Talk:Pharyngitis
This article is rated B-class on Wikipedia's content assessment scale. It is of interest to the following WikiProjects: | |||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Pharyngitis.
|
old
[edit]Betadine is sold in Finland, but I think it is not suitable for gargles! Ioidine compounds can cause serious thyroid problems, when swallowed! 195.163.176.146 06:30, 5 February 2007 (UTC)
This previously very much a Wikipedia:Stub:Subhasish Basu.
- I have split viral from bacterial, placing the more common viral first.
- I have placed treatment above the causes, as together with the prior introduction this seems to set out the range of causes and self-help measures, so forming a nice low-level start to the article.
- Salt-water gargles are often suggested in articles, but seems little evidence that provide anything other than temporary relief (and can be dangerous if swallowed by young chidren).
- Virus I have tried to expand out and provide links, this still looks a little sparse so any contributions welcome :-)
- In particular I have tried add structure to streptococcal symptoms and complications and provided links to the evidence on the role of antibiotics - the Cochrane meta-analysis looked at 26 studies covering 12,669 cases.
David Ruben 19:54, 26 July 2005 (UTC)
Added information on Betadine and TCP gargles, but I don't know if these are available outside the UK. 138.250.16.16 13:56, 13 December 2005 (UTC)
- Betadine throat gargle is available in Australia as well - tastes horrid, but it is quite effective.
Will scraping off the bacteria (with a spoon) on the back of the throat help?--@ije
- That's a joke, right? I'm going to be unable to sleep tonight with images of spoons scraping away at the flesh at the back of the throat...--62.136.136.85 21:21, 5 February 2007 (UTC)
Am I the only one that thinks that when it says "There have been some studies that show ingesting a solution high in protein can have a profound relieving effect on sore throats..." there needs to be some example given? Right now it sounds like some kind of sexual innuendo. —Preceding unsigned comment added by 67.183.29.100 (talk • contribs) 19:52, 19 April 2007
- That's why its tagged as needing a citation - I can't find any obvious hit at PubMed to verify this and with the tag having been unanswered since February, time to delete the apparent nonsense. David Ruben Talk 23:31, 19 April 2007 (UTC)
I think that iodine should not be mentioned on this page; there is no evidence that it reduces duration of infection and no rationale for its use in symptom relief. ben 09:23, 16 June 2006 (UTC)
Voice loss/change?
[edit]I am by no means whatsoever at all any kind of knowledgeable person when it comes to... things like this, but I have had a sore throat for a while now and my voice has gone deeper and more... pasty when my throat has been worse. --62.136.136.85 21:19, 5 February 2007 (UTC)
Relation with smoking?
[edit]Can someone please add something about the relation of smoking with sore throats. I get it all the time :( --ExE 16:11, 16 July 2006 (UTC)
- Tobacco smoking weakens the immune system, probably having the most effect on the respiratory system, though I have no idea of the exact mechanisms behind it. The relationship should definitely be mentioned in the article, if an appropriate citation can be found. Richard001 19:58, 2 January 2007 (UTC)
Relationship with colds
[edit]Can something be said of the relationship between colds/influenza and pharyngitis? From my personal experience, and I assume it is the same for almost everyone else, colds and sore throats go hand in hand. Is this because the same virus is causing both symptoms, or does the presence of one weaken the bodies defenses in other areas, making it very easy for one to strike when the other is present? Richard001 07:54, 2 January 2007 (UTC)
- Interesting point, but lets move influenza out of this as it really is qualitatively and quantitatively different illness to what most people state as "having the flu" when they really mean "having a cold".
- Nasal congestion and irritation (coryza) do often present at the same time as a sore throat. Indeed the presence of a simultaneous cold as a presenting pharyngitis pretty much guarantees that the patient has a viral infection (90% of sore throats) as generally a bacterial pharyngitis does not present with coryza.
- I always have taken this to be one single illness (viral infection) presenting with a number of symptoms (runny nose, nasal irritation causing sneezing, temperature, sore throat, mild headache, mild generalised ache or tiredness), rather than different modes of illness (eg as bacterial tonsillitis is different from a bacterial urinary tract infection).
