“My throat hurts.”
That is one of the most common complaints we hear at Student Health and Counseling, often followed by vivid descriptive imagery like “drinking acid,” “swallowing needles,” or “killing me.”
Sore throat, being so common, deserves a review of its causes and cures.
Dry air is a common culprit. If your nose is stuffed up, you will breathe through your mouth, scorching the tender tissues. Doing this all night in your sleep will guarantee a sore throat when you wake up. New Mexico’s famous dry winds add to the problem.
Mucous drainage from the nose is caustic to the throat. A sore throat caused by drainage might be the first clue that you are getting a cold, even if your nose doesn’t seem runny. That is because only about a third of the mucous in your nose drains out the nostrils. The other two-thirds drains down the back of your throat. Drainage-induced sore throats usually last only a day or two and are followed by more classic cold symptoms like congestion and cough.
Allergies harass the throat by the two methods above, plus direct irritation from the pollen, smoke or animal dander that you’re allergic to. It is spring allergy season now, so this kind of sore throat is common.
Viruses and bacteria can assault the throat directly, causing swollen tonsils, inflammation, and what patients usually call “white stuff” on the tonsils.
This reminds me of the day I learned the hard way to be careful what words I choose for my exam-room descriptions. After gazing into the inflamed depths of a young woman’s throat, I cheerfully informed her that her tonsils were covered with pus. She promptly swooned. In fact, that is what it is, but I don’t call it that anymore, at least not to a patient’s face.
Peering into the depths behind your teeth is a natural impulse when your throat hurts. You grab a flashlight and head for the bathroom mirror.
Here is what you’ll see. First, your tongue. Holy moley, what are those bumps? If you have never looked at the back of your tongue before, you might be alarmed by the rather large round bumps back there. Not to worry. Those are just taste buds.
Next is the uvula, that little thing that hangs down in the middle. This odd little appendage mostly dangles from your soft palate, moving when you swallow or hit high C in your opera class. Uvulas come in all sizes and shapes. Some are even forked.
The tonsils squat on either side of the throat, flanking the uvula. They can vary in size from person to person and week to week. Tonsils are actually part of our immune system, like outposts of our personal homeland security. They house white blood cells and other defenders.
When the tonsils are challenged by infection, they swell up and send out the cavalry, a.k.a. that word that made my patient swoon.
Tonsillitis is infection or inflammation of the tonsils. Some people have had their tonsils removed because of repeated bouts of tonsillitis, but those people can still get sore throats and throat infections.
Finally, behind it all, the back wall of the throat.
This is where you might see what is delicately called post-nasal drip. Sheets of thick, yellow, slimy … You get the idea. It might sound gross to you, but it is informative to medical professionals.
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A doctor’s job is to sort out the cause of your sore throat and advise you accordingly. A major question that needs answering is whether you have a bacterial infection. Streptococcus pyogenes is the name of a bacterium that causes what is commonly known as strep throat. The classic symptoms of strep throat are fever, severe sore throat, swollen red tonsils with white infectious material on them and headache. The same symptoms can come from a virus infection, however, so we usually do a special test, swiping your throat with a soft swab, if we suspect strep.
If you have a strep infection, you’ll need an antibiotic to clear it up.
Without antibiotic treatment, strep can cause complications in the heart and kidneys, among other things, so it deserves investigation.
Whatever the cause of your sore throat, there are some measures you can take to feel better. If your nose is congested, blow it, and rinse out your sinuses with a Neti pot. Consider taking a decongestant pill or a pain pill like acetaminophen. Suck on a lozenge. Drink warm tea or water with honey and lemon. My personal favorite is throat comfort tea, available in any supermarket and often made from the bark of a slippery elm tree.
Or go for cool comfort if that feels better, with chilled drinks or a popsicle. Gargling with warm salt water will soothe the swollen tissues and help wash off the white stuff. Use no more than quarter teaspoon of salt in a cup of water. Humidify the air you breathe by running a humidifier, especially in your bedroom. Avoid irritants like cigarette smoke.
Most sore throats are not serious and will resolve on their own.
When should you see a health professional? If you have fever over 100 degrees, if the pain is so severe you can’t swallow liquids or can’t sleep, or if the cavalry is out in full force on your tonsils, you should get checked. If you are having trouble breathing because of the size of your tonsils, get yourself to the emergency room. Or if it just goes on too long and bugs you too much, let us help.
Student Health and Counseling is located across the mall to the east of the SUB. Come in or call 277-3136 for an appointment.
Dr. Peggy Spencer has been a UNM Student Health physician for 17 years and a Daily Lobo contributing columnist for three years. E-mail your questions to her at Pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health provider.
