Strep throat is a common illness, with over 600 million cases each year worldwide. This article will discuss what strep throat is, including its causes, symptoms, and disease attributes. We’ll then discuss how to test for strep throat and conventional and integrative treatments.
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What is Strep Throat?
Strep throat is the result of an infection. Strep throat can occur in people of all ages, but it is commonly found in children aged 3-15 years old. Children under the age of three rarely get strep throat.
What Causes Strep Throat?
Strep throat is caused by the bacteria called group A Streptococcus (often referred to as group A strep for short). However, many viruses can cause a sore throat, too, which is why it’s essential to be seen by a doctor, as not all sore throats are strep throat. Only three out of every ten children with a sore throat have group A Streptococcus infection.
Strep Throat Symptoms
Symptoms of strep throat include:
- Fever
- Sore throat that may start suddenly
- Red throat
- Petechia (tiny red spots) on the roof of the mouth
- Painful swallowing
- Enlarged and red tonsils
- Pus or white patches on the tonsils
- Enlarged lymph nodes in the front of the neck
- Vomiting
- Nausea
- Stomach pain
- Headaches
- Rash
Some people who contract group A strep may be asymptomatic, meaning they will have no symptoms. This is important to note as even those who are asymptomatic can still pass the infection on to others.
Treatment of strep throat in symptomatic people is critical. For children, if left untreated, strep throat can cause rheumatic fever, which is an inflammatory condition that can cause permanent damage to the heart. Other complications of strep throat include sinus infection, ear infections, abscesses (pockets of pus) on or around the tonsils, and an inflammatory kidney disease called post-streptococcal glomerulonephritis.
How Long Does Strep Throat Last?
Once antibiotics are started, many people will begin to feel better within a day or two of treatment, and symptoms should completely resolve within seven to ten days after treatment begins.
Is Strep Throat Contagious?
Strep throat is a contagious illness that is spread through respiratory droplets or direct contact with an infected person. With respiratory droplets, group A Strep tends to inhabit the nasal passageways and throat. Thus coughing, sneezing, and even talking can spread the bacteria to other people, as individuals can inhale the droplets. This also means that if infected people share cups, utensils, plates, etc., they can spread the illness. If people touch things that have bacterial droplets on them and then proceed to touch their nose or mouth, they may also become infected. Because of this, daycare settings, schools, and military training facilities are great examples of breeding grounds for strep throat, as these places are often crowded with large groups of people. Rarely, strep throat can also be passed from food contaminated by someone with the illness. Once infected, strep throat symptoms manifest two to five days later.
What is Recurrent Strep Throat?
Recurrent strep throat, as its name implies, it's the phenomenon of continual strep throat infections. For children, the standard of care includes possible removal of tonsils (tonsillectomy) if the child experiences the following: more than seven strep throat infections in one year, five or more strep throat infections in one year for two years, or three or more strep throat infections in a year for three years.
How is Strep Throat Diagnosed: Functional Medicine Labs to Test for Patients Suffering From Strep Throat
Many functional medicine labs can help diagnose strep throat. A throat swab or blood test will be performed depending on the circumstances. Let’s look at the two most commonly used functional medicine labs in clinical practice for diagnosing strep throat.
Strep Throat Rapid Test and Throat Culture
A physician will take a history and do a physical exam on a patient with a sore throat. If strep throat is suspected, the back of the throat will be swabbed for a rapid strep test. This test is painless and can produce results in a few minutes. If positive, the physician will proceed with treatment.
Because of the risk of rheumatic fever in untreated strep throat in children, a negative rapid test result will be “double-checked” in children suspected of strep throat infection. To "double-check," the swab is sent to the lab for further evaluation and confirmation of the negative results. This type of test is called a throat culture and is a test offered by Access Medical Laboratories. Throat cultures are not routinely performed on negative tests in adults, as adults do not carry a risk of developing rheumatic fever from a strep infection.
Streptococcus Antibodies Profile
The body produces antibodies to strep usually a week after the initial infection. Suppose a patient presents with a condition that may have resulted from a previous strep infection- such as glomerulonephritis but was never diagnosed with strep. In that case, the physician may want to order strep antibodies.
Antibodies will tell the physician if the patient did indeed have a previous infection that was undetected at the time. In these cases, the strep antibody, antistreptolysin O (ASO), is checked in the blood. ASO BioReference Laboratories offers an ASO Titer test. The reference range for children is as follows: 6 months-2 years: less than or equal to 50 Todd units/mL; 2-4 years less than or equal to 160 Todd units/mL; and 5-12 years 170-330 Todd units/mL. Adult levels should be equal to or less than 160, and infants under six months should have levels similar to their mother’s.
