Treating a chronic sore throat

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Dear Dr. Klaper:
I have recently become a lacto-vegetarian, and I keep experiencing one sore throat episode after another. Do you have any ideas as to why this may be happening and perhaps some suggestions for the best way to treat a full-blown sore throat when it does occur? — D. T.

Dear D.T.:

Recurring sore throats in a dairy-consuming vegetarian raise several possibilities. The membranes lining the throat are well endowed with mucous-secreting glands.

Smearing dairy proteins, like casein and lactalbumin, on these sensitive throat membranes several times per day (in milk, yogurt, ice cream, cheese, etc.) may cause mucous to drip down the back of the throat, causing frequent swallowing and resulting inflammation. (The medical term for inflammation of the throat — the pharynx — is pharyngitis.)

Dairy proteins are not the only possible allergy-inciting culprit in foods — other proteins from soy, peanut, or wheat (or for that matter, most any other plant or animal protein in a given individual person) may incite a mucous drip — and resultant irritated sore throat.

If such a food-based allergy is suspected, eliminate that food for several weeks and see if the symptoms clear. Then, reinstitute the food and see if the symptoms recur. If so, plan to avoid that food, long term.

Another cause of frequent sore throat episodes is a chronic bacterial infection of the paranasal sinuses (spaces in the skull bones which make our voice more resonant and which connect into the nasal cavity).

Whether a case of acute or chronic infectious sinusitis is discharging bacteria-laden secretions down the back of the throat, is a question to be answered with the help of your physician.

Appropriate diagnostic tests (physical examination, scans, etc.) may need to be arranged to confirm or rule out this diagnosis.

Other serious causes of sore throats (tumors, etc.) can also be investigated at that time.

More commonly, your frequent sore throats are most likely a sign that the resistance of your throat tissues, as well as your general body immunity, has temporarily decreased — largely as a result of how you have been operating your body.

Popular immune-depressing forces include late night celebrations, hours spent in cigarette smoke-filled rooms, alcohol ingestion, prolonged exposure to air conditioning, an imbalanced diet (top-heavy with refined sugars, processed, salty, and excessively spicy foods, deficient in immune-enhancing fruits and vegetables), emotional stress, etc.

Such common immune-crippling features of Twenty-First Century life, may allow microbes that normally live in your throat — but which are usually prevented from causing infection due to your normally-healthy immune system — to take advantage of your now weakened defenses. Thus, while unwise choices and actions can open the door to frequent sore throats, better decisions can fortify us against them.

Once the sore throat is in full force, you can help your body overcome the problem by correcting the imbalances that fostered the sore throat as well as improving the local conditions in the throat tissues. Start by enhancing your immune status through:

(a) Getting enough sleep.

(b) Drinking enough (pure, room temperature) water.

(c) Eliminating any immune-damaging influences, e.g., cigarette smoking, refined sugar eating, etc.

Important: If your throat is very inflamed when you look in the mirror (red, swollen tissues, possibly with white spots on the tonsils), and if you feel systemically ill (chills, fever, muscle aches, etc.), you should see your doctor to determine whether your throat infection is caused by Streptococcus bacteria.

If any lab test your doctor performs confirms that you have a true ‘Strep throat,’ respect this microbe — it can cause serious damage to your heart valves and kidney (rheumatic fever).

If your physician prescribes that you take antibiotics for 10 days to thoroughly eradicate the streptococcus bacteria and help eliminate your chances for rheumatic fever complications, follow your physician's advice and take the antibiotics for all 10 days. At the conclusion of the course of antibiotics, restore the intestine's healthy microbial balance by consuming non-dairy, mixed-strain acidophilus bacteria before each meal for two to six weeks.

To help improve local conditions in the throat tissue, take advantage of an old fashioned remedy — gargling really works! Why? Gargling three to six times in 24 hours with warm salt water will:

(a) wash the throat membranes free of the overlaying mucous layer, which contains inflammation-inciting proteins, microbes (including Strep bacteria), etc., and

(b) dilate the blood vessels and bring the white blood cells, natural antibodies, any antibiotics, etc., to the throat area.

Gargling as described above, 2 to 4 times per day, usually results in a much more comfortable throat the following day. To prepare an appropriate solution for safe gargling, take a glass of warm water (only slightly warmer than room temperature) and add just a pinch of salt — just enough to make it taste slightly salty. Do not ‘pickle’ your throat membranes with too concentrated a salt solution.

A solution of healing herbs may also be used to gargle. Steep 1?3 teaspoon golden seal powder in 1 cup warm water, then strain, and gargle.

A litre of golden seal solution can be made and stored in the refrigerator between uses — 1 teaspoon of golden seal powder per litre.

Avoid gargling with hydrogen peroxide and/or tea tree oil, as these potent substances can actually injure the hypersensitive throat membranes.

To gargle, hold the glass of salt water in your hand, open your mouth, and take a deep breath in. Tilt your head back, slide a generous mouthful of salt water to the back of your throat, and, with your mouth still open, breathe out through the water. Continue until the end of the breath, and then expectorate the salt water into the sink. Repeat until the full glass of salt water is used.

Finally, remember that your throat membranes are inflamed. To avoid retarding their healing, do not do anything to inflame them further!

Do not burn your already-irritated throat membranes with heat! Until throat pain subsides, avoid hot soups, coffee, tea, etc.
Do not burn your inflamed throat membranes with acid liquids! Avoid orange juice, citrus fruits, pineapple, cola drinks or any liquid which is acidic in nature until your throat is pain-free.
Do not injure your throat membranes mechanically! Avoid scratchy foods such as potato chips, celery stalks, etc., until throat is pain free.
When your throat is very sore, it is not important to eat solid foods at all. Just keep up with your fluid losses by drinking at least two quarts of water daily.

When it is comfortable to swallow, soft, room temperature, non-acidic foods (peaches, carrot juice, non-citrus fruit smoothies, etc.) will aid healing.

4. When swallowing is comfortable, a daily, high-potency multivitamin tablet can help restore the body's metabolic balance. If you are going to take Vitamin C tablets, do not use a chewable form, which can make the throat more irritated.

If your physician suggests any anti-inflammatory tablets or injections, it is because they have been shown to markedly decrease the duration and intensity of the discomfort in your throat. Consider taking your M.D. up on her/his offer.

With very sore throats, gargling with viscous Xylocaine before eating can make mealtimes less agonising until the throat pain begins to fade. Ask your physician about this.

It helps to know that most sore throats subside almost completely within 24 to 72 hours of initiation of treatment.

If you are not experiencing such resolution of your sore throat in that time, check back with your physician.

Although presenting as a painful problem, listening to (and acting upon) the messages being sent to you by your recurring sore throats can benefit your overall health.

PHOTO (COLOR): Michael Klaper

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By Michael Klaper, MD, Director, Institute of Nutrition Education and Research

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