- Given that common self-limiting illnesses generally do not require conventional medicines (or they have little overall effect in recovery time), the area is ripe for speculation, pseudoscience and alternative medicine wishful thinking (hmmm there opens up a large can of worms), so ideas of weakened immunity are not I think based on any hard evidence as far as I am aware (HIV/AIDS is quite different from having a cold where the gums & tonsils will happily continue to fight off the host of normal oral bacteria, and the gut continues to prevent any number of nasty anaerobic bacteria - i.e. people with a cold do not enerally get bowel-based septicaemia. Furthermore the evidence is that people can cope with multiple vaccinations at a single time).
- Instead I always gathered that the cold virus went not for "the nose" but rather "upper respiratory tract epithelium", i.e. the nose, throat and upper airways. Hence a "cold virus" will generally affect the nose and the throat.
- What is needed here is of course some external source that we may research this from and cite & verify the information (rather than my half-remembered medical school lectures or acquired wisdom of clinical practice). So searching on PubMed for terms “Pharyngitis Coryza” gives many studies on which antibiotics are used, but little that seems to look specifically at the frequency of specific symptoms or combination of presentations.:
- "Understanding the symptoms of the common cold and influenza." PMID 16253889 informs us that "The mechanisms of symptoms of sore throat, rhinorrhoea, sneezing, nasal congestion, cough, watery eyes, and sinus pain are discussed, since these mechanisms are not dealt with in any detail in standard medical textbooks." - unfortunately full article is not freely available online.
- Interesting study on which viruses are involved (and that seems make little difference to symptoms) comes from "Frequency and natural history of rhinovirus infections in adults during autumn." PMID 9350748 (full PDF).
- “Rhinovirus infection of the normal human airway." PMID 7551410 is the article I think we seek as it gives in the abstract the sequence of viral infection, the chemicals released and the resulting symptoms – i.e. indicating that a viral cold may have sore throat as part of the same infection & illness process.
- Hope this helps, how much needs be put into the articles I am unsure. Obviously a "cold" is not the same as a "sore throat", the former is an illness category (an illness due to one of a number of viruses), the latter is really more of a symptom (which may be due to a virus, bacteria, or tonsillitis or indeed a referred pain from tooth or ear problems) David Ruben Talk 18:39, 2 January 2007 (UTC)
Image suggestion
[edit]A similar shot of a healthy throat would provide a useful comparison for those not used to seeing the well-lit backs of throats. --Dweller 15:41, 12 June 2007 (UTC)
Symptomatic Treatments
[edit]popsicles? peppermint candy? yogurt? Surely these are the result of someone's idea of a joke.—G716 <T·C> 04:25, 18 September 2007 (UTC)
- Milk seems to work well. I suspect yogurt would too. ⇌Elektron 11:22, 20 September 2007 (UTC)
I am going to add Chloroseptic style sprays here.Pink-thunderbolt (talk) 03:16, 13 December 2007 (UTC)
Cayenne pepper as a treatment
[edit]The Wiki article about Cayenne pepper suggests that it could be effective in treating this condition. Even though there appears to be no scientific proof for that claim there are numerous anecdotal reports to be found on the Internet (e.g. on earthclinic.com) which point in that direction. So it would probably be useful to list it along the other household remedies. —Preceding unsigned comment added by 87.175.91.160 (talk) 00:39, 3 November 2007 (UTC)
theoretically since Cayenne peppers contain capsaicin, a substance P depletor used to treat different types of pain, I would say this treatment is logical... albeit it would probably burn the throat significantly... and may cause choking due to inspiration... —Preceding unsigned comment added by 70.150.134.2 (talk) 05:47, 31 May 2008 (UTC)
Well, Cayenne peppers can cause a runny nose, maybe it helps release some of the phlegm. 88.105.126.96 (talk) 23:15, 26 October 2009 (UTC)
Re: Above two topics
[edit]This is all touchy feely pseudoscience rubbish. I recommend we stick with legitimate medical findings not herbal remedies, if any of this witchdoctery drivel worked we wouldn't have the medical industry, we'd turn to shaman everytime we got a disease. Jachin (talk) 19:51, 24 January 2008 (UTC)
Re
[edit]I don't know about the results of applying Cayenne pepper to cure a sore throat, but you certainly can't simply ignore herbal remedys as a whole. Milk has a soothing effect (treatment of symtoms), while things like onion or lemon juice supply the body with large quantities of vitamin C, thus helping it to cure itself. By the way, the most common source of pharyngitis - viral infection - cannot be treated with pharmaceutical products ( unless you want to get virostatical infusions ). So the only way is to prevent secondary infections and wait until the immune systeme has eliminated the virus. 87.188.239.107 (talk) 20:06, 7 October 2008 (UTC)
- We need research. Will work on referencing what I can find refers for and removing what I cannot find references for. Viral pharyngitis can be treated symptomatically. Doc James (talk) 13:50, 9 December 2008 (UTC)
Sore Throats caused by Screaming
[edit]I've noticed there isn't anything relating the cause of this on the Pharyngitis page. I am interested in why this happens. —Preceding unsigned comment added by 68.7.32.177 (talk) 19:06, 24 April 2008 (UTC)
Likewise
Predator106 (talk) 19:14, 24 September 2008 (UTC)
(sorry about the 1st edit, it was me but I forgot to log in, hate how wikipedia lets me stay logged in for only 30 days).
