Chronic pharyngitis

Chronic pharyngitis is a disease in which persistent inflammation of the pharyngeal mucosa develops.

Chronic pharyngitis occurs in adults with periods of exacerbations and remissions.

Acute viral infections, chronic physical and mental overstrain, and a decrease in the body's defenses can provoke an exacerbation of the disease.

There are the following reasons for the development of chronic pharyngitis:

  • frequent respiratory viral infections,
  • undertreated cases of acute pharyngitis,
  • prolonged exposure to irritating substances on the mucous membrane of the pharynx, upper respiratory tract,
  • chronic inflammatory diseases (sinusitis, tonsillitis, dental caries, rhinitis),
  • diseases of the gastrointestinal tract (gastroesophageal reflux disease (GERD), pancreatitis),
  • conditions after tonsillectomy (removal of the tonsils),
  • alcohol abuse, tobacco smoking,
  • violation of nasal breathing (curvature of the nasal septum, polyps and adenoids),
  • use hot, hot foods.

There are three clinical forms of the disease in chronic pharyngitis:

  • catarrhal
  • hypertrophic (granular),
  • atrophic.

The catarrhal form of chronic pharyngitis is the most favorable in the course of the disease. In this case, inflammation of the superficial layers of the mucous membrane of the pharynx develops, characterized by moderate edema.

Hypertrophic form manifests itself in the form of growths of the mucous membrane of the pharynx (nodules, bumps).

Atrophic form is the most unfavorable form of chronic pharyngitis. At the same time, the pharyngeal mucosa becomes thinner and becomes dry. The treatment of this form takes a very long time.

Symptoms of chronic pharyngitis

If an adult has chronic pharyngitis, the following symptoms occur:

  • persistent sore throat,
  • sore throat,
  • foreign body sensation in the throat,
  • pain when swallowing,
  • dry, unproductive frequent cough,
  • presence of bad breath.

During the period of remission of the disease, the patient has only local signs of the disease. For the exacerbation of pharyngitis is characterized by the development of intoxication of the body (fever, weakness, malaise), increased local signs of the disease.

For the catarrhal form is characterized by the presence of more pronounced pain in the throat, which is aggravated after hypothermia, with viral infections, after overwork. When viewed from the mucous visible her hyperemia, swelling.

With the development of an adult hypertrophic or granulosis pharyngitis in the first place are complaints about the sensation of a foreign object in the throat. When granular form can be found random, chaotic growths of the mucous membrane in the form of nodules, elevations. And with a hypertrophic form, a thickening of the mucous membrane is observed without nodule formation.

In the atrophic form of chronic pharyngitis, the patient has mainly complaints about:

  • dry throat
  • hacking cough,
  • constant discomfort in the throat.

On examination, you can see the thinned mucous membrane of the pharynx, dry mucous membranes, crusts, small hemorrhages.

During exacerbations there may be symptoms of inflammation of adjacent organs (laryngitis, tracheitis, tonsillitis).

Diagnostics

Diagnosis of chronic pharyngitis is based on a thorough survey and examination of the patient.

Be sure the doctor conducts pharyngoscopy - examination of the pharyngeal mucosa.

At the same time, he can detect the characteristic signs of any form of chronic pharyngitis.

Thus, with the catarrhal form, the following changes in the posterior pharyngeal wall can be detected:

  • redness,
  • puffiness
  • small amount of mucus.

The presence of the following changes in the pharyngeal mucosa is characteristic of the hypertrophic form:

  • thickening, swelling,
  • developed venous network (stagnation),
  • in case of a granular hypertrophic form, nodules of red color up to 0.5 cm are also detected.

In the atrophic form, the following changes are found on the pharyngeal mucosa:

  • thinning
  • dryness,
  • crusts
  • minor hemorrhages
  • pale pink color.

To determine the causative agent of the disease take a scraping from the mucous membrane of the posterior pharyngeal wall, conduct bacterioscopic examination.

In general, a blood test during the remission of the disease may have no changes, and during an exacerbation, the general signs of inflammation (increase in leukocytes, ESR) are determined.

Treatment of chronic pharyngitis

Treatment of chronic pharyngitis is carried out by an otolaryngologist.

Treatment is carried out in an outpatient setting, hospitalization is not required.

Treatment should be carried out strictly under the supervision of a specialist, and it is necessary to strictly follow all prescribed recommendations.

First of all, it is necessary to eliminate all harmful effects on the pharyngeal mucosa:

  • exception of spicy, salty, hot, cold food,
  • inhalation of harmful, irritating substances
  • alcohol exclusion
  • to give up smoking.

