My Throat Is Sore

Have you ever suffered from a sore throat? One that lasts just one day, or that causes you ongoing pain? Sore throat pain comes in all types and severity – and there are a variety of causes which may be contributing. I see many patients who complain of throat pain. Sometimes the diagnosis and treatment is relatively simple and straight forward – for others it may be more complex. We will explore several common possible causes of a sore throat.


Infections: Viral vs. Bacterial


Whether bacterial or viral illness is the source of the sore throat, very often the physical exam findings are the same. A red throat, a swollen throat, a yellow film or spots on the tonsils, and/or lymph node swelling in the neck may be present. One way to differentiate between viral and bacterial processes in the throat is to obtain a culture of the throat. A Q-tip like swab is placed across the infected area. This swab can be analyzed instantly with a rapid strep test which can identify a streptococcal infection (“strep throat”) within minutes. Often patients with viral illnesses from the flu (as opposed to a common cold ) are feeling very weak, and typically have fever and muscle aches. Unfortunately, fever, weakness, muscle aches may accompany bacterial illness of the throat as well.  



Bacterial infections are treated with antibiotics whereas viral illnesses are generally treated with symptom treating medications such as antihistamines, decongestants and over the counter fever reducers and pain relievers.  

Holistically, I generally recommend that my patients take natural immune-boosters such as vitamin C, zinc, and Echinacea. When necessary I will also suggest salt water (saline) nose sprays and a facial steamer.   


Acid Reflux

As I have written in about in my past blogs (Acid Reflux without Heartburn), a common, yet surprising, cause of sore throat is acid reflux or gastroesophageal reflux disease (GERD). While the sore throat from acid injury to the throat is typically more of a chronic sore throat as opposed to the more sudden onset of sore throat typical of infectious causes, a large portion of my patients who come in complaining of chronic sore throat (with or without hoarseness) more often than not the culprit is acid reflux. Many of these patients are completely unaware they are afflicted by acid reflux because they do not suffer from the esophageal or stomach burn that is most commonly associated with GERD. The throat irritation and ‘burn’ from GERD occurs when the stomach acid backs up into the esophagus and then into the throat. This “throat burn” is called LPR (LaryngoPharyngeal Reflux).



Treatment for acid reflux and subsequently the sore throat pain is explored holistically in detail in my previous blog Treating Acid Reflux Through Diet. When I discover acid reflux is the cause for the throat pain I typically start the patient on either prescription proton pump inhibitors or over-the-counter proton pump inhibitors. Sometimes the medicine is enough to treat the acid reflux and sore throat problems – but in more difficult cases my patients must ascribe to new lifestyle and eating habits to find relief.




Common allergens such as pollens, pet dander, chemicals/pollutants and molds can also contribute to a sore throat. Food allergies can also cause a sore throat, though those also typically involve sudden onset of throat swelling as well. In patients where infectious and acid sources of sore throat have been ruled out I will often recommend that the patient undergo an allergy work up.  



For those patients diagnosed with allergies there are many treatment options to lessen their symptoms – from over the counter antihistamines and decongestants to sinus rinses, saline nasal sprays. Sometimes patients with persistent allergies require allergy shots. Patients with allergies to pet dander, dust mites, and other at-home allergens may need to look into obtaining and using allergen reducing cleaning products and linens.


So the next time you feel the pain from a sore throat, you may be experiencing any one of the causes mentioned above. Persistent sore throat or severe sore throat is a symptom that deserves attention from your doctor.  For more information please visit

Added to ENT on Thu 04/01/2010