Sore Throat

Sore throat is a common symptom. Usually it is caused by relatively trivial infections of the upper respiratory tract, but there are also more serious causative conditions. This article aims to be a general overview, more information can be found in texts dedicated to individual pathological states.



Laryngitis is a common cause of sore throat. Usually it's a viral infection that also causes deepening of the voice, dry cough and acute hoarseness.


Pain usually occurs during swallowing. The tonsils are red, enlarged and covered with white or yellow coats. In modern times, thanks to antibiotics, tonsillitis is not too dangerous, but untreated it can be followed by a number of complications, including abscess formation or development of so-called rheumatic fever.

Infectious mononucleosis

This viral disease is very similar to streptococcal tonsillitis by its symptoms. It manifests by pain in the throat and with white coatings of tonsils. Antibiotics, however, are completely ineffective and aminopenicillin agents given to the patient with mononucleosis may even cause an unpleasant rash.


The uncomfortable feeling occurs by so-called esophageal reflux disease when acidic stomach contents flow back into the esophagus. Esophageal mucosa is damaged and this may be accompanied by unpleasant feelings of sore throat. Fast relief comes with use of antacids. Antacids are substances containing sodium carbonate that neutralizes acidity of gastric juice.


Allergic reactions, especially food allergies or allergies caused by inhaled allergens may result in irritation of nasopharyngeal mucosa and uncomfortable feeling of burning pain in the throat.


In developed countries it is a rare cause of sore throat. Diphtheria is an infectious disease of childhood age caused by bacteria known as corynebacterium diphtheriae. Bacteria cause severe inflammation of upper respiratory tract associated with formation of membranes that narrow airways. This may be fatal by choking the child. The disease incidence ha been significantly reduced due to vaccination program.

Cancer diseases

Tumors growing in cervical area, such as laryngeal and esophageal cancer may manifest by pain. However it must be noted that this is common rather for later stages of those conditions. These tumors are more common in smokers and alcoholics, but it is not a rule.


Goiter (enlarged thyroid gland) can cause problems like throat pressure and pain and swallowing troubles. That is due to pressure of enlarged thyroid gland on pharynx and esophagus. The actual enlargement of the thyroid gland tells us nothing about its function – it may be normal, increased, or decreased.

Heart attack

Even this eventuality must be allowed for. Although a myocardial infarction classically manifests with severe chest pain, this pain may irradiate to other body parts like into left hand, abdomen or into the throat.

Diagnostic approach

To ascertain the causes of sore throat, it is advisable to do medical history and examine mouth and pharynx by a spatula. A more detailed examination using special mirrors is usually performed by an otolaryngologist. To confirm infectious causes it is possible to take a local swab and send the sample for microbiological examination. If we have reasons to suspect a problem into digestive tract, endoscopic examination can be performed (esophagogastroduodenoscopy). In case of thyroid gland enlargement neck ultrasound can be used. To assess the extent of possible neck tumors computed tomography is performed.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources