Strep Throat and Sore Throats

Strep Throat and Sore Throats

Sore throats can be painful and annoying. Fortunately, most sore throats are caused by a minor illness and go away without medical treatment.

Several conditions can cause a sore throat or throat problems.

Viral infections

Sore throats may be caused by a viral illness, such as:

  • The common cold, the most common type of viral infection.
  • Infection of the voice box (laryngitis).
  • Mononucleosis (mono, “the kissing disease”), a viral infection that tends to cause a persistent sore throat.
  • Other viral infections, such as mumps, herpangina, or influenza.

Bacterial infections

A bacterial infection may also cause a sore throat. This can occur from:

  • Strep throat, which usually does not occur with congestion or a cough.
  • An inflammation or infection of the tonsils (tonsillitis) and sometimes the adenoids (adenoiditis).
  • An infection of the tissues around the tonsils (peritonsillar abscess).
  • Inflammation of the uvula (uvulitis).
  • In rare cases, a sexually transmitted infection (STI), such as gonorrhea or chlamydia. If you have engaged in high-risk sexual behavior, consider whether you may have gonorrhea or chlamydia. For more information, see the topic Sexually Transmitted Infections.

Irritants and injuries

A sore throat that lasts longer than a week is often caused by irritants or an injuries, such as:

  • Throat irritation from low humidity, smoking, air pollution, yelling, or nasal drainage down the back of the throat (postnasal drip).
  • Breathing through the mouth when you have allergies or a stuffy nose.
  • Stomach acid that backs up into the throat, which may be a symptom of gastroesophageal reflux disease (GERD). Although GERD often occurs with heartburn, an acid taste in the mouth, or a cough, sometimes a sore throat is the only symptom.
  • An injury to the back of the throat, such as a cut or puncture from falling with a pointed object in the mouth.
    Chronic fatigue syndrome, a condition that causes extreme tiredness.

Treatment for a sore throat depends on the cause. You may be able to use home treatment to obtain relief.

Because viral illnesses are the most common cause of a sore throat, it is important not to use antibiotics to treat them. Antibiotics do not alter the course of viral infections. Unnecessary use of an antibiotic exposes you to the risks of an allergic reaction and antibiotic side effects, such as nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill beneficial bacteria and encourage the development of dangerous antibiotic-resistant bacteria. For sore throats caused by strep, treatment with antibiotics may be needed.

What is sleep apnea?

What is sleep apnea?

Sleep apnea means that your breathing often is blocked or partly blocked during sleep. The problem can be mild to severe, based on how often your lungs don’t get enough air. This may happen from 5 to more than 50 times an hour.

This topic focuses on obstructive sleep apnea, which is the most common type.

A less common type of apnea, called central sleep apnea, can occur in people who have had a stroke, have heart failure, or have a brain tumor or infection. Even though this topic isn’t about central sleep apnea, some of the treatments discussed here may also help treat it. Talk with your doctor to find out more about central sleep apnea.

What causes obstructive sleep apnea?

Blocked or narrowed airways in your nose, mouth, or throat can cause sleep apnea. Your airways can become blocked when your throat muscles and tongue relax during sleep.

Sleep apnea can also occur if you have large tonsils or adenoids. During the day, when you are awake and standing up, these may not cause problems. But when you lie down at night, they can press down on your airway, narrowing it and causing sleep apnea. Sleep apnea can also occur if you have a problem with your jawbone.

In children, the main cause of sleep apnea is large tonsils or adenoids.

Sleep apnea is more likely to occur if you are overweight, use certain medicines or alcohol before bed, or sleep on your back.

What are the symptoms?

The main symptoms of sleep apnea that you may notice are:

  • Not feeling rested after a night’s sleep.
  • Feeling sleepy during the day.
  • Waking up with a headache.

Your bed partner may notice that while you sleep:

  • You stop breathing.
  • You often snore loudly.
  • You gasp or choke.
  • You toss and turn.

[/arrow_list_three]Children who have sleep apnea:

  • Nearly always snore.
  • May be hyperactive or have problems paying attention during the day.
  • May be restless during sleep and wake up often. They also may have problems with bed-wetting

[/arrow_list_three]But children may not seem very sleepy during the day (a key symptom in adults). The only symptom of sleep apnea in some children may be that they do not grow as quickly as most children their age.

Can sleep apnea cause other problems?

Having sleep apnea can lead to serious problems such as:

  • High blood pressure.
  • High blood pressure in your lungs.
  • An abnormal heart rhythm, heart failure, coronary artery disease (CAD), or stroke.
  • Depression.
  • Diabetes.

If you have sleep apnea, you also may not be sleeping as well as you could. If you feel sleepy during the day and this gets in the way of the normal things you do (like work, school, or driving), it’s important to talk to your doctor. Be safe. Do not drive while you are drowsy.