Lemon or Lime juice is for symptomatic relief... no benefit in killing off throat bacteria...
[edit]This statement, "Swallowing a couple teaspoons of raw lemon or lime juice several times a day may help destroy microorganisms in bacteria-related throat infections." needs to have a source... As a health care professional, this doesn't even make sense... even if the acidity could kill off the bacteria, it would not have enough contact time to do so... and if you could kill off any, it would be likely that you would kill off other bacteria which had colonized the throat... in turn hurting the patient even further by allowing the infectious organism or ANOTHER infectious organism to move in and claim the free space.
I will be monitoring this for the next few days and then will make changes unless a source can be provided. It sounds like a home made remedy without any basis in medicine. —Preceding unsigned comment added by 70.150.134.2 (talk) 05:41, 31 May 2008 (UTC)
Removal of unsourced info
[edit]Removed a lot of unsourced info that just confuses things. Still a lot of work needed on this page. Currently provides a poor overview of the topic.
Here is a 2000 review in the NEJM http://content.nejm.org/cgi/content/full/344/3/205
--Doc James (talk) 16:59, 9 December 2008 (UTC)
- I have removed:
- “Inflammation of the tonsils (tonsillitis) and/or larynx (laryngitis) occur simultaneously, which can make eating difficult or painful.” ‘’’Reason’’’: ‘’No source. Inflammation / tonsillitis may not always be the cause of a sore throat, hence proper reference required.’’
- ”Antiviral drugs ‘’’do not decrease the length of illness’’’ and are not used except in cases when the patient's immune system is compromised.” ‘’’Reason’’’: No source for this statement. And the Herpes Simplex virus is treated with antiviral drugs and can reduce the length of illness which contradicts this statement (unless we have some further information which pertains to another type of sore throat)
- I think it's important to highlight that every cause has it's respective treatment. Eventually, I think this article should explore the treatment of every cause and then reference the main article when appropriate. --CyclePat (talk) 15:23, 11 April 2009 (UTC)
- Would agree. Pharyngitis is just a symptoms like chest pain or abdominal pain. And should in the end be set up like those pages.--Doc James (talk · contribs · email) 18:54, 11 April 2009 (UTC)
- We also first of all need to divide it into acute and chronic as they are totally different.--Doc James (talk · contribs · email) 18:56, 11 April 2009 (UTC)
- I wouldn't go as far as splitting the article, quite yet, but yes... it is important to hightlight the differences and perhaps eventually have something that resembles those articles Chest pain or abdominal pain. ;) --CyclePat (talk) 17:17, 15 April 2009 (UTC)
- We also first of all need to divide it into acute and chronic as they are totally different.--Doc James (talk · contribs · email) 18:56, 11 April 2009 (UTC)
Chronic pharyngitis.
[edit]The article need more general information on the Chronic pharyngitis and comparison with Acute pharyngitis. --CyclePat (talk) 17:11, 15 April 2009 (UTC)
- Would agree. Changed the name to acute pharygitis as chronic pharyngitis is not dealt with at all.--Doc James (talk · contribs · email) 17:42, 15 April 2009 (UTC)
- I made it explicit in the lede that the article deals with the acute form, but this is only a makeshift solution. Either the page Pharyngitis should be a disambiguation page, or (my prefererred approach) the article should treat both acute and chronic forms, and then be moved back to Pharyngitis. --Lambiam 07:04, 29 May 2009 (UTC)
- As per concern about wp:precision regarding Acute (medical), i have kept the prefix. Once the article expanded for "chronic sore throat" as well, then we can move it to "sore throat". Regards, Doorvery far (talk) 09:39, 27 August 2009 (UTC)
Percentage ranges
[edit]Viral - "These comprise about 40–80% of all infectious cases" - What exactly does this mean - seems like a wide range? Kim Tucker (talk) 10:43, 17 February 2013 (UTC)
Move?
