharynx (for example, operations for obstructive syndrome). sleep apnea etc.). The combination of the above-mentioned effects with the deodorizing effect of the drug is beneficial in patients with tumors of the upper respiratory tract, in particular, those receiving radiation therapy.

Antiseptic for mucous membranes "Octenisept" has, perhaps, the widest spectrum of antimicrobial action, covering gram-positive and gram-negative bacteria, chlamydia, mycoplasma, fungi, protozoa, as well as herpes simplex viruses, hepatitis B and HIV. The effect of the drug begins within a minute and lasts for an hour. Octenisept does not provide toxic effect and is not absorbed through intact mucous membranes. An octenisept solution is used, spraying this solution onto the mucous membranes using an insufflator. Of course, the main disadvantage of this drug is that it is not available in forms convenient for independent use, and its use is mainly limited to the practice of specialized departments.

Local antibacterial agents can be widely used in the treatment of pharyngitis. The choice of the optimal drug is determined by the spectrum of its antimicrobial activity, the absence of allergenicity and toxic effect. Of course, the most effective local drugs will not completely replace the need for systemic introduction antibiotics for sore throat and pharyngitis caused by beta-hemolytic streptococcus. On the other hand, due to the nonbacterial etiology of many forms of pharyngitis, the appearance of all more resistant strains bacteria, as well as unwanted effects In general antibiotic therapy, local administration of drugs with a wide spectrum of antimicrobial activity is the method of choice in many cases.

Treatment of pharyngitis during pregnancy

Any illness during pregnancy is unpleasant and brings to the expectant mother a lot of inconvenience. First of all, this is due to the fact that during pregnancy, most effective methods Treatments are not available because they may adversely affect the development of the fetus. This is relevant and sufficient for treatment harmless disease called pharyngitis.

When treating pharyngitis, you must follow several rules. The main ones are: providing rest to the sore throat (in order not to strain the vocal apparatus, try not to talk, and, if necessary, do it rarely and in a whisper), periodically gargling, taking the necessary medications. Warm is very useful in this case. drinking plenty of fluids. Note: not cold and, in no case, not hot. For drinking it is better to use alkaline (milk, mineral water still), as well as vitamin-containing drinks (cranberry juice, tea with lemon). Spicy, salty, and smoked foods should be excluded from the diet.

Infusions and decoctions are suitable for gargling medicinal herbs: chamomile, calendula, plantain, sage. You can buy ready-made tinctures that need to be diluted with water. This could be Rotokan, Romazulan and others. In addition, Furacilin solution is used for rinsing. Aerosols and sprays, for example, Hexoral, do a good job.

Today, the pharmaceutical market offers a huge selection of various lozenges that help with pharyngitis. These include Sebidin, Strepsils, Faringosept. Falimint, Septolete, Strepsils-plus are contraindicated for women expecting a child. However, it should be noted that lozenges and lozenges are effective only for mild forms of the disease.

As a rule, the temperature with pharyngitis is insignificant and rarely exceeds 38°C. This became the reason that they try not to lower the temperature. In very rare cases, given the condition of a pregnant woman, Efferalgan, Calpol or another Paracetamol-based drug is used to lower the temperature.

Important!!! Treatment of pharyngitis during pregnancy, although simple, requires medical supervision.

Pharyngitis is an inflammatory disease of the mucous membrane in the throat, which usually develops against the background of colds and infectious diseases. If treatment for this disease is not started in a timely manner, it can become chronic and lead to many severe consequences. Therapy usually requires complex treatment; it is important to get rid of the symptoms of the disease and eliminate the causative agent of the inflammatory process. Treatment of pharyngitis in adults with drugs is an important part of the entire complex of therapy.

All drugs used for this disease can be divided into several groups. The following remedies are usually used depending on the main causes and symptoms of pharyngitis:

1. Antibiotics. Antibacterial agents usually required for bacterial lesions. Depending on the extent of the bacterial spread and the activity of the infection, antibiotic sprays may be required to local application or tablets for complex treatment.
2. Anti-inflammatory drugs. They are usually supplemented with a powerful analgesic effect and help relieve pain and sore throat that occurs with pharyngitis. It's worth remembering that similar drugs They never eliminate the cause of the disease, they only help cope with the symptoms.
3. Homeopathic medicines. This group remedies are usually used as an auxiliary treatment; homeopathy is used to maintain the body's defenses and help cope with the infectious lesion that caused pharyngitis. It is worth remembering that the effectiveness of these drugs is not officially recognized, so you should not rely solely on them.

