Pharyngitis is an inflammatory disease of lymphoid tissue and pharyngeal mucosa. Pharyngitis, the symptoms of which are characterized mainly by the infectious nature of the onset, rarely occurs in isolation, and therefore the main manifestations of this disease are most often combined with diseases of the upper respiratory tract.
Quite often considered a disease seen in middle-aged and senile age. The pharyngitis in children, as a rule, proceeds in an acute form. In addition, statistics on the incidence of pharyngitis indicate that men fall ill more often than women.
Pharyngitis, as you may have noticed, may be acute, but its transition to the chronic form of the flow is not excluded. The disease is accompanied by a pain in the throat, a feeling of general discomfort
Given the peculiarity that the pharynx is anatomically divided into the main three divisions( nasopharynx, oropharynx and larynx), the inflammatory processes developing in it can also be conditionally divided into types corresponding to their localization. Division, we repeat, will be conditional, in particular, if it is an acute form of pharyngitis, it is explained by the diffuse damage of acute bacterial and viral infections of the upper respiratory tract mucosa. Accordingly, the nature of the emerging disease can be defined more as a migratory and, in most cases, a descending one.
In the chronic form of pharyngitis, the morphological changes occurring in the mucosal area are mainly concentrated in one of the pharyngeal regions, as a result of which it is possible to repulse the conventionality in isolating individual nosologies( for example, the chronic form of nasopharyngitis).
The development of pharyngitis occurs under the influence of an infectious agent, and in 70% of cases as such viruses are, and in the remaining 30% it is a bacterial infection, an allergic reaction, fungal infection or trauma.
As for chronic pharyngitis, the development of the disease in this form occurs against the background of a prolonged course of inflammation arising in the mucous pharyngeal region, as well as against frequent colds or joining a bacterial infection, which is already topical for the infection. As a cause of chronic pharyngitis, it is also possible to identify unfavorable climate conditions, environmental conditions, bad habits( smoking, alcohol).As we noted above, the chronic form of the disease takes a long time.
Chronic form of pharyngitis, as, indeed, and any other chronic diseases, exacerbates at the moment of immunity decline, with the appearance of various types of infectious diseases, with hypothermia, and also as a result of the impact exerted on the body by stress and stress.
As a result of a prolonged course of the inflammatory process, concentrated in the mucosa and lymphoid tissue, a disturbance occurs in their blood circulation, which in turn leads to atrophy. Based on the specific degree of damage, as well as from its depth, the catarrhal form of pharyngitis, hypertrophic form and atrophic form, respectively, are distinguished. In intermediate forms between the listed also secrete pharyngitis lateral and granulosa. We will consider each of these forms separately after providing general information on the symptomatology of pharyngitis.
The general picture of the symptomatology of the disease we are considering in acute form is extremely diverse, but in most cases the complaints of patients are reduced to the unpleasant sensations that arise during swallowing. They can appear in the form of dryness, perspiration, burning or tickling, a sense of presence in the throat of a foreign body and other similar manifestations in this area. In addition, there may be weakness, headaches( persistent or recurrent), a small temperature.
In addition, acute pharyngitis can also occur in conjunction with a symptom such as an increase in the occipital and submandibular lymph nodes, in some cases, the pressure on them can be accompanied by pain. Zalozhennost and pain in the ears in this case require immediate treatment to the doctor - this kind of manifestations indicate the movement of the pharynx infection to the middle ear, which, in turn, can cause inflammation in it with subsequent loss of hearing.
The above symptoms may also accompany catarrhal angina or purulent angina, therefore the difference from it is the greater severity of the pain syndrome in combination with a sharp increase in temperature indices( up to 39 ° C).Sometimes these diseases can be combined.
Pharyngitis in children is often diagnosed as an acute infectious disease( scarlet fever, measles).In some cases, such a disease as diphtheria occurs in the form of pharyngitis, which leads to not too serious treatment of it. Diphtheria in particular is characterized by the formation of white or gray-white in the tonsils and back wall of the plaque, which is difficult to remove.
To mask the symptoms of pharyngitis can also some types of neurological disorders, systemic diseases. Given this factor, without attention signs that indicate possible pharyngitis, can not be left, as it is impossible and completely in this situation to rely on self-medication.
