A doctor's diary

Medical stories, health, and wellness


  • 21 Home Remedies for Sore Throat

    Sore throats refer to pain or irritation of the throat, which worsens during swallowing. The most common cause of sore throat is viral infections such as common cold, and flu. Therefore, sore throat is usually common during the cold season.

    Other causes of sore throats include: strep throat, chemical irritations, allergies, dryness, and gastro-esophageal reflux disease (GERD).

    Most sore throats resolve on their own within a week. They do not require antibiotic treatment and can be easily cured at home.

    However, strep throat, a sore throat caused by the Streptococcus pyogenes bacterium needs antibiotic therapy. This will prevent long term complications such as heart failure. See how a simple sore throat could lead to congestive heart failure

    Signs and Symptoms of Sore Throat

    The following signs may indicate a sore throat:

    • Painful or scratchy throat
    • A husky voice
    • Pain in the throat when swallowing or talking
    • Swollen tonsils
    • Swollen lymph nodes around the neck

    In other cases, a sore throat may be accompanied by the following:

    • A fever
    • Headache
    • Runny nose
    • Dry cough

    Note: A sore throat without a cough, or running nose, that is accompanied with high fevers could be a strep throat infection. Consult your doctor.

    Home Remedies for Treating Sore Throats

    When dealing with a sore throat, looking for treatment options that offer relief without causing further irritation is essential. Home-care remedies are easy to prepare and do not require expensive ingredients.

    1.     Apple Cider Vinegar

    Apple Cider for Sore Throat

    Apple Cider Vinegar is readily available in most home kitchens. It contains acetic acid, which helps in fighting bacteria. This makes it a perfect remedy for killing bacteria that causes sore throats.

    Directions for use:

    • Put warm water in a cup. Then put a tablespoon of apple cider vinegar and a tablespoon of honey. Mix and drink to help relieve painful throats.
    • Mix a cup of warm water with a tablespoon of apple cider vinegar. Gaggle the mixture for at least 2 minutes. Repeat this three times a day.
    • Put warm water in a cup and add two tablespoons of apple cider vinegar. Then add a tea bag and mix. Drink apple cider vinegar tea to reduce throat inflammation.
    • Apply a tablespoon of apple cider vinegar on the hands. Rub this on the throat area for 2 minutes. The smell of apple cider vinegar will provide relief for the sore throat.

    Caution: one should take apple cider vinegar in low quantities due to its acidic nature. It can erode the tooth enamel and the stomach lining.

    2.     Gargle Salt Water

    Salt is the most common kitchen ingredient in every home. Its availability makes it the go-to home remedy for sore throat. Also, salt is cheap and safe to use.

    To prepare a saltwater gargle, you only need two ingredients- salt and water.

    Directions for use;

    • Put warm water in a cup and add a tablespoon of salt. It is recommended to use warm water because it helps the salt dissolve easily.
    • Next, stir the salt to mix and gargle for at least 30 seconds. It is best to gargle the mixture at the back of the throat to get optimal results.
    •  After gargling, spit out the water and repeat this a few times. It is also safe to drink leftover salt water.

    Saltwater gargles are effective in extracting water out of the throat area, which reduces swelling.

    The salt also acts as a protective barrier, killing harmful bacteria and preventing more from entering the throat.

    Therefore, gargling warm salty water frequently during the day will reduce throat pain.

    Caution:  Salt water gargles should be moderated because drinking too much salt can lead to dehydration.

    3.     Honey

    Honey for sore throat

    Honey is perfect for curing sore throat because it contains anti-inflammatory benefits. It is a natural sweetener making it more preferred than other home remedies such as apple cider vinegar.

    Directions for use;

    • Put warm water in a cup and add a tablespoon of honey.
    • Stir to mix and drink the mixture.
    • To get better results, it is best to use raw honey.
    • Add a tablespoon of honey to the apple cider or salt water recipes to improve the taste.
    • Substitute sugar with honey when making tea. Drink honey tea regularly during the day.

