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8 surprising facts everyone should know about sore throats and earaches

Dr Nuala O’Connor shares the inside track on these two common symptoms.

Oct. 16, 2020

resist colds

THERE IS NOTHING more disappointing than waking up one morning, swallowing and wondering suddenly where did those razor blades come from?  But how much do most of us really know about what goes on near your tonsils, or within your ear canal, and how to get rid of pain as quickly as possible when things do go wrong there?

We spoke to Dr Nuala O’Connor, GP and Lead for Antibiotic Resistance with the Irish College of General Practitioners to find out more about what to do when pain strikes.

1. Sore throats are almost always caused by viruses

If heading to the doctor’s office for a prescription is your first port of call when aches set in, you actually might be better off heading to the pharmacy instead, for two reasons. Firstly, they are almost always caused by viruses, not bacteria, as Dr O’Connor explains:  Sore throats are generally caused by viruses so they usually come as part of another group of symptoms like runny nose, headache, cough, and earache. A small proportion (around 5%) is caused by bacteria named strep.  Be aware of the symptoms of COVID-19 and if you think you may be affected please stay at home and ring your GP for advice.

2. Don’t rule out glandular fever

One thing you should be especially careful of when it comes to sore throats is that it may be glandular fever. They will have a bad sore throat that comes back immediately when painkillers wear off, says Dr Nuala:

This tends to be most common in the 14-16 year old age group usually exposed to the virus from shared drinking vessels. It’s people who feel suddenly unwell, have white pus on their tonsils and feel very miserable and tired.  They will need a blood test to determine.

3. Most earaches get better with painkillers

As miserable as earaches can feel, using antibiotics to combat them is rarely a good idea, shares Dr O’Connor. In the best case scenario, they will only speed up your recovery by 24 hours and it is “quite appropriate to withhold antibiotics for an earache”.

For sore ears, about 20% are caused by bacteria (more likely if the infection is in both ears); the role of antibiotics for earache is questionable. They won’t reduce the chance of an eardrum bursting or lessen hearing issues. They also won’t relieve the temperature or pain as paracetamol and ibuprofen will.

4. You may need to adjust your diet for a sore throat

Along with giving your body 48 hours to recover from it, a severe sore throat might involve taking precautions with your diet to lessen the pain such as limiting food and drinks that are likely to worsen your throat pain says Dr O’Connor:  Drink lots of fluids and eat soft foods if you have a red raw throat – things like yoghurt and ice cream and avoid sharp toast for example. Very hot fluids may actually irritate it so stick to cold drinks.

5. These common illnesses can last longer than you’d think

Reckon a long-lasting symptom is a sign you might need an antibiotic? That’s actually a common misconception and sometimes you simply have to give your body the time it needs to recover. “A lot of people don’t understand how long common illnesses last” says Dr Nuala who gives us an idea:

The worst pain will go on for 48-72 hours. A sore throat will take 7-10 days to clear completely and there’s a similar timeframe for ears, which can take seven days to get back to normal.

6. Kids can be affected by earache

An infection causes extra fluid to stream into your ear canal and it can take a little bit of time for it to get absorbed. Children can have fluid in their ears up to three months after so when they get a fresh head cold, an earache can flare up again.

7. You shouldn’t always expect antibiotics when you visit your doctor

As the Lead for Antibiotic Resistance with the Irish College of General Practitioners, Dr Nuala isn’t shy about admitting that we have a problem with overprescribing antibiotics in Ireland. She’s joined by the President of the Irish Pharmacy Union who also recently shared his concern.  We use far more antibiotics than our European counterparts, prescribing about twice as many in Ireland as Scotland yet there’s no evidence that we are a sicker or more vulnerable population.

Dr O’Connor calls this a ‘societal problem’, and reminds that a visit to the doctor shouldn’t always result in a prescription:  Some people go to the doctor and if they don’t get given anything, they see it as a bad outcome. A good outcome is actually that you don’t need an antibiotic.

8. Unnecessary antibiotics can make you sicker

Taking antibiotics for a viral infection isn’t just ineffective, it can actually be dangerous for a myriad of reasons, highlights Dr O’Connor:  It can do you personal harm if taken when not needed – they can cause rashes, nausea, vomiting, diarrhoea, tummy upset and increase your resistance so the next time they may just not work for you.  If you’re worried, particularly about young children, there is never any harm in going to your GP and getting checked out, even just to ensure that you’re on track to recovering from a viral infection.

Feeling under the weather? Check out for practical advice on how to mind yourself or your family when you’re sick, including advice from doctors around the country. A collaborative effort from the HSE, GPs and pharmacists.

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