For the entire period of treatment, it is recommended to observe abundant drinking regime.

It is necessary to maintain the humidity of the inhaled air in the room at a sufficient level (50-70%).

This can be done with the help of special devices - ultrasonic humidifiers, or by folk methods - you can hang wet sheets in the room, place containers with water.

Gargling with the following remedies has an effective therapeutic effect:

  • decoction of chamomile, sage, calendula,
  • Miramistin,
  • Rotokan,
  • Furacilin.

Antihistamines are prescribed to reduce tissue swelling:

Treatment of the pharynx is also used:

Local antiseptics are used:

Antibacterial drugs are accepted only for exacerbations of the inflammatory process with a proven bacterial nature. The following antibacterial agents are mainly used:

  • Amoxiclav,
  • Flemoxine Solutab,
  • Hemomycin,
  • Klacid
  • Cefixime.

Self-treatment with antibacterial drugs can, on the contrary, lead to the progression of the disease.

In the presence of granular hypertrophic pharyngitis, the following treatments are used:

  • Cautery silver
  • Laser coagulation (laser burning of pellets),
  • Cryotherapy (liquid nitrogen).

Be sure to receive drugs aimed at restoring the microflora of the pharyngeal mucosa:

In the treatment of atrophic pharyngitis produce the following methods:

  • removal of crusts from the mucous membrane,
  • lubrication of the mucous membrane of the pharynx sea buckthorn, peach, apricot oil.

Effective use for chronic pharyngitis inhalation oil solutions, for this you can use:

  • Peach oil,
  • olive,
  • rose oil,
  • menthol oil.

Applied and hardware methods of physiotherapy:

Complications

Incorrectly or unfairly treated pharyngitis is fraught with the spread of inflammation to neighboring organs with the development of the following diseases:

  • tonsillitis,
  • laryngitis,
  • tracheitis,
  • bronchitis,
  • regional lymphadenitis.

It is also possible the development of systemic inflammatory diseases:

The most serious complication of atrophic chronic pharyngitis is the transition to the malignant form - cancer.

Prevention

To preventive measures include:

  • quitting smoking and alcohol
  • avoid inhalation of harmful substances
  • timely and completely treat acute forms of pharyngitis, other inflammatory diseases of the nasopharynx,
  • treat associated diseases of the gastrointestinal tract,
  • rejection of spicy, hot, cold foods.

1. Instructions for medical use of the drug Sage lozenges

2. Allergic reactions - according to the instructions for medical use

Causes and risk factors

The causes of chronic pharyngitis can be both pathogenic microorganisms and the aggressive effects of adverse environmental factors.

The overwhelming majority of pathogens, most often provoking the development of an acute disease, which, when delayed diagnosis and incompetent treatment is transformed into a chronic form, are represented by the following viruses:

  • rhinoviruses (more than 80% of all cases of morbidity),
  • adenoviruses,
  • coronaviruses,
  • flu viruses and parainfluenza,
  • respiratory syncytial virus,
  • herpes simplex viruses type I and II
  • enteroviruses,
  • Coxsackie virus,
  • Epstein-Barr virus,
  • cytomegalovirus.

In some cases, viruses are peculiar "pioneers", creating optimal conditions for the activation of their own conditionally pathogenic microflora and the attachment of a secondary bacterial infection. More often inflammation of the pharyngeal mucosa is caused by neisseries, diphtheroids, green (non-hemolytic) streptococci, β-hemolytic streptococci, epidermal staphylococcus, corynebacterium (except for diphtheria), fungi of the genus Candida.

In addition to viral and bacterial agents, the cause of chronic pharyngitis can be a systematic exposure to aggressive physical or chemical factors:

  • ionizing radiation
  • dust,
  • volatile chemicals (toluene, formaldehyde, paint and varnish compounds, hydrocarbon processing products, etc.),
  • hot vapors and liquids
  • mechanical injury to the mucous membrane,
  • combustion products
  • allergens, etc.

The development of chronic pharyngitis contributes to the impact on the body of local and general risk factors, which include:

  • structural features of the mucous membrane,
  • work in hazardous production (metallurgical and other types of industry, involving work in the hot shop, coal mines, oil refineries, factories for the production of paints and varnishes, pesticides, fertilizers, etc.),
  • work in the rescue area,
  • smoking, alcohol abuse,
  • obstructed nasal breathing (allergic rhinitis, curvature of the nasal septum, polypous growths),
  • change of endocrine background (menopausal period, thyroid hypofunction, etc.),
  • hypo-or avitaminosis,
  • state of immunosuppression
  • diseases of the gastrointestinal tract,
  • general hypothermia,
  • the presence of severe chronic diseases (diabetes, kidney and heart failure, bronchial asthma, etc.),
  • the presence of chronic infection in the oral cavity or nearby ENT organs,
  • dry, hot climate,
  • unfavorable ecological situation
  • advanced age (age-related involutional changes of the mucous membrane).

