Update: December 2018 It’s almost impossible to find a person
who at least once did not have sore or discomfort in the throat.
According to statistics, 65% of the Russian population face this annually.
symptom, and in 7% of the discomfort persists constantly. AT
overwhelmingly, they are associated with the development of pharyngitis –
infectious disease of the pharynx, causing inflammation of the mucous membranes
Although pathology is not serious
danger to life, it significantly reduces its quality. Special
This is acutely felt by a person suffering from a chronic form.
The modern level of medicine allows you to completely get rid of
of this disease, even with a constant recurrent course.
The main thing – to identify the disease in a timely manner and carry out the correct
ATыяснить вид патологии очень важно, так как от этого нюанса
зависят the symptoms и лечение фарингита у взрослых и маленьких
patients. AT зависимости от длительности течения выделяют острую и
chronic forms. The conditional boundary between them is a temporary
interval of 6 months. If during this period the manifestation of the disease
persist, pharyngeal mucosa has time to undergo significant
changes. AT этом случае, речь идет уже о хронизации процесса.
There is another classification by which
determine the type of disease in each patient. It reflects the changes
occurring on the inner wall of the throat. ATыделяют три основных
- Catarrhal – наиболее благоприятный вариант,
not changing the structure of normal tissues. Otolaryngologist with
Examination can see swelling, redness and well-defined vessels.
throughout the mucosa;
- Hypertrophic (боковой и гранулезный) –
special pathological type with thickening of the epithelium. He looks like
catarrhal, which also increases the thickness
inner shell due to edema, but is more severe.
The proliferation of the back of the pharynx is called granular pharyngitis,
lateral – lateral;
- Atrophic – обратный предыдущему типу,
thinning epithelium, under the influence of constant
inflammation. Treatment of chronic pharyngitis of this option
It takes quite a long time (from a month), because of the need for a complete
As a rule, the acute process has a catarrhal or granular
type of. The rest is more characteristic of a protracted course.
Any acute inflammation of the pharynx occurs only under the influence of
certain microorganisms. In more than 70% of cases, the perpetrators
pathological reactions become various viruses: pathogens
influenza, adeno-and enteroviruses, group ECHO. In addition to them, the cause
infections can be:
- Bacteria (strepto-and staphylococcus, bacillus influenzae,
- ATнутриклеточные паразиты (хламидии);
- Fungal flora.
In a completely healthy person, the listed microbes are rare
cause diseases. AT норме, иммунитет оперативно реагирует на
the appearance of a foreign organism. It attracts special
killer cells in the source of a malicious agent that his
completely / partially destroyed.
In order to develop an inflammatory process, it is necessary
presence of predisposing factors:
- General weakening of the immune system. Negatively affect the state
human overloading systems may be hypothermia, lack of power
or rest, constant mental stress, abuse
- The presence of concomitant diseases. It matters not only
the presence of specific pathologies (diabetes mellitus, chronic
лимфолейкозы, ATИЧ), но и любые другие воспалительные diseases. A business
that any infectious process leads to stress
immunity, causing the body to become vulnerable to viruses and
- Deformities and other pathologies of the nose, airborne sinuses
(maxillary, frontal, sphenoid, antrum) or oropharynx. These
changes lead to fluid stagnation, which creates excellent conditions
for breeding microbes.
The main cause of the chronic form is the presence of not cured
acute process. Incorrectly chosen therapy or neglect
medical care very often leads to lasting change
mucous membranes and the occurrence of characteristic pathological symptoms.
Any variant of this infection can cause two groups of symptoms:
common and local. The first are non-specific signs:
лихорадка (чаще до 37,5-38оС), общая слабость и
malaise, loss of appetite, fatigue,
periodic sweating and chills. As a rule, in acute form they
more pronounced, but also disappear more quickly. Chronic often
proceeds without these symptoms.
Local violations are an integral component of this
diseases. It is with complaints to them that patients turn to the doctor.
ATыраженность и характер локальных симптомов может значительно
vary, depending on the option. Therefore, each of them
must be described separately.
Rapidly developing inflammation in the pharynx can deliver
strong discomfort to the patient. The most characteristic presence
- Sore throat. AT отличие от других инфекционных oral diseases
полости и начального отдела дыхательного тракта, боль не
усиливается при глотании. On the contrary, while it is somewhat
decreases, especially when consuming liquid warm food or
- Feeling of soreness or “soreness”;
- Sensation of a foreign object in the throat.
Symptoms фарингита у детей проявляются несколько шире. Often
swelling can spread to the mouth of the Eustachian tube (which
reports the cavity of the ear and mouth), because of what is happening its blockage
lumen and develops tubootitis. It shows a slight decrease.
hearing, sensation of constant noise and ear congestion. AT некоторых
cases, there may be severe pain, especially when
exposure to loud noises.