[edit]- The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.
The result of the move request was no consensus for move. –Juliancolton | Talk 16:10, 26 August 2009 (UTC)
Acute pharyngitis → Sore throat —
- Acute pharyngitis → Sore throat — Already redirect, but needs admin to move. Current title has only 41k google hits while 6.9M hits for the later. More common name, by huge margin. — Doorvery far (talk) 03:56, 19 August 2009 (UTC)
- Also the new title is mentioned and bolded in lead already. Doorvery far (talk) 04:02, 19 August 2009 (UTC)
- I suspect that "acute pharyngitis" is more specific than "sore throat"; best ask a doctor. Anthony Appleyard (talk) 05:11, 19 August 2009 (UTC)
- Article was initially "sore throat", then moved to "pharyngitis", then further to "acute pharyngitis". rev history of moves. Even if "acute pharyngitis" is sub-article, that can be considered merged into "pharyngitis". For info, only "pharyngitis" has 678k google hits. And indeed, the article can be moved back(reverted) by normal user once moved by admin. Doorvery far (talk) 05:46, 19 August 2009 (UTC)
- Support — WP:COMMONNAME, obviously
— V = I * R (talk to Ω) 06:30, 19 August 2009 (UTC) - Oppose WP:PRECISION. This is about acute pharyngitis, not all the things that can be described as a sore throat. The redirect is doubtless the best we can do for now; but the ideal solution would be for someone to write sore throat as a dab for them all. Septentrionalis PMAnderson 16:17, 19 August 2009 (UTC)
- I'm decidedly not an expert on medicine, but this article seems to cover the whole topic, of which "Acute pharyngitis" is just one aspect. The article probably needs expert attention to copy edit it properly, but that's no excuse to have the redirect/content backwards is it?
— V = I * R (talk to Ω) 19:51, 19 August 2009 (UTC)- Neither am I; but it says it doesn't cover the whole topic: The remainder of this article is about the acute form is in the second paragraph. Septentrionalis PMAnderson 20:33, 19 August 2009 (UTC)
- As for "precision", the acute (medicine) is just an adjective. If it is subset or sub-article of pharyngitis, it can be considered merged, and spinned out if it expands or deserves. If you look at history, the moves were sore throat -> pharyngitis -> acute pharyngitis. Also, the "remaineder of article is acute" is not verified, and when i go through the refs - only few of them refer as "acute" sore throat. Even that case it can further be moved to Acute sore throat(469k google hits) as consensus? Doorvery far (talk) 04:52, 20 August 2009 (UTC)
- Regardless of intent, this article apparently currently serves as Wikipedia's "Sore throat" article since Sore throat redirects here. If there is to be more specific sub articles from this one (such as an actually specific Acute pharyngitis article), then I think that we should allow that to happen on it's own. If the content of this article is lacking in some manner (which seems obvious) then that is certainly a problem, but it's not a problem which should be resolved by (failing to) move and rename the page. Content disputes != movereq requirements.
— V = I * R (talk to Ω) 09:59, 22 August 2009 (UTC)
- Regardless of intent, this article apparently currently serves as Wikipedia's "Sore throat" article since Sore throat redirects here. If there is to be more specific sub articles from this one (such as an actually specific Acute pharyngitis article), then I think that we should allow that to happen on it's own. If the content of this article is lacking in some manner (which seems obvious) then that is certainly a problem, but it's not a problem which should be resolved by (failing to) move and rename the page. Content disputes != movereq requirements.
- As for "precision", the acute (medicine) is just an adjective. If it is subset or sub-article of pharyngitis, it can be considered merged, and spinned out if it expands or deserves. If you look at history, the moves were sore throat -> pharyngitis -> acute pharyngitis. Also, the "remaineder of article is acute" is not verified, and when i go through the refs - only few of them refer as "acute" sore throat. Even that case it can further be moved to Acute sore throat(469k google hits) as consensus? Doorvery far (talk) 04:52, 20 August 2009 (UTC)
- Neither am I; but it says it doesn't cover the whole topic: The remainder of this article is about the acute form is in the second paragraph. Septentrionalis PMAnderson 20:33, 19 August 2009 (UTC)
- I'm decidedly not an expert on medicine, but this article seems to cover the whole topic, of which "Acute pharyngitis" is just one aspect. The article probably needs expert attention to copy edit it properly, but that's no excuse to have the redirect/content backwards is it?