Possible complications and consequences

Complications of chronic pharyngitis may be:

  • tonsillopharyngitis,
  • Eustachitis, labyrinthitis,
  • laryngitis,
  • paratonsillite,
  • paratonsillar, or pharyngeal abscess,
  • mediastinitis
  • malignant degeneration of the atrophic form of the disease,
  • secondary damage to the heart, kidneys, joints.

With timely diagnosis and complex treatment, the prognosis is favorable.

General information

Pharyngitis - It is an inflammatory process of the mucous membrane of the pharynx acute or chronic nature. Pharyngitis manifests itself with sore throat, discomfort and pain in the throat.

It is customary to subdivide pharyngitis into species according to the localization of inflammation. A person’s throat has three divisions - nasopharynx (upper section), oropharynx (middle department) and hypopharynx (bottom section). But such a unit in most cases will only be conditional, because with the development acute pharyngitis there is a diffuse lesion of the mucous membrane. The defeat of bacterial and viral infections occurs in a peaceful manner and is mostly downward. If the patient develops chronic pharyngitis, the inflammation occurs in one of the above departments of the pharynx.

Types of pharyngitis

The disease is divided into acute and chronicpharyngitis. In turn, given the etiological factor, emit viral, fungal, bacterial, allergic, traumaticacutepharyngitisas well as pharyngitis provoked by the action annoying factors.

Classification chronic pharyngitis carried out according to the nature of the changes that occur in the mucous membrane. Allot catarrhal (plain), atrophic (subatrophic) and hypertrophic pharyngitis. Quite often there is a combination of different types of pharyngitis. In this case, the mixed form of the disease is determined.

The most common acute pharyngitis is the catarrhal form of the disease with ARVI. In general, about 70% of pharyngitis occurs as a result of exposure to various viruses - coronaviruses, rhinoviruses, adenovirus, flu viruses and parainfluenza. Most often pharyngitis develops under the influence of rhinoviruses. However, a viral infection causes only the primary development of the disease, which later develops under the influence of a bacterial infection. In more rare cases, pharyngitis may develop under the influence of other viruses.

Causes of pharyngitis

Mostly pharyngitis in children and adults occurs due to inhalation of too cold or polluted air. Also provoke the manifestation of pharyngitis can some irritation by chemicals - tobacco, alcohol, etc. The occurrence of infectious pharyngitis occurs due to exposure to microbes - Streptococcus, staphylococcus, pneumococci. It also develops under the influence of a number of viruses and fungi. Sometimes the manifestation of pharyngitis causes the spread of infection from the center of inflammation located next to the pharynx. Often pharyngitis occurs in patients rhinitis, sinusitis, caries.

In some cases, the development of chronic pharyngitis occurs due to the presence of pathology of the gastrointestinal tract. This is possible with cholecystitis, gastritis, pancreatitis. Chronic catarrhal pharyngitis manifested as a consequence of getting the acidic contents of the stomach into the throat in a dream, if the person progresses gastroesophageal reflux disease. In this situation, it is important to initially eliminate the main disease. Also the cause of atrophic changes in the mucous membrane of the pharynx often becomes malignant smoking.

The development of pharyngitis is often observed in people who suffer from persistent breathing with the nose. The development of pharyngitis is directly influenced by constant mouth breathing and the effect of vasoconstrictor drops, which flow down into the pharynx.

Chronic pharyngitis also sometimes develops as a consequence of allergy, as well as in patients with various endocrine disorders, with diabetesas well as cordial, pulmonary and renalfailure.

Symptoms of pharyngitis

In the process of development of the disease in humans there are marked symptoms of pharyngitis. This disease is characterized by pronounced sore throat, a feeling of constant dryness and discomfort. The patient may complain about the presence of pain in the process of swallowing, which are most pronounced with an empty pharynx. Sometimes the development of pharyngitis is associated with severe general malaise, an increase in body temperature. If pharyngitis causes inflammation of the tubopharyngeal cushions, the patient may experience pain in the ears.In the process of palpation cervical lymph nodes the patient may feel their pain and increase. There is also hyperemia of the posterior pharyngeal wall and palate arches. However, tonsil inflammation that occurs when angina, not visible.

