People have come to accept sore throats as a part of life. Usually they aren’t an indication of anything too serious. But especially during the colder months, our emergency rooms in Longview and Tyler see plenty of patients struggling from sore throat complications caused by the flu or an infection: kids who refuse to eat or drink, teenagers with swollen glands, and adults with intolerable throat pain.

Although most sore throats can be treated with over-the-counter medications, about 40 million adults will see a doctor for strep throat alone. But there are other causes of sore throats besides the streptococcal bacteria that may require a doctor’s visit. And as common as sore throats may be, some causes may need to be taken more seriously than others.

What Causes Sore Throats?

Viruses: If you have a sore throat along with a runny nose, cough, sneeze, fatigue, aches, or pains, you likely have a virus. There are hundreds of viruses that cause sore throats and other cold and flu symptoms, especially during the winter time. Although most cases of sore throat caused by viruses are short lived, mononucleosis- commonly known as the dreaded “mono”- can cause symptoms that last up to four weeks. This infection is caused by the Epstein-Barr Virus (EBV).

Bacteria: As we touched on earlier, strep throat is an infection of the throat caused by the streptococcus bacteria. Although strep throat can happen to anyone, it is more common in children under 16 years of age. Strep throat isn’t normally a serious condition, but in worse-than-average cases, it can spread to other areas outside the throat, tonsils, or sinuses if left untreated. It may also cause an inflammatory reaction. Tonsillitis can also result from different types of bacteria.

Allergies: Your throat may also become irritated by different allergens in the air. Pollen, spores, mold, mildew, and other allergens can lead to postnasal drip, which is the main cause of allergy-induced sore throat. This happens when your sinuses become congested, causing tainted mucus to drain down the throat. Patients who experience throat issues from allergies may describe the sensation as “scratchy” or “raw.”

Acid Reflux: Acid reflux might not be your first guess as the cause of your sore throat, but there’s actually a condition called Laryngopharyngeal Reflux (LPR) that causes throat irritation and pain. Also known as “silent reflux”, the acid travels into the back of your throat and can make you feel like you have a sore throat that won’t go away. You may also feel like you have a lump at the back of your throat or feel the need to clear your throat all the time. Lifestyle habits such as smoking, alcohol consumption, caffeine, diet, and late night eating can all lead to acid reflux.

Cancer: Throat pain, hoarseness, and difficulty swallowing may indicate something more serious, like cancer. However, it is important to note that throat cancer is less common than other cancers. Throat cancer is often categorized as either pharyngeal cancer or laryngeal cancer. Pharyngeal cancer forms in the pharynx, the hollow tube that runs from behind your nose to the top of your windpipe. Laryngeal cancer forms in the larynx, also known as your voice box.

Do I Need Antibiotics for My Sore Throat?

While most bacteria respond to antibiotic treatment, viruses do not. So if your sore throat is caused by the flu or cold virus, antibiotics won’t work. To soothe the pain, you may want to try lozenges, over-the-counter medications, or gargling with warm salt water. But if you have strep throat, a doctor will likely prescribe antibiotics.

If you have school-aged children with strep throat, you should definitely seek medical attention before letting them return to school. Antibiotics may not make them feel better right away, but it can prevent the spread of strep to other parts of their body and to other kids. Antibiotics cannot always kill bacteria, especially in cases where they’ve grown resistant through excessive use or improper usage. When in doubt, consult your doctor to determine if antibiotics are necessary for your specific case.

Are Sore Throats Contagious?

A sore throat is a symptom of an illness or medical condition, so a sore throat itself is not contagious. The question you should ask is if the illness or medical condition that caused the sore throat is contagious. Obviously, some conditions like allergies, acid reflux, and cancer that may cause sore throats aren’t contagious, but viruses and bacteria are. Colds, flus, the Epstein Barr Virus, strep throat, and other bacteria and viruses are highly contagious, and most of these are spread by having contact with an infected person’s saliva. Nasal fluids can also transmit viruses, such as the cold, flu, and strep throat. The best thing to do is to consume an immune boosting diet and practice germ-prevention practices at work, school, and home to reduce your family’s likelihood of catching or spreading “the cooties.”

Why Do I Have a Sore Throat at Night?

While any of the conditions above can cause a sore throat that persists through the night, some people wonder why they get sore throats that only show up in the night time. This is actually more common than you think. To determine why you’re only getting sore throats in the evening, consider things in your environment that may be irritating your throat.

Does your heat or AC come on in the evenings? Your heating system can activate dust, pollen, and other allergens in your home and can aggravate your throat. On the other hand, cold, dry air from your AC can steal moisture from your mouth and nose, leaving your throat and nasal passages dry. Also, don’t underestimate the ability of outdoor allergens that can creep into your home. Pollen, smoke, molds and other irritants can make their way into your homes as your family members return from work and school.

A sore throat at night may also indicate reflux disease. If you go to bed soon after dinner, stomach acid activity in the esophagus can intensify. Acid reflux at night can also be the direct result of the types of foods you eat for dinner. Caffeine, alcohol, spicy foods, chocolate, mint, citrus, tomatoes, pepper, vinegar, ketchup, and mustard are just some of the foods you may want to avoid in the evenings.

When Should I See a Doctor for a Sore Throat?

If you have persistent sore throats, a sore throat that lasts for more than a week, or if you can barely tolerate your throat pain, you should seek medical advice right away. You want to be especially mindful with children who refuse to eat or drink. A doctor can advise you on effective protocols and pain medications to ensure your child is hydrated and nourished.