How is sleep apnea diagnosed?

Your doctor will probably examine you and ask about your past health. He or she may also ask you or your sleep partner about your snoring and sleep behavior and how tired you feel during the day.

Your doctor may suggest a sleep study. A sleep study usually takes place at a sleep center, where you will spend the night. Sleep studies find out how often you stop breathing or have too little air flowing into your lungs during sleep. They also find out how much oxygen you have in your blood during sleep. You may have blood tests and X-rays.

How is it treated?

You may be able to treat mild sleep apnea by making changes in how you live and the way you sleep. For example:

  • Lose weight if you are overweight.
  • Sleep on your side and not your back.
  • Avoid alcohol and medicines such as sedatives before bed.

If lifestyle changes don’t help sleep apnea, you may be able to use an oral breathing device or other types of devices. These devices help keep your airways open while you sleep.

Sleep apnea is often treated with a machine that helps you breathe while you sleep. This treatment is called continuous positive airway pressure, or CPAP (say “SEE-pap”). Sometimes medicine that helps you stay awake during the day may be used along with CPAP. If your tonsils, adenoids, uvula, or other tissues are blocking your airway, your doctor may suggest surgery to open your airway.

New Treatments & Children’s Risks

New Treatments & Children’s Risks

Published on July 21, 2014
By Melissa A.M. Hertler, MD, Director of the Allergy Program at Wheaton Franciscan – Sinus Care Institute in Wauwatosa.

Are New Allergy Treatments Available to Replace Weekly Allergy Injections?

Yes. For treatment of allergy symptoms, there are now 3 FDA-approved sublingual tablets (tablets that dissolve under the tongue) that contain either grass pollen antigen or ragweed pollen allergen. These are taken at home, every day, rather than at the doctor’s office. They are designed as an alternative to injections of these pollen antigens (allergy shots), and are nearly as effective.

In Wisconsin, there are many people with allergies to more than just grass or ragweed pollens, because there is an abundance of different kinds of pollens from early Spring until late Fall. There are sublingual allergy drops (a liquid that is made by an allergist) that contain one or several different allergens and are given daily under the tongue at home as well.

These drops can contain pollen allergens, or dust, mold or even pet dander. Again, they are nearly as effective as allergy shots, and are a good alternative for adults who fear needles, or cannot make it to the doctor’s office for weekly injections, as well as for children.

Sublingual allergy drops have been used in Europe for many years, and have shown to be an effective alternative with more convenience and less risk of a reaction to the allergen than with injections.

Why is the First Year of Life Critical for Asthma and Allergy Risks?

The first year of life is a critical period in the development of the immune system, especially its ability to recognize the difference between self and non-self, as well as the development of allergies and asthma.

The biggest risk for the development of allergies and asthma seems to be your family history, in that there is a genetic predisposition to atopy, or an allergic state, which seems to arise only after exposure or sensitization.

The newest data available seems to support the protective effect of some allergen and bacteria exposures within the first year of life, on the later development of asthma and allergies. The allergens that were most protective were cockroach, mouse and cat in the house dust samples, as well as exposure to certain bacteria.

Previous studies have shown that children that are raised on farms have a lower risk of allergies and asthma, while children raised in urban environments (primarily inner-city) have much higher risks of developing asthma and allergies, but none was able to explain a straightforward relationship between allergen exposure and later development of allergies and asthma.

It is becoming evident that it is most likely a combination of the right exposures at a critical time in the development of the immune system that is most important in developing protection from allergies and asthma later in life. There is a scientific hypothesis or theory that is being studied that purports that there is an increasing rate of allergies and asthma as a direct result of decreased exposures as young children to bacteria, parasites and other infections because of our improved hygiene and cleanliness of our homes. This is called the “Hygeine Hypothesis.”

What Can Parents Do About Allergy Symptoms?

As a parent, one wishes to protect our children from infections and exposures to dirt and germs; however, it appears that there may be some benefit to early exposure to some pet and rodent dander, cockroach allergens and bacteria with respect to the later development of allergies and asthma.

There are many factors that contribute to the overall risk of a child, and there are some factors that may be more readily controlled. It is known that childhood exposure to tobacco smoke within the home is a risk factor for the development of asthma, as is exposure to indoor and outdoor pollutants. More studies need to be done to help figure out what the right combination of allergens and germs are to help shape the immune system to prevent allergies and asthma, but we don’t know that answer yet.

As practical advice to parents, it’s prudent to avoid exposing your child to tobacco smoke or significant pollution, and although we don’t know the exact mechanism or combination of allergens and bacteria, a little dirt won’t hurt!


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