Symptomatic of chronic pharyngitis is not accompanied by an increase in temperature and a significant change in the general condition of the patient.
The main sensations described by the patients are reduced and dryness in the throat, to the presence of a "lump" in it, due to which there is a need for coughing and in expectoration. The manifestation of a cough, as a rule, is of a persistent nature, this cough is dry. The actual discomfort in the throat is mostly due to the need for constant swallowing of mucus that is concentrated in the region of the posterior pharyngeal wall, as a result of which the patients become irritable, this condition determines some discomfort for normal cases, and also disturbs the quality of sleep.
Let us single out the main factors contributing to the appearance of a chronic form of pharyngitis:
Chronic pharyngitis, as a rule, is not an independent disease, flowing mainly with pathologies of the digestive tract( pancreatitis, cholecystitis, gastritis, etc.).If you get into the throat of contents from the stomach, which is possible against a background of gastroesophageal reflux disease or hernia in the area of the esophageal opening of the diaphragm, chronic catarrhal pharyngitis often develops. In this case, the lack of measures to eliminate the main underlying cause leads to the fact that it is impossible to cure this form of pharyngitis - the treatment will not be sufficient and will determine the short-term positive effect of its use.
Catarrhal pharyngitis, as we noted earlier, is one of the forms of chronic pharyngitis. The main symptoms of catarrhal pharyngitis are in a characteristic for the disease as a whole manifestation in the form of a sneer in the throat and perspiration in it, a feeling of foreign body and light painful sensations when swallowing. In the throat, a mucous viscous discharge is accumulated, which causes the patient to systematically expectorate and cough.
Especially strongly manifested cough in the morning, moreover, in some cases it can be accompanied by severe nausea and vomiting.
Pharyngoscopy as a method of diagnosing the disease, reveals the presence of diffuse hyperemia in the pharyngeal mucosa, as well as its thickening, the presence of a purulent secret on it. All this is caused by constant swelling, which is relevant for the chronic form of the disease for connective tissue and the affected mucosa.
Hypertrophic pharyngitis is the next form of chronic pharyngitis. Characterized this form of hypertrophy of the epithelium, which determines, in fact, its name. In addition, granules and other kinds of consolidation appear. The mucous becomes bright red, this inflammation does not appear everywhere in the affected area, certain irregularities are noted in the upper shell. Possible is also a variant of manifestations, in which small vessels in the area of certain areas of the mucosa are subject to increase, which creates a specific type of pattern from them.
The soft sky, like the tongue, is characterized by a sharp thickening, marked by a sharp hyperplasia of the lymph nodes, which occurs due to the influence of the irritating type of factors, which result in the formation of grains of large sizes of red shade.
Symptomatics is similar to the previous form of pharyngitis( its catarrhal form), but in this case it has a deeper and more pronounced nature of manifestations. Again, in the morning, coughing is especially severe, nausea and vomiting are possible.
With this form of pharyngitis, hypertrophic degeneration is possible in adenoid tissues located from the side walls of the pharynx. Emetic movements lead to a significant bulging forward, which makes it possible to examine them without hindrance. With significant hypertrophy, the trigeminal nerve undergoes stimulation, resulting in a cough that becomes reflexive.
In some cases, the lymphadenoid tissue forms long strands that can be seen with slightly infiltrated posterior archs. This kind of pharyngitis is defined as a lateral pharyngitis, in which the pharynx looks narrowed. In some cases, this form of pharyngitis can be combined with a granular form of pharyngitis.
The main symptom of the disease in this form is a peculiar manifestation in the form of tickling in the throat, scratching. Often patients also feel dryness in the pharynx, swallowing is accompanied by mild pain. Again, the appearance of an abundant layer in the form of viscous and mucous secretions, densely adjacent to the pharyngeal walls, is also noted. These secretions are difficult to expect, their separation from the pharyngeal walls practically does not occur.
These processes are also accompanied by significant irritation of the throat, resulting in frequent frequent vomiting.
At night, the accumulation of mucus occurs in a more intense mode, it may be lowered to the larynx, so that patients experience severe spasms in combination with bouts of severe cough.
Granulosa pharyngitis is accompanied by a marked lesion of lymphoid tissue, which in particular manifests itself in the form of variously sized red nodules, centered in the region of the posterior pharyngeal wall. Formed granules become a strong stimulus for the trigeminal nerve. Often there is a transition from granulosa pharyngitis to atrophic pharyngitis, as a result of which the pharyngeal membrane is characterized by severe anemia and dryness, which appeared against the background of gland atrophy combined with tissue fibrosis.
Chronic pharyngitis in this form acts as the last stage of the disease. Its completion is accompanied by the formation and development of progressive sclerosis of each of the organs of the mucous membrane, as well as the lymphoid and glandular apparatus and submucosal layer.
The secret in this case becomes more and more viscous, there is a difficulty in its separation. Drying of the detachable forms dense crusts, because of which patients experience considerable discomfort and anxiety.
Due to the formation of crusts in the nasopharynx, patients develop paresthesias in various forms, and there are unpleasant sensations of the presence of a foreign body in this area. It also happens that these crusts, with considerable effort on the part of the patient, stand out, having the appearance of significant fragments, or even casts from the surface of the nasopharynx.
The mucous area of the posterior pharyngeal wall acquires dryness and pallor, becomes shiny, through it you can see crimped blood vessels. The sharpness of pharyngeal reflexes expressed in the initial stages of pharyngitis in the atrophic form of the flow of pharyngitis disappears completely, which indicates that atrophy is also affected by nerve endings, not only nerves sensitive, but also nerves trophic, that is, vegetative. It is due to this result that, in general, a disappointing feature regarding the possibility of achieving a reparative effect in the course of treatment at a given stage of the disease can be introduced.
When considering chronic atrophic pharyngitis as the final stage of development of previously listed forms of this disease, it can be determined that the result of its course is determined by the peculiarities of the ordinary inflammatory process, the decisive role for which is assigned to the pathological processes of the chronic scale of the defeat of the nasal pharyngeal part.
Meanwhile, you should not miss the so-called essential( or genuine) atrophic pharyngitis, which acts as the primary constitutional disease, it, in turn, is a syndrome of systemic dystrophic disease of the gastrointestinal tract. Disease this leads to the hypotrophy of each of the structures of the gastrointestinal tract while reducing their functional characteristics. Actual dysfunctions in this case are gastritis( anatzidic, hypocidal), intestinal hypotonia, functional type of disturbance related to the activity of the hepatolienal system, etc.
Predominantly, these disorders, which may very well be characterized by a predisposition( congenital or acquired)in conjunction with the primary form of atrophic pharyngitis, and the manifestations of the latter may not have any specific infectious origin.
Accordingly, along with dyskinesia of the intestine and stomach, violations in the pharyngeal-esophageal region are also noted. This, in turn, leads to a completely explainable interest on the part of the doctor in determining atrophic pharyngitis of the actual features of the patient's gastrointestinal tract, and in most cases the patients can actually identify the presence of certain symptoms of the disease in this area.
As a result of such a connection, the opposite effect is not excluded, that is, with the effectiveness of a therapy specific for a patient, the state of the pharynx also improves, and sometimes it is not necessary to take any measures aimed at achieving this result.
It is noteworthy that chronic colitis can be accompanied by catarrhal pharyngitis, and already in this case the treatment should be complex, that is, focused on both diseases.
To diagnose a disease it is enough to consult a doctor for a routine examination of the oral cavity. It is possible that it will be necessary to collect( smear) the detachable, which is required to detect a particular type of pathogen in it.
Treatment of pharyngitis is symptomatic if, of course, the course of the disease is not accompanied by a general deterioration in the patient's condition. This implies a gentle diet and compresses to the front surface of the neck, hot foot baths, gargling, hot drink, inhalation.
Uncomplicated forms of the disease exclude the need for antibiotics. Local( and not systemic) antimicrobial therapy is performed. The purpose of antimicrobials can be made with orientation to inhalation, insufflation or rinsing, in addition, lollipops and tablets, anti-inflammatory, antiseptic, analgesic preparations can be prescribed.
The main criteria in the choice of drugs is their compliance with a wide range of activities( including antimicrobial and antiviral activity), low absorption of drugs from mucous membranes, a lack of toxic effect, reduced allergenicity and a complete absence of irritant effect on the mucosa.
To diagnose the disease, you need to contact an otolaryngologist( LOR), you can pre-visit the therapist, who will subsequently determine the general actions and specialists for subsequent counseling.
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