- Oppose the Google argument; precision and medical names over google results... Sceptre (talk) 18:39, 20 August 2009 (UTC)
- ...I'm confused. "The Google argument?" You're opposed to a move because the name the page is being nominated to is receiving 168% more hits then the current article title?
— V = I * R (talk to Ω) 09:59, 22 August 2009 (UTC)
- ...I'm confused. "The Google argument?" You're opposed to a move because the name the page is being nominated to is receiving 168% more hits then the current article title?
- The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.
Move, cont.
[edit]An editor just moved the page, despite there being no consensus established above. I have therefore reverted the move. In addition, I also think the move is bad and that the article should keep the correct name. I have no problem with a new sore throat article. Verbal chat 09:50, 27 August 2009 (UTC)
- Agree with Verbal. This part should stay with pharyngitis. Doc James (talk · contribs · email) 10:56, 27 August 2009 (UTC)
- Yes, this is encyclopedia, not a doctor's handbook and doctors make for 1% of population. And please dont point me to medical related wiki policy, general policy wp:commonname comes above that. And if you go through ref's of the article without prejudice, you can see mention of 'acute sore throat'. I would go for dispute resolution RFC, soon. Doorvery far (talk) 13:43, 27 August 2009 (UTC)
- Sure feel free. Let me know when you do. Doctors are 3:1000 population btw.Doc James (talk · contribs · email) 14:06, 27 August 2009 (UTC)
Sore throat
[edit]Have come to the conclusion that sore throat is indeed the more general term with acute pharyngitis being a specific type. This paper for example talks about post op soar throat which one would not really call post op pharyngitis. Soar throat is a symptom well pharyngitis is more of a disease. Anyway will create this page.Doc James (talk · contribs · email) 17:02, 17 February 2010 (UTC)
Merge
[edit]The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
Tonsillitis and pharyngitis are sufficiently interchangeable that they should be discussed on one page not two. See this ref for example [2] and [3] Doc James (talk · contribs · email) 11:22, 12 October 2010 (UTC)
- Oppose Personally, I don't use the terms interchangeably (Tonsillitis may be grouped into pharyngitis, but not all pharyngitis is tonsillitis). Then again, it's not all about me. I can see your logic, but I can't seem to bring myself to support a merge, as the two infections, however similar they may be, are their own conditions with their own identifications. I would support a merge if the two were grouped together in disease classifications. Tyrol5 [Talk] 00:59, 13 October 2010 (UTC)
- They are frequently grouped together. What do you refer to by classification? This is a page from the Merck Manuel which uses "Tonsillopharyngitis" [4]. Doc James (talk · contribs · email) 04:42, 13 October 2010 (UTC)
- By classification, I mean the ID codes (e.g. ICD10). I can clearly see your logic, but I don't want to run the risk of confusing the reader. As for the Merck manual, I duly note its credibility, but I cannot agree to grouping it as 'Tonsillopharyngitis.' Depending on the severity of these two conditions, they can have drastically different treatments. Tyrol5 [Talk] 19:34, 13 October 2010 (UTC)
- They are frequently grouped together. What do you refer to by classification? This is a page from the Merck Manuel which uses "Tonsillopharyngitis" [4]. Doc James (talk · contribs · email) 04:42, 13 October 2010 (UTC)
- Oppose, per MEDMOS naming standards. --Arcadian (talk) 05:00, 13 October 2010 (UTC)
- Oppose. I don't use these terms interchangeably. Its certainly true that the two conditions can coexist, most commonly as a result of viral or bacterial URTI, but I do not believe that one necessarily implies the other. The two conditions have enough in common that both articles should have clear links to the other though, which they don't really seem to at the moment. Mattopaedia Say G'Day! 09:38, 13 October 2010 (UTC)
- If one reads the two pages though they could basically be the same. Same causes, same treatments, same symptoms, same prognosis, same complications. One could define the terms in a section on definitions and the rest would be the same.Doc James (talk · contribs · email) 17:23, 13 October 2010 (UTC)
- Depending on the severity of these conditions, the treatment/prognosis will be different. Your run of the mill case of pharyngitis typically will not require surgical care, unless it is part of an underlying chronic condition. On the other hand, persistent tonsillitis will oftentimes necessitate surgery. These key differences are the justifications for not merging the articles. My point is that they have key differences, regardless of their similarities, and are two separate conditions that, depending on the circumstances, will have different treatments and prognoses. Tyrol5 [Talk] 19:48, 13 October 2010 (UTC)
