Pharyngitis in adults

Overview

Pharyngitis is a sore throat caused by inflammation of the pharynx, the tube that connects your mouth and nose to your esophagus and windpipe. It is often due to a viral infection but can also be bacterial.

Yes, pharyngitis is very common. Almost every adult experiences a sore throat from time to time.

Adults of all ages can get pharyngitis, but it is more common in younger adults and those who are around many people, such as in schools or offices.

Symptoms

Common symptoms

• Sore or scratchy throat
• Pain when swallowing
• Dry or irritated throat
• Red or swollen tonsils
• Hoarseness or voice changes
• Mild cough

Symptoms in children

• Fever
• Difficulty swallowing
• Irritability or fussiness
• Loss of appetite
• Swollen glands in the neck

Symptoms in older adults

• Sore throat may be less severe
• Dry mouth or throat
• Hoarseness
• Difficulty swallowing (especially if other health conditions exist)
• General feeling of being unwell

Causes

Main causes

• Viral infections, such as the common cold, flu, or COVID-19
• Bacterial infections, most commonly group A Streptococcus (strep throat)
• Environmental factors like dry air, smoke, or allergies

Risk factors

• Close contact with someone who has a sore throat or cold
• Smoking or exposure to secondhand smoke
• Seasonal allergies
• A weakened immune system

When to see a doctor

See a doctor urgently if:

• If you have trouble breathing or swallowing
• If you cannot swallow your saliva
• If you have severe pain or swelling in your throat

Book a routine appointment if:

• If your sore throat lasts longer than a week
• If you have a high fever or pus on your tonsils
• If you have swollen, tender lymph nodes in your neck
• If you have a history of rheumatic fever or heart valve problems

Diagnosis

A doctor will ask about your symptoms, examine your throat, and gently feel the sides of your neck for swollen glands.

Tests that may be done

• Rapid strep test — a quick swab of your throat to check for group A Streptococcus bacteria
• Throat culture — a swab sent to a lab to confirm a bacterial infection if the rapid test is negative but symptoms are suspicious

What to expect at your appointment

The examination is usually quick and painless. The doctor may use a tongue depressor and a light to look at your throat. If a swab is needed, it may cause a brief gagging sensation. Results for a rapid test are available in minutes; a culture takes 24–48 hours.

Treatment

Treatment depends on the cause. Most pharyngitis is viral, so antibiotics will not help. Rest, fluids, and over-the-counter pain relievers are usually enough. If bacteria are found, antibiotics may be prescribed.

Self-care at home

• Rest your voice and get plenty of sleep
• Drink warm or cool fluids, like tea, soup, or water
• Gargle with warm salt water (a teaspoon of salt in a glass of warm water)
• Use a humidifier or sit in a steamy bathroom to moisten the air
• Suck on ice chips or throat lozenges

Medical treatments

If a bacterial infection is confirmed, a doctor may prescribe a course of antibiotics. Over-the-counter pain relievers such as paracetamol or ibuprofen can help reduce fever and soothe pain. Always follow the dosing instructions on the package or ask your pharmacist. Never take aspirin for a sore throat without a doctor's advice.

When is surgery considered?

Surgery is rarely needed. In cases of severe, recurrent tonsillitis (inflammation of the tonsils), a doctor may recommend a tonsillectomy (removal of the tonsils). This is considered only if infections are frequent and interfere with daily life.

Living with this condition

Most sore throats clear up in about a week. During that time, rest, drink plenty of fluids, and avoid irritants like smoke or shouting. You can continue your normal activities as long as you feel well enough.

Lifestyle tips

• Avoid smoking and secondhand smoke
• Use a humidifier to keep air moist
• Wash your hands often to prevent spreading the infection
• Replace your toothbrush after you recover

Diet and exercise

Eat soft, easy-to-swallow foods like yogurt, mashed potatoes, or soup. Stay hydrated. Gentle exercise, like walking, is fine if you have energy, but avoid strenuous activity until you feel better.

Mental health and emotional wellbeing

A sore throat can be uncomfortable and frustrating, but it is usually temporary. If you feel anxious about your symptoms or if they interfere with your daily life, talk to your healthcare provider. They can offer reassurance and advice.

Prevention

While you cannot always avoid pharyngitis, you can lower your risk by washing your hands regularly, avoiding close contact with sick people, not sharing utensils or cups, and keeping your immune system healthy with good sleep and nutrition.

Vaccines

Getting the annual flu vaccine can reduce your risk of flu-related sore throat. Other vaccines, such as those for COVID-19, may also help prevent viral infections that lead to pharyngitis.

Screening programmes

There is no routine screening for pharyngitis. If you have symptoms, your doctor will test only if needed.

Complications

If left untreated

• Untreated strep throat can sometimes lead to rheumatic fever, which can affect the heart, joints, and nervous system (rare in developed countries).
• Peritonsillar abscess — a collection of pus behind the tonsils, causing severe pain and difficulty opening the mouth.
• Ear infections or sinusitis may develop.

Long-term outlook

The outlook is excellent. Most people recover fully within a week, even without specific treatment. With proper self-care and medical guidance when needed, complications are very unlikely. Your body is well equipped to fight off the infection.

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