Conventional Treatment for Strep Throat
Because of the risk for rheumatic fever, all cases of symptomatic strep throat will be treated with antibiotics. It’s important to take the exact dose of antibiotics your physician prescribes, including taking them for the entire recommended duration. This is important because even if the patient’s symptoms have subsided after a few days of antibiotic treatment, the bacteria may still be present in the body, leading to further complications. Over-the-counter fever and pain medications such as Tylenol or Ibuprofen may also be given for symptomatic relief.
Complementary and Integrative Medicine Treatments for Strep Throat
While antibiotics are used to treat the infection, many complementary and integrative approaches can help with symptomatic relief. Dietary changes and supplementation are a few we'll take a look at next.
Nutrition for Strep Throat Infection
Strep throat can cause painful swallowing; thus, appetite is likely to be suppressed, or the patient may be afraid to eat due to the pain. Soft foods, such as oatmeal, applesauce, and yogurt, and warm liquids, such as tea, can be helpful to ensure the patient is still receiving nutrients. Additionally, cool treats such as popsicles can help to soothe the pain.
Supplements and Herbs for Strep Throat Infection
Many supplements and herbs can aid in the healing process along with conventional medical treatments. Sage throat spray, vitamin D, and probiotics may be beneficial additions to an integrative medicine treatment plan.
Sage Throat Spray for Strep Throat
Sage is well known as a culinary herb. Sage has also been used medicinally throughout history in Chinese medicine, while Greece, Rome, and Native Americans also used it too. Studies have shown that sage throat spray may be effective at soothing a sore throat for those with strep throat. One study included 286 participants who had a sore throat and were given throat sprays with various concentrations of sage extracts over a three-day period. Results showed a throat spray with a 15% (140 microl sage extract) concentration was effective at reducing sore throat symptoms as compared to a placebo.
Vitamin D for Strep Throat
Vitamin D is a fat-soluble vitamin that is important for bone health, immune function, muscle, and blood sugar regulation. Vitamin D may also be associated with strep infections. Data suggests that vitamin D deficiency is correlated with an increased risk of infections from Streptococcus species, including strep throat. Evidence shows vitamin D may be helpful in eradicating strep infections due to its immune-stimulating and, thus, antibacterial properties.
Probiotics for Strep Throat
While probiotics may not directly affect strep throat infections, they should be included in treatment plans. Probiotics are supplements that aim to support the microbiome. The microbiome is a collection of bacteria, fungi, and viruses, that inhabit our large intestine. These microbes play a role in many body processes, including digestion and absorption, immune regulation, hormone metabolism, and more. Although antibiotics are necessary for strep throat infections, one of their side effects is antibiotic-associated diarrhea, as it seems they kill off microbes in the microbiome. Probiotics, supplements that contain strains of healthy gut bacteria, can help to repopulate the microbiome after antibiotic treatment.
A meta-analysis published in the Journal of the American Medical Association (JAMA) in 2012 included 63 randomized control trials of over 11,000 participants and showed that probiotic supplementation was associated with a reduction in antibiotic-associated diarrhea. A more recent meta-analysis published in the British Medical Journal in 2021, including 42 studies with over 11,000 participants, echoed those results and also showed probiotics had a “protective effect in preventing antibiotic-associated diarrhea.” Recommendations discussed in an editorial from the Journal of Family Practice include giving probiotics concurrently with and for the duration of antibiotic treatment.
Herbal Tea for Symptom Relief of Streptococcal Pharyngitis
Licorice, barberry, thyme, and oregano infusions have gained recognition as valuable ingredients for the development of functional beverages, biomedicine, and natural health products aimed at managing streptococcal pharyngitis. These herbs possess potent antimicrobial properties, making them effective against the bacteria responsible for causing the condition. Licorice root, known for its soothing properties, acts as an expectorant and helps alleviate throat irritation. Barberry, with its berberine content, exhibits broad-spectrum antimicrobial activity, including against Streptococcus bacteria. Thyme, rich in thymol and other antimicrobial compounds, can reduce inflammation and provide relief from sore throat. Oregano, packed with phenolic compounds and essential oils, displays strong antibacterial properties. Harnessing these botanical ingredients in infusions allows for convenient consumption, providing an opportunity to develop functional beverages, biomedicine, and natural health products that can effectively manage streptococcal pharyngitis while offering additional health benefits.
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Summary
Strep throat is a common condition that we may all endure at least once in our lifetimes, while many of us may contract it multiple times. Knowing what strep throat is, including its symptoms, can help us know when to see a physician for care. Conventional medicine treatment of antibiotics should continue to be used in all cases of symptomatic strep throat in children due to the severe sequelae of strep throat. Integrative medicine treatments can be wonderful additions to treatment plans and can aid in reducing the symptoms of strep throat and side effects of medications, including diarrhea.
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