- Do you have any references to back this up?Doc James (talk · contribs · email) 05:30, 15 October 2010 (UTC)
- Depending on the severity of these conditions, the treatment/prognosis will be different. Your run of the mill case of pharyngitis typically will not require surgical care, unless it is part of an underlying chronic condition. On the other hand, persistent tonsillitis will oftentimes necessitate surgery. These key differences are the justifications for not merging the articles. My point is that they have key differences, regardless of their similarities, and are two separate conditions that, depending on the circumstances, will have different treatments and prognoses. Tyrol5 [Talk] 19:48, 13 October 2010 (UTC)
- If one reads the two pages though they could basically be the same. Same causes, same treatments, same symptoms, same prognosis, same complications. One could define the terms in a section on definitions and the rest would be the same.Doc James (talk · contribs · email) 17:23, 13 October 2010 (UTC)
- Oppose I don't use terms interchangeably.
- Whilst I agree overlap in discussing bacterial vs viral (aka antibiotics vs let nature take its course), and issue of strep complications, they are really of different areas (the primary picture in both articles are quite distinct).
- The ICD10 codes are different (probably a weak point).
- Severe tonsillitis is quite separate in management - a quinsy needs surgical incising & drainage, and rarely (but see one case and never forgotton) Lemierre's syndrome cautions against assuming that antibiotics are never needed. A bad pharyngitis just needs better selection/delivery (?iv) antibiotics.
- Finally recurrent occurances for tonsillitis gives rise to consideration for tonsillectomy, but this is never the case for just pharyngitis.David Ruben Talk 18:39, 13 October 2010 (UTC)
- WRT your last point this paper [5] title is "Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial" A quinsy is a tonsillar abscess which I agree is a different condition. Your tonsils are in your pharynx thus tonsillitis is a type of pharyngitis. When one types tonsillitis into uptodate the first page is "pharyngitis" [6] They also refer to it as Streptococcal tonsillopharyngitis. I agree that there are different ICD10 codes. They are next to each other. Doc James (talk · contribs · email) 23:54, 13 October 2010 (UTC)
- Comment I did not use these terms interchangeably either before studying the literature further. However much of the literature uses the terms interchangeably including: The Merck Manual, and Uptodate. Doc James (talk · contribs · email) 00:23, 14 October 2010 (UTC)
- Here the AHRQ discusses them together [7] Doc James (talk · contribs · email) 00:27, 14 October 2010 (UTC)
- This book chapter is "Pharyngitis (Pharyngitis, Tonsillitis, Tonsilopharyngitis, AND Nasopharyngitis)" Doc James (talk · contribs · email) 00:28, 14 October 2010 (UTC)
- The Guideline you refer to is titled "Tonsillitis and pharyngitis in children" - which therefore is distinguishing teh two as separate entities (else the title would be simply "Pharyngitis in children"). As for Chapter heading that too is clearly distinuishing - the main discussion clearly "pharyngitis" but it then sets out more precise categorisation with "Pharyngitis, Tonsillitis, Tonsilopharyngitis, AND Nasopharyngitis" - PS I like the last one, are we to include the common cold in this article too (most sore throats viral and usually at time of a cold) ? David Ruben Talk 21:17, 14 October 2010 (UTC)
Another ref says
- "Pharyngitis is subdivided into two categories: illness with nasal symptomatology (nasopharyngitis) and illness without nasal involvement (pharyngitis or tonsillopharyngitis)"[8]
- "Pharyngitis refers to infections of the pharynx and may also include tonsillitis, in which case the complex is referred to as pharyngotonsillitis."Rafei K, Lichenstein R (2006). "Airway infectious disease emergencies". Pediatr. Clin. North Am. 53 (2): 215–42. doi:10.1016/j.pcl.2005.10.001. PMID 16574523.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - The MESH lists tonsillitis as a subtype of pharyngitis.[9]
Doc James (talk · contribs · email) 05:24, 15 October 2010 (UTC)
- A Cochrane review just came out in Oct 2010 which states "Pharyngitis or tonsillitis, a throat infection that usually presents with a sore throat, is a common upper respiratory tract infection." and then proceeds to use the terms interchangeable throughout. It does not state "are" common URTI indicating that these two terms are a single entity. The full ref is van Driel ML, De Sutter AI, Keber N, Habraken H, Christiaens T (2010). "Different antibiotic treatments for group A streptococcal pharyngitis". Cochrane Database Syst Rev. 10: CD004406. doi:10.1002/14651858.CD004406.pub2. PMID 20927734.