For viral pharyngitis, medications can be used to help suppress the activity of the virus. However, to do this, you must first undergo an examination to establish the exact cause of the disease. It is worth noting that even if inflammation viral nature, antivirals are not always necessary; in this case, it is usually more important to strengthen the immune system.

In some forms of the inflammatory process, a dry cough occurs; it is provoked by purulent discharge on the mucous membrane in the pharynx. To improve the discharge of secretions and get rid of coughing attacks, antitussive drugs are used. For example, with granulosa pharyngitis, cough medications are especially necessary.

Most medications to treat pharyngitis are sold over the counter, with the exception of some types of antibiotics. However, this does not mean that you need to strive for self-treatment. For therapy to be most effective, it is necessary to accurately determine the causative agent of the inflammatory process.

Also, in addition to taking medications, you should not forget about other aspects of treatment. In order for the effect of medications to be most pronounced, bed rest should be observed during the acute form of the disease. You need to drink enough fluids, regular clean water, warm tea.

You should switch to a diet without foods that irritate the mucous membranes. These include foods that are too hot or cold, dishes with a lot of spices, and foods that are too salty or sour.

Important! Before starting treatment, you should definitely consult your doctor.

How to treat the disease

To make it easier to navigate among the drugs and choose the most suitable means, it is worth giving a list of the most popular and effective medicines against pharyngitis and other diseases of the nasopharynx.

Antibiotics

Tablets with a systemic effect are rarely required for this disease; local agents are usually used. These include: Bioparox, IRS – 19, Imudon. It is worth noting that these drugs do not relieve the symptoms of the disease, they only help eliminate the cause. Therefore, the effect of their use does not become noticeable immediately.

For the same purpose, rinsing with Miramistin is used. This solution has an antiseptic effect that helps destroy bacterial damage. You should rinse as often as possible, especially at the very beginning of treatment.

Anti-inflammatory painkillers

Usually they use drugs for topical use, which are available in the form of sprays and tablets, lozenges for resorption. They do not fight the cause of the disease, but help eliminate pain and sore throat. There are many inexpensive but effective drugs, the following tools are usually used:

1. Lozenges and tablets: Grammidin, Strepsils, Faringosept and their analogues.
2. Sprays: Yox, Hexoral, Tantum Verde and their analogues.

Most of these drugs are quite safe, but you should not use them more often than indicated in the instructions. If the inflammatory process in the throat is accompanied by an increase in body temperature, you should turn to anti-inflammatory painkillers in tablet form, for example, Nurafen and other ibuprofen-based products wide range actions.

Homeopathy

Homeopathy is used as a concomitant therapy; you should not rely entirely on these drugs. For pharyngitis and other inflammatory diseases of the nasopharynx, the following remedies are usually used:

• Rumex;
• Causticum;
• Echinacea Angustofolia and others.

In fact, there are many names of homeopathic medicines, but not all of them are quite effective. You should choose your medicine wisely; you should read the descriptions of several different medicines before making a choice.

Important! To strengthen the immune system for this disease, you can also use vitamin-mineral complexes and home remedies based on medicinal herbs.

The order of drugs for inhalation

Inhalations are especially important for pharyngitis, which is accompanied by coughing and the formation of purulent discharge on the mucous membrane. Inhalations help ease breathing, improve sputum discharge and kill pathogenic bacteria. Inhalations are especially recommended to ease breathing after fifty.

Procedures should be carried out using special drugs– nebulizers. The following tools are usually used:

1. Mineral water or saline solution. The most common and useful remedies for pharyngitis are recommended to use Narzan or Borjomi. Inhalations with these substances will help eliminate dryness and soreness.
2. Furacillin. Ready solution sold in pharmacies in ampoules; for one procedure, take half furacillin and half saline solution. This drug has a pronounced antibacterial effect.
3. Lazolvan or Ambrobene in the form of solutions for inhalation. These medications are necessary when coughing occurs due to pharyngitis. They will help improve the release of phlegm and secretions from the mucous membrane in the throat.

It is recommended to take several inhalations a day and alternate between different products. This can be done in the presented sequence. Inhalations will also help enhance the effect of other drugs that are used against pharyngitis.