Saturday, June 5, 2010

Cronis Pharyngitis

Overview

Sore throat, also called pharyngitis, is the inflammation of the pharynx (throat). The throat extends from the nasal passages above and behind the mouth to the esophagus (tube that carries food to the stomach) in the neck. Sore throat occurs most commonly with a viral upper respiratory infection (URI).

It is also symptomatic of a number of diseases, including:

diphtheria,
mononucleosis caused by Epstein-Barr virus,
gonorrhea, and
acute HIV infection.
Incidence and Prevalence

Approximately 40%– 60% of cases of sore throat are caused by a virus and about 15% are associated with Streptococcus infection (strep throat). In the United States, children typically average five sore throats per year and Streptococcus infection every 4 years. Adults typically experience two sore throats per year and Streptococcus infection approximately every 8 years.

The incidence worldwide is higher, possibly because of resistance to antibiotics caused by overprescription. Sore throat is more prevalent in winter, when respiratory disease incidence is highest. The incidence of pharyngitis and strep throat is highest in children between the ages of 5 and 18. Sore throat is rare in children younger than 3 years old.

Causes and Risk Factors

Viral upper respiratory tract infection that produces postnasal drip, such as the common cold, and seasonal allergies are the most common causes of sore throat. Organisms such as Streptococcus, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Neisseria gonorrhoeae cause bacterial pharyngitis. Infection is spread by person-to-person contact.

Risk factors include the following:

Coughing
Inhaling pollutants (e.g., household cleaners, automobile exhaust)
Other illnesses (e.g., diphtheria, mononeucleosis)
Seasonal allergies
Smoking and second-hand smoke
People with seasonal allergies to pollen often experience sore throat as a result of postnasal drip.

Signs and Symptoms

Swallowing may be difficult or painful and the throat may feel scratchy. The throat often appears red, swollen, or puffy, and may have white spots of purulent exudate (pus). Fever and cough are also common. Examination may reveal swollen tonsils (near the base of the tongue), which may also be covered with white or gray exudate. The lymph nodes in the neck often become swollen and tender.
Sore Throat Complications

Complications such as rheumatic fever (inflammation of connective tissue and joint pain), scarlet fever (fever with body rash), tonsil abscess, and glomerulonephritis (kidney disease) can result from untreated streptococcal infection. Severe pharyngitis associated with Corynebacterium diphtheriae and infectious mononucleosis can obstruct the airway and cause lower respiratory problems (e.g., pneumonia).

Longstanding infection of the tonsils (tonsillitis) can result in peritonsillar abscess, which affects the connective tissue of the tonsil.

Diagnosis

Diagnosis is made by examining the throat, observing its appearance, and feeling the neck for swollen lymph nodes. Because viral and bacterial pharyngitis can look the same, a throat culture is often used to determine if bacteria is present. The throat is swabbed with cotton and the sample is sent to a laboratory for culture and analysis. It takes more than 24 hours to obtain results. A rapid strep test may be performed and analyzed in the physician's office; results are available in about 15 minutes. This test is not as reliable and negative results must be confirmed by culture.

Treatment

Sore throat related to viral URI usually resolves without medication. Gargling with warm salt-water and taking acetaminophen (Tylenol®) may relieve pain and reduce swelling. Bacterial pharyngitis is treated with antibiotics.

If the tonsils have been chronically infected, they may need to be removed surgically (tonsillectomy).

Friday, June 4, 2010

Tips Eating

Eat a variety of nutrient-rich foods. You need more than 40 different nutrients for good health, and no single food supplies them all. Your daily food selection should include bread and other whole-grain products; fruits; vegetables; dairy products; and meat, poultry, fish and other protein foods. How much you should eat depends on your calorie needs. Use the Food Guide Pyramid and the Nutrition Facts panel on food labels as handy references.
Enjoy plenty of whole grains, fruits and vegetables. Surveys show most Americans don't eat enough of these foods. Do you eat 6-11 servings from the bread, rice, cereal and pasta group, 3 of which should be whole grains? Do you eat 2-4 servings of fruit and 3-5 servings of vegetables? If you don't enjoy some of these at first, give them another chance. Look through cookbooks for tasty ways to prepare unfamiliar foods.
Maintain a healthy weight. The weight that's right for you depends on many factors including your sex, height, age and heredity. Excess body fat increases your chances for high blood pressure, heart disease, stroke, diabetes, some types of cancer and other illnesses. But being too thin can increase your risk for osteoporosis, menstrual irregularities and other health problems. If you're constantly losing and regaining weight, a registered dietitian can help you develop sensible eating habits for successful weight management. Regular exercise is also important to maintaining a healthy weight.
Eat moderate portions. If you keep portion sizes reasonable, it's easier to eat the foods you want and stay healthy. Did you know the recommended serving of cooked meat is 3 ounces, similar in size to a deck of playing cards? A medium piece of fruit is 1 serving and a cup of pasta equals 2 servings. A pint of ice cream contains 4 servings. Refer to the Food Guide Pyramid for information on recommended serving sizes.
Eat regular meals. Skipping meals can lead to out-of-control hunger, often resulting in overeating. When you're very hungry, it's also tempting to forget about good nutrition. Snacking between meals can help curb hunger, but don't eat so much that your snack becomes an entire meal.
Reduce, don't eliminate certain foods. Most people eat for pleasure as well as nutrition. If your favorite foods are high in fat, salt or sugar, the key is moderating how much of these foods you eat and how often you eat them.
Identify major sources of these ingredients in your diet and make changes, if necessary. Adults who eat high-fat meats or whole-milk dairy products at every meal are probably eating too much fat. Use the Nutrition Facts panel on the food label to help balance your choices.
Choosing skim or low-fat dairy products and lean cuts of meat such as flank steak and beef round can reduce fat intake significantly.
If you love fried chicken, however, you don't have to give it up. Just eat it less often. When dining out, share it with a friend, ask for a take-home bag or a smaller portion.
Balance your food choices over time. Not every food has to be "perfect." When eating a food high in fat, salt or sugar, select other foods that are low in these ingredients. If you miss out on any food group one day, make up for it the next. Your food choices over several days should fit together into a healthy pattern.
Know your diet pitfalls. To improve your eating habits, you first have to know what's wrong with them. Write down everything you eat for three days. Then check your list according to the rest of these tips. Do you add a lot of butter, creamy sauces or salad dressings? Rather than eliminating these foods, just cut back your portions. Are you getting enough fruits and vegetables? If not, you may be missing out on vital nutrients.
Make changes gradually. Just as there are no "superfoods" or easy answers to a healthy diet, don't expect to totally revamp your eating habits overnight. Changing too much, too fast can get in the way of success. Begin to remedy excesses or deficiencies with modest changes that can add up to positive, lifelong eating habits. For instance, if you don't like the taste of skim milk, try low-fat. Eventually you may find you like skim, too.
Remember, foods are not good or bad. Select foods based on your total eating patterns, not whether any individual food is "good" or "bad." Don't feel guilty if you love foods such as apple pie, potato chips, candy bars or ice cream. Eat them in moderation, and choose other foods to provide the balance and variety that are vital to good health.