A sore throat does not always require antibiotic treatment. iStock
Ibuprofen, antibiotics, tea or ice cream? We tell you what to take and how to know if it is time to go to the doctor
Dec 28, 2023 . Updated at 11:52 a.m.
He sore throat It is, along with nasal congestion and cough, the most typical symptom that the virus has arrived. winter. With the drop in temperatures, especially during the night and in the morning, when the sun is not yet hot, waking up with irritation, pain or discomfort becomes a daily occurrence.
There are numerous options on the market aimed at solving this. From lozenges to sprays, analgesics, infusions or anti-inflammatories, including traditional traditional options, such as honey or gargles, we analyze the effectiveness of the most popular remedies for sore throats, debunking myths about their treatment and we clarify when to go to the doctor, with the help of experts.
bacteria or virus
The first thing to know is that not all sore throats are the same. The most common causes of this symptom may be irritation, bacteria either virus. And depending on the case, the treatment will vary. As the doctor points out Juliana Cabrerafrom the Spanish Society of Primary Care Physicians (Semergen), “with the arrival of the cold, the covid, the respiratory syncytial virus and the flu, all of them will present with a sore throat along with other symptoms.”
In other words, knowing the cause of your sore throat can be a key first step in knowing how to act. In this sense, the presence of other symptoms that accompany pain is a determining clue. The most important of these, of course, is a fever high and persistent. This sustained elevation in body temperature is indicating a possible presence of bacteria.
What to do if the fever rises? “One must go to the doctor if you have a fever of more than 38º and a very sore throat, because there may be plaques and some bacteria. If you take an anti-inflammatory and, after six or eight hours, you are still 38º, you have to go to the doctor. If you have had covid and flu tests and they have been negative, but your throat hurts very much, you have to go to the doctor. Also if you touch yourself and you have ganglia. That may mean that the disease is bacterial,” says Cabrera.
In these cases, doctors can test for the presence of streptococcus and, if the bacteria has colonized the tonsils, a course of antibiotics will be started. Among them, the most effective is amoxicillin.
Despite everything, it must be remembered that, in most cases, the causes of pain are viruses, so antibiotics would not be indicated. «Everything depends on the origin. Normally, a sore throat can have two causes. One is inflammation of the tonsils due to a bacterial process caused by streptococci. But the majority of infections are viral, and in those cases we treat with anti-inflammatories such as ibuprofen,” observes the doctor. Jesus Sueirofrom the Galician Association of Family and Community Medicine.
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Another symptom that accompanies this pain is nasal congestion. «There are sore throats that do not originate in the throat itself, but are caused by poor nasal breathing. If a patient has colds very frequently, becomes congested and, especially at night, breathes through the mouth, then he wakes up with a dry mouth and a sore throat due to this irritation,” says Sueiro.
«The change in temperature affects a lot. We are hot during the day, then at night it is cold and we have the heater and winter clothes on in bed, so we are suffocating while we sleep and undress, then we get cold and we get a sore throat. These are the typical pains that appear in the morning,” Cabrera agrees.
When congestion is the cause, we can attack the sore throat by resolving it. “These problems improve with treatments to relieve airway obstruction, such as antihistamines, nasal washes or even short courses of vasoconstrictors or, in some chronic cases, antihistamines or topical nasal corticosteroids,” recommends Dr. Sueiro.
home remedies
The problem that typically occurs with a sore throat is irritation and inflammation caused by changes in temperature or respiratory viruses. When this is the case, it is key to prevent the area from drying out due to the air we breathe, because this leads to greater irritation. «The most effective thing is to prevent the house from having a very dry environment. That dryness It makes you cough more. For this, it is important to humidify the environment. But the heating dries out the air in the rooms a lot, so we can put a glass of water near the radiator so that the air becomes a little humid,” advises Cabrera.
In this sense, it can also be useful to moisten the respiratory tract area by doing nasal washes. «There is always mucus in the cavity between the nose and throat. Washing with serum or salt water relieves these symptoms and is more effective than drinking water,” says Sueiro.
The gargle They can be useful in some cases. «What we achieve with this is to moisten the area a little and, if there are plaques, we may tear them off and the infection will go away faster. Gargling with salt water is a disinfectant, it is like the serum with which you clean wounds. The effect is that you clean and drag away the pus to accelerate healing and so that it bothers me less at that moment,” explains Cabrera.
The candy or throat lozenges are not a bad alternative to soothe the irritated area, with one condition: it is always better to check that they do not have sugar. However, you must know that the relief provided by these candies is momentary and consuming them does not constitute a cure, regardless of the active ingredients they contain. «They produce relief but it is very temporary. You will immediately have the discomfort again after taking them. We are not saying that they are not used, but their effectiveness is limited and does not last long,” says Sueiro.
As for the HoneyAlthough “it has a good reputation,” the doctor highlights that “it has a high sugar content. “It can be taken in preparations with warm milk and nothing happens, it has no drawbacks, but you do have to be careful with the sugar.”
If the pain is persistent, you can resort to pain relievers over-the-counter, such as ibuprofen or acetaminophen. «Whenever we talk about a sore throat without fever, that would be indicated. But if there is a fever, the doctor has to see it, because, perhaps, an antibiotic is indicated,” Cabrera clarifies.
Hot or cold?
There are two diametrically opposed schools of thought when it comes to the liquids we should drink to relieve a sore throat. On one side are those who recommend drinking hot infusions, broth, milk or tea. On the other hand, those who claim that there is nothing better for an irritated pharynx than the cold. Both points of view follow a logic.
«Drinking something hot takes away the discomfort, but what you really have is inflammation. To reduce inflammation, it is best to cold. Anyway, the hot water It will promote vasodilation, the area will be irrigated more and that will help a little more to regenerate the tissues. In principle, then, there is no single recommendation, but rather everyone can do what feels best to them,” says Cabrera.