{{cite journal}}
: CS1 maint: multiple names: authors list (link) emphasizing that pharyngitis is the preferred term. Doc James (talk · contribs · email) 22:04, 3 December 2010 (UTC)- Whilst an important review on choice of antibiotics, it neither further promotes or rejects the proposed topic merger.
- In common usuage, pharyngitis is used as a symptom description interchangeably with sore throat (accepting that not all sore throat is pharyngitis and might include herpetic ulcers over palate, uvulitis etc), but it is not generally used to signify anatomically an exclusive area/disorder.
- So given that most sore throats are viral, and most often occurs alongside symptoms of nasal irritation and congestion, in otherwords the common cold, then by extension of the proposal to be inclusive (and merely discuss aspects of some sub-feature in a side section - eg role of not using amoxicillin in tonsilitis in case condition may be glandular fever), then might we not merge whole lot with rhinopharyngitis? The overall management of most cases would be set out by symptomatic measures (rest, fluids, steaming/humidity & analgesia) and would merely give a side paragraph outlining the minority of cases needing antibiotics.
- A case of reductio ad absurdum I agree, but I think there are good grounds therefore for keeping closely related articles apart - the history of routine to now selective tonsillectomy alone should keep the major discussion about tonsillitis out of any article about a sore throat where the tonsils are not involved.
- PS rhinopharyngitis I see currently redirects to pharyngitis which is wrong as no mention is made of treating a viral cold. Nasopharyngitis redirects to Common cold. David Ruben Talk 17:03, 4 December 2010 (UTC)
- We do have a page of sore throat. Have corrected the redirect on rhinopharyngitis.
- A Cochrane review just came out in Oct 2010 which states "Pharyngitis or tonsillitis, a throat infection that usually presents with a sore throat, is a common upper respiratory tract infection." and then proceeds to use the terms interchangeable throughout. It does not state "are" common URTI indicating that these two terms are a single entity. The full ref is van Driel ML, De Sutter AI, Keber N, Habraken H, Christiaens T (2010). "Different antibiotic treatments for group A streptococcal pharyngitis". Cochrane Database Syst Rev. 10: CD004406. doi:10.1002/14651858.CD004406.pub2. PMID 20927734.
- Pharyngitis is in the literature used to refer to oropharngitis ( the tonsils are within the oropharynx ) and thus would be part of pharyngitis while the common cold effects the rhinopharynx and those would not be part.Doc James (talk · contribs · email) 17:13, 4 December 2010 (UTC)
- I agree as to what the terms should apply to (yet most of my patients who present c/o sore throat will in fact have just the common cold, with sore throat as but one symptom) - indeed they are different and so overly merging of topics may be inappropapriate :-) David Ruben Talk 01:21, 5 December 2010 (UTC)
- Thanks, James, for pointing me to the Cochrane review. I'd stopped watching this page a few weeks ago and didn't realise the discussion was ongoing. Having read that review, I can say that there's nothing in there that has given me cause to reconsider my opinion. The plain language summary bundles together the terms sore throat, pharyngitis, tonsillitis etc because its a plain language summary. To me, the implication of a plain language summary is that the language used is not precise, and this is done because the lay reader will no doubt have remembered various terms used in different contexts by different doctors and probably relate all of them under "sore throat" because that, subjectively, is what they experience; and they're aware doctors have a bunch of different names for "sore throat" perhaps without realising that we often use the different names to imply different things. This is also telling in the review when you look at their Medline search strategy and see they've expanded a lot of wildcard terms, especially tonsillo- and pharyngo- prefixes and similar combinations. They're looking for articles about antibiotic treatment of various "sore throat" conditions and their objective is to highlight the fact that there is very little need for antibiotics in the treatment of sore throat from whatever cause. I think this points out some of the difficulties in writing medical articles for wikipedia. We are writing for a lay audience, after all, and when doctors can't agree on nomenclature this certainly makes things difficult for the lay reader looking for information. So, what