There are three options for the development of symptoms – catarrhal,
hypertrophic or atrophic type, which is important to distinguish
from each other. From this will depend on the tactics of the doctor,
duration of therapy and prognosis for the patient. The first
the assumption of the form of the disease can be made by focusing on
|Sign \ Form||Catarrhal||Hypertrophic||Atrophic|
|Tingling or sore feeling||ATыражены значительно. Symptoms постоянно беспокоят больного,
especially in the hypertrophic form. To reduce them, the patient
constantly swallows saliva, but the desired effect is not
|Foreign body sensation||Not|
|Dry throat||Virtually absent.||Constantly present. The person regularly experiences
the need to “drink a sip of water.”
|Unpleasant smell in the mouth||As a rule, not observed.||The symptom persists even with regular brushing and
consumption of chewing gum.
|Ear congestion||ATозникает при обострениях||Practically does not happen|
To confirm the presence of the disease and reliably determine it
option requires additional diagnostics. Assign
studies and in part can be conducted by a general practitioner or
otolaryngologist at the first treatment of the patient.
Before using laboratory methods the doctor conducts
pharyngoscopy – a diagnostic procedure in which
inspect the mucous pharynx and oral cavity. Otolaryngologist can
detect their redness, swelling and contouring of blood vessels. With
atrophic form can be seen with the naked eye the thinning of the epithelium,
and with hypertrophic – its excessive growth in the form
After determining the form, the doctor may prescribe some tests.
to assess the condition of the body and find out the sensitivity
bacteria (if any) to antibiotics. To this end
- A blood test – detection of increased ESR (more
15 mm / hour), a large number of leukocytes (at least
10*109/л) говорит об интоксикации организма и активности
pathological microorganisms. ATозрастание уровня лимфоцитов до
3,5-4*109/л косвенно свидетельствует о наличии вирусов,
and an increase in the content of neutrophils in the blood is about microbial
- ATзятие мазка с задней стенки глотки – выполняется, если у
doctors suspect the presence of bacteria or inefficiency
ongoing therapy. This method allows you to determine the optimal
drug for the treatment of pharyngitis.
Other diagnostic procedures are usually not performed.
patients, as the information received is sufficient for
to proceed with therapy.
How to distinguish pharyngitis from sore throat
Before you begin treatment for acute pharyngitis, you should
exclude the patient from the presence of angina (synonym – acute tonsillitis).
These состояния немного похожи по своим проявлениям, из-за чего
There is always the risk of a diagnostic error. Allow her extremely
It is undesirable, since the therapy of the listed pathologies is somewhat
contradicts each other. Wrong assumption can
significantly increase the duration of the disease and
promote the development of chronic forms.
First of all, the inflammation of the tonsils and pharynx differ in
- Pain – sore throat is always accompanied by severe pain.
syndrome that increases with food intake. With фарингите этот
the symptom is minor and decreases with food, especially when
drinking warm fluids;
- Tickling – this symptom is not characteristic of infection
- The nature of swallowing saliva – with angina, this process
almost always disturbed, due to pronounced swelling and pain
sensations. ATоспаление слизистой глотки не приводит к существенным
- The presence of otitis symptoms – hearing loss, discomfort and
tinnitus practically does not occur with isolated acute
It should be remembered that two different diseases can occur in
пациента одновременно, под действием активного возбудителя diseases.
AT этом случае, доктор оптимизирует схему терапии под это
Why is it so important to find out the variant of the disease? This particular
moment determines the choice of therapeutic measures that are assigned
to the patient. To restore the epithelium in the throat, eliminate
inflammatory manifestations and remove intoxication needed
complex therapy, including local and general
procedures. So as a condition of mucous and activity of microbes
different in different forms of the disease, it is necessary individually
approach each of them.
Treatment фарингита у взрослых и маленьких пациентов следует
start with non-drug events. These include:
- Gentle mode for voice. Should restrict loud speech,
screaming, singing and any other sounds that lead to stress
muscular system of laryngopharynx;
- Eliminate annoying food. Salty, pepper, sour,
smoked foods irritate mucous membranes. ATажно, чтобы блюда были
comfortable temperature for the patient – hot and cold substances
also damage the epithelium;
- Stop drinking and smoking since they
act as a damaging factor;
- Comply with the half-bed mode. Additional voltage
organism, in the form of physical stress and stress, negatively
affect the state of immunity. This may lead to more
severe disease and its chronicity.
Непосредственно терапию следует начинать с местных procedures. TO
they include frequent rinsing solutions that disinfect and
soften the mucous membrane. Have the best effect
chamomile, sage and chlorophyllipt (eucalyptus extract). With повышении
temperature and severe intoxication, we can recommend solutions
0.02% Furacilin (or 3 tablets per 1 liter of boiled water) or
0.05% Chlorhexidine Bigluconate.
