This list of reasons for your child’s sore throat can be rather long. Some of the more common reasons include infections (e.g. strep throat and other bacterial or viral causes), post-nasal drip from just a simple cold, allergy-related symptoms, and reflux (AKA GERD). And pending the cause of your child’s sore throat, the management will obviously differ. So while we ignore some of the rarer causes of sore throat and focus in on some of the more common ones I just mentioned, I’ll share some insight as to how we treat your child’s sore throat.

Strep Throat
Although a multitude of strep bacteria exist, one is particular causes the dreaded strep throat. The presentation of strep throat usually is with fever and sore throat (including difficulty swallowing) but without the cold symptoms (e.g. cough and runny nose) you would see from just your typical virus. Tummy pain and headache may accompany the symptoms as well and even some neck pain (from the swollen lymph nodes in the neck) may also occur. If one were to look inside the mouth, besides a red throat, there may be tiny red spots (petechiae) on the roof and back portion of the mouth and even the whitish patches (exudate) on the tonsils may be noted. When a rash accompanies strep throat, we call it Scarlet Fever but treatment is the same for both. In fact, treatment for strep throat usually involves a 10 day course of antibiotics. The reason treatment of strep throat is so very important is the complications from strep can be quite significant. In particular, one thing we like to avoid is something called rheumatic fever. Rheumatic fever occurs when nodules form in either your child’s joints, skin, or muscles, but most concerning is when they form on the heart muscle and the heart valves. This can lead to permanent scarring of the heart valves and, well, you probably can get an idea of how serious this might become. Problematic valves can ultimately lead to heart failure. So if any of the symptoms above (particularly without the cold symptoms) are seen in your child, please have him be seen by his physician.

Post-nasal drip from a simple cold
So often this is the reason for your child’s sore or irritated throat. What occurs here is the runny nose from your child’s cold is basically going down the back of your child’s throat…tickling or creating a scratchy feeling as it goes and ultimately creating an irritating cough. Now as I know many of you are aware, there is no specific antiviral medicine for colds. It is basically supportive care. So, depending on your child’s age, either suctioning or blowing of the nose, pushing the fluids, and maybe a popsicle or two, the only other thing to be tried is using a medicine to dry up the runny nose. But if unclear it is a postnasal drip triggering the throat irritation, we certainly encourage you to discuss with your physician so an appropriate diagnosis and treatment plan can be made.

Reflux (GERD)
Simply put, just think of the stomach acid flowing back up the esophagus (the tube that connect the throat with the stomach). The persistent flow of the stomach acid can generate an extremely irritated throat and even some hoarseness, but along with these symptoms, one may also have the feeling of heartburn or a sour taste in the mouth. There are a variety of medications that can be used and obviously we want to avoid any foods that may aggravate the reflux symptoms. So if reflux is the concern, please discuss further with your child’s physician on the best management plan.

Now an irritated throat from allergies tends to follow similar management as the post-nasal drip path and mononucleosis (caused by a virus) will have a sore throat that lasts for an extended period of time, but this covers the more common reasons your child may have a sore throat.

Would love to hear any of your questions?


Dr. Jeremy