to do? I think that since "sore throat" is a symptom of a number of conditions, most of which are viral pharyngitis, rhinopharyngitis and tonsillitis, the Sore throat article should point out exactly that sore throat is a symptom that can be attributed to a variety of conditions, blah blah, most of which are self-limiting but there's some bad ones so see your doctor blah blah blah and then link to pharyngitis, tonsillitis, uvulitis, rhinitis, epiglottiits and something about tonsillar and other pharyngeal malignancies. I think these articles should be separate because they are not the same - pharyngitis may include tonsillitis, but the reverse is not true. Pharyngitis may also include uvulitis but the reverse is not true. Pharyngitis may be secondary to rhinitis or rhinopharyngitis, and conversely rhinitis or rhinopharyngitis may be secondary to pharyngitis, but this does not make them the same thing. Epiglottitis is also associated with sore throat symptoms and pharyngitis, but these also are not interchangeable terms. Because these terms have differing anatomical implications about the distribution of a pathologic inflammatory process of whatever aetiology, the articles should also link to each other to help the reader find more information on the scope of inflammatory conditions that can affect the upper aerodigestive tract. Unfortunately, I think the interchangeable term phenomenon seen in the medical literature around these conditions is nothing more than linguistic laziness, and because the authors are not careful with their terminology thay have propagated this amongst their readers. I think we should be careful to avoid this in wikipedia articles. Mattopaedia Say G'Day! 22:22, 7 December 2010 (UTC)
- I agree as to what the terms should apply to (yet most of my patients who present c/o sore throat will in fact have just the common cold, with sore throat as but one symptom) - indeed they are different and so overly merging of topics may be inappropapriate :-) David Ruben Talk 01:21, 5 December 2010 (UTC)
- Pharyngitis is in the literature used to refer to oropharngitis ( the tonsils are within the oropharynx ) and thus would be part of pharyngitis while the common cold effects the rhinopharynx and those would not be part.Doc James (talk · contribs · email) 17:13, 4 December 2010 (UTC)
Archived as no merge. Doc James (talk · contribs · email) 06:49, 8 December 2010 (UTC)
Note the swelling and redness
[edit]The image in the article sidebar is very clear and detailed but my knowledge is not. So, when challenged to Note the swelling and redness", I didn't have a mental image of a healthy throat to compare with. I can guess that it's not supposed to look so veiny and is that impression of the far wall being close to the opening a correct one? I have no confidence in my intuitions. Unfortunately, a web search for images of "healthy throat" turn up all sorts of manky looking gobs, including a fair selection of stretched and cropped versions of this very pharyngitical image! The throat and tonsils articles have, respectively, no image and am idealised drawing. But the human mouth articles, however, does have an image to compare with, which is shown here. 79.66.204.177 (talk) 13:47, 12 September 2016 (UTC)
- What is the question? Picture looks normal. Doc James (talk · contribs · email) 19:21, 12 September 2016 (UTC)
- Are you a medical doctor, Doc James? Such a background is very helpful when distinguishing "normal" from "not normal". The note above is about the experience of somebody who is not an expert on throats (normal or otherwise) finding the caption Note the swelling and redness less than useful given that there is no comparison model. The picture of a normal throat provided just above is that comparison for the picture in the article. 79.66.204.177 (talk) 22:16, 16 September 2016 (UTC)
- Yes an emergency physician. You are suggesting we add this photo as a comparison? If so sounds reasonable. Doc James (talk · contribs · email) 21:57, 18 September 2016 (UTC)
- Are you a medical doctor, Doc James? Such a background is very helpful when distinguishing "normal" from "not normal". The note above is about the experience of somebody who is not an expert on throats (normal or otherwise) finding the caption Note the swelling and redness less than useful given that there is no comparison model. The picture of a normal throat provided just above is that comparison for the picture in the article. 79.66.204.177 (talk) 22:16, 16 September 2016 (UTC)
- What is the question? Picture looks normal. Doc James (talk · contribs · email) 19:21, 12 September 2016 (UTC)