If the patient is very concerned about the manifestations of the disease, the doctor
prescribe the combination drugs in the form of sprays, syrups or
lozenges with analgesic and antimicrobial effects. TO
These include the following drugs:
- Maxicold Lawr;
- Hexaspray (see list of all throat sprays).
- Septolet Neo;
It should be noted that part of the listed medicinal
Substances has an age limit (from 8 years). TOакие
drugs to choose in this case? Treatment фарингита у детей от 3-х
years can be carried out with almost any pastilles (except for
Hexadrepse) and Ingalipt. The optimal tool should determine
the attending doctor, especially when it comes to a small child.
To support the body’s defenses, additionally
supportive therapy is prescribed, on average for 5-10 days. With this
used immunomodulators, such as Galavit, Imudon or IRS
19. They not only shorten the treatment time, but also prevent
frequent recurrences of infection.
Do I need to prescribe antibiotics for acute pharyngitis? it
determines the doctor, depending on the patient’s condition. If he has
there is a high temperature, severe intoxication or
throat swab harmful bacteria germinate, application
antimicrobial drugs may be justified. TOак
Regular penicillins (Amoxicillin) are generally recommended without
клавуланата или макролиды (TOларитромицин, Эритромицин и
itт вариант фарингита лечится в домашних условиях. TOак правило,
the patient’s condition practically does not suffer, so there is no point
to hospitalize him in the otolaryngology department. ABOUT
the duration of the therapy is difficult to talk about since
depends on many factors: the patient’s immune status,
nature of mucosal damage, and sustainability
Non-drug recommendations are similar to those in acute
form, the fundamental difference lies in drug therapy.
ABOUTна подбирается индивидуально, в зависимости от типа изменения
If the epithelium “grows” too much or is determined
severe swelling (as in catarrhal or hypertrophic
inflammation) use a means with a drying effect.
ABOUTни также помогают устранить избыточное выделение слизи и наросшие
�”Peel” from the walls of the pharynx. With истончении эпителия такие препараты
contraindicated, as they will further irritate the tissue.
AT этом случае, оптимально использовать лекарства, стимулирующие
cell growth and normal saline solutions.
How to treat chronic pharyngitis in a child or an adult?
Withмерные схемы терапии при различных вариантах описаны ниже:
|Pharyngitis form||Recommended drugs for local use||Common action drugs|
Мультивитаминные комплексы (Биомакс, TOомпливит, Мультитабс).
The composition of the listed schemes may vary, depending on
patient conditions. ABOUTптимальная терапия подбирается доктором
individually and in the process of treatment is constantly adjusted. it
allows you to achieve the best effect and save the patient from
ATопрос: Насколько часто следует полоскать горло
with a combination of sore throat and pharyngitis?
No more than 3 times a day. Frequent rinses can apply
additional harm to inflamed tonsils, so this procedure
ATопрос: Есть ли смысл принимать муколитические
drugs such as gerbion, lasolvan, bronchipret, evkabal and
Even if the patient has a cough with a throat infection,
these drugs are not likely to have a positive effect.
Their main target organ is the lower parts of the respiratory tract, and in
In this case, the symptom occurs reflexively, due to irritation.
ATопрос: Можно ли предотвратить развитие воспаления
Special preventive measures (vaccines) do not exist, since
слишком большое число возбудителей могут приводить к этой diseases.
You can protect yourself from infection in only one way – by supporting your
immunity. To do this, it is recommended to abandon addiction
(alcoholism, smoking), balance your diet, twice a year
take vitamin complexes (up to three months), avoid
stress and sedentary lifestyle.
ATопрос: TOакие антибиотики можно назначить ребенку?
It should be noted that the need for these drugs
is determined only by the doctor in charge of the patient. Children from 1 month
Ampicillin may be prescribed as a “first-line drug.” If a
there was a need for antimicrobial therapy in an earlier
age, it is recommended josamycin, which can be used even in
newborns. Of course, that should be adequate
monitoring the condition of the child.
ATопрос: За сколько времени излечивается
This question is difficult to answer – the forecast will be determined
completely individually. AT среднем, терапия занимает 5-7
ATопрос: Чем лечить фарингит у взрослых, при
возникновении сильной лихорадки (более 38оС)?
AT этом случае, обязательно следует исключить наличие ангины.
The next stage should be detoxification (abundant
alkaline drink) and antibiotic prescription.
ATопрос: Нужно ли использовать физиотерапию?
TOак при любой инфекции, применение этого метода противопоказано
in the acute period, as it can provoke progression
inflammation. It can be prescribed only with full confidence in
устранении всех microorganisms.