Very often acute pharyngitis is the first sign of a number of infectious diseases. Thus, it can occur measles, rubella, scarlet fever.

In chronic pharyngitis, there is no increase in body temperature, and the general well-being of the patient does not significantly deteriorate. A person constantly feels dry throat, tickling and a feeling of a lump in his throat, which makes him have a constant desire to clear his throat. Pharyngitis in a patient is persistent. dry coughwhich differs significantly from cough with bronchitis. The constant discomfort in the chronic form of pharyngitis also causes the need to constantly swallow the mucus that builds up on the back of the pharyngeal mucus. As a result, a person becomes very irritable, can not sleep properly and do ordinary things without being distracted.

Symptoms atrophic pharyngitis expressed severe dryness of the pharynx. Its mucous membrane is thinned, sometimes it is covered with dried mucus. Sometimes non-mucosal surfaces show injected vessels. For hypertrophic pharyngitis the presence of hyperplastic lymphoid tissue lesions on the back of the pharynx is characteristic. Tubopharyngeal cushions may also increase. During exacerbation of the disease, hyperemia and edema of the mucous membrane are added to these symptoms of pharyngitis.

Chronic pharyngitis in children is sometimes expressed not only by persistent dry cough, but also by the presence of wheezing. Therefore, during the examination, the physician should clearly differentiate this condition with bronchial asthma.

Pharyngitis treatment

If a patient has been diagnosed with acute pharyngitis or there has been a sharp exacerbation of the chronic form of the ailment, and there are no marked disorders in the general condition of the person, then symptomatic treatment of pharyngitis is used in this case. It is important for the patient to observe a certain period. dietwithout eating foods that irritate the mucous membrane. It should not be in the acute period to eat hot and very cold dishes, sour and salty foods. It is not less important to use a lot of fluid in order to activate elimination from the body. toxins. In the day you need to drink at least two liters of different drinks. Showing hot foot baths, holding warming packs, which are put on the neck in front. You can use steam inhalation, produced at home, as well as drink warm milk with honey. It is very important to quit smoking for the duration of the illness. With uncomplicated pharyngitis treatment antibiotics not practiced.

Sometimes the doctor prescribes local antimicrobial drugs, as well as antibacterial agents. For pharyngitis, an antiseptic is usually prescribed - it can be hexetidine, chlorhexidine, benzydamine, ambazon et al. Local anesthetics and essential oils are also used (tetracaine, lidocaine, menthol). Perhaps the use of drugs containing natural antiseptics, vitamins.

Antimicrobial agents are used for gargling, in the form of inhalation, insufflation, pills and lollipops. It is important that drugs that have a wide spectrum of action against microbes and viruses are applied to the mucosa. However, they should not be toxic, provoking irritation and allergic reactions.

Preparations in the form of lozenges for sucking are usually prescribed for milder forms of pharyngitis. It is important to note that most of these drugs include chlorhexidinewhich is a toxic substance. Therefore, it is impossible to prevent excess doses of drugs and their uncontrolled intake. The latter is especially true for children.

Some preparations containing, for example, propolis, derivatives iodine, sulfonamides may cause allergic reactions. Medicines that contain essential oils and herbal antiseptics can also provoke allergies in some patients.

In order to reduce pain in the throat, non-hot solutions can be used for rinsing. furatsillinaeasy solution potassium permanganate. Rinses during the acute period can be practiced every hour.

If pharyngitis occurs in a person too often, then this is direct evidence of problems with the body's defenses. Therefore, the treatment of pharyngitis should in some cases include correction immunity.

Therefore, to appoint the best drug for the treatment of pharyngitis should only doctor, guided by its antimicrobial activity, as well as the individual characteristics of the patient.

Pharyngitis classification

The main cause of pharyngitis is the inhalation of hot, cold or polluted air, the effect of chemical irritations. Infectious pharyngitis can be triggered by various viruses (influenza, adenoviruses) as well as microorganisms (strepto-, staphylo-, pneumococci), and fungi of the genus Candida. Pharyngitis often develops due to the spread of infection beyond the center of inflammation adjacent to the pharynx (sinusitis, rhinitis, caries). The cause of the disease can also be traumatic injuries of the pharynx - acute pharyngitis, which can occur after the removal of a foreign body or surgery.

Pharyngitis classification

Watch the video: Healthwatch: What's the cure for chronic strep throat? (December 2019).

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