    Honey also contains antimicrobial properties, which help fight off bacteria. It also aids in suppressing itchy throats and dry coughs.

    Caution: This remedy should not be given to children under one year since honey may cause infant botulism. Their systems still need to be fully developed to fight off the clostridium botulinum bacteria found in honey.

    4.     Lemon Water

    Lemon water for sore throat

    Lemons are effective in curing sore throats because they contain vitamin C. Vitamin C is essential for improving the immune system in its fight against infections.

    Directions for use;

    • Take a lemon and cut it into two.
    • Squeeze the lemon juice into a cup of warm water and drink.
    • Add lemon juice to salt water or honey remedies for better results.

    Lemons have antioxidant properties, which help reduce inflammation caused by a sore throat. Also, it breaks down mucus in the throat and promotes saliva production releaving the dryness caused by a sore throat.

    Caution: Lemon water is not recommended for people with gastric ulcers. Lemons are citrus fruits, and their acidic nature may lead to more stomach lining erosion.

    5.     Ginger Tea

    Ginger Tea for sore throat

    Ginger is a natural spice that is used to add taste to food. However, ginger can also cure sore throat because it contains gingerol.

    Gingerol has medicinal properties derived from its anti-inflammatory components. These are key in reducing swollen glands around the neck when one has a sore throat.

    Powdered ginger is readily available in stores, but fresh ginger is preferred when making ginger tea.

    Directions for use;

    • Take a fresh piece of ginger root and peel.
    • Cut into small pieces or grate finely.
    • Boil a cup of water in a pot.
    • Put the grated ginger in the boiled water and close the lid.
    • Let it soak for about 10 minutes.
    • Add one tablespoon of honey.
    • Add lemon juice, mix, and drink.

    Caution: Taking too much ginger tea can cause heartburn, bloating, and diarrhea.

    6.     Peppermint Tea

    Peppermint tea for sore throat

    Peppermint is a natural herb and cross-breed of water mint and spearmint. It is known to have medicinal value for treating headaches, digestive issues, and the common cold.

    Also, peppermint has a naturally sweet smell. It is used in making toothpaste because of its refreshing smell.

    Its anti-inflammatory and antibacterial components make it perfect for relieving sore throat.

    Peppermint tea bags are readily available at local stores. Alternatively, one can buy fresh peppermint leaves to grow their own.

    Directions for use;

    • Boil two cups of water in a pot.
    • After turning off the heat, add two peppermint teabags.
    • Alternatively, add a handful of peppermint leaves to the water.
    • Let the leaves boil for 3 minutes.
    • Strain and let it cool before drinking.

    Peppermint is naturally sweet, so the tea does not require one to add sweeteners. Apart from peppermint tea, one can buy peppermint candy at the store.

    Peppermint candy has menthol, which provides a cooling effect for an itchy, inflamed throat.

    Caution: Peppermint should be used in moderation as it can cause nausea. This usually happens when applied in its oil form.

    7.     Cinnamon Tea

    Cinnamon tea for sore throat

    Cinnamon is a refreshing spice loaded with several medicinal benefits. First, cinnamon has been used in Chinese medicine since ancient times due to its soothing effects.

    It has antibacterial, antiviral, and anti-fungal components, which boost the immune system to fight infections.

    Therefore, cinnamon is a great choice when dealing with bacterial infections which cause strep throat and the common cold.

    Cinnamon is readily available in local markets in herbal form or as a spice.

    Directions for use;

    • Put two cups of water in a pot.
    • Add cinnamon sticks and bring to a boil.
    • Cover with a lid and let it simmer down for ten minutes.
    • Add a sweetener such as honey or sugar.
    • Sieve into a glass and drink.

    The number of cinnamon sticks depends on one’s preference and the number of people.

    Caution: Cinnamon exists in two types: Cassia and Ceylon. Cassia should not be consumed in high quantities because it can damage the liver.

    8.     Marshmallow Tea

    Marshmallow plant for sore throat

    The roots and leaves of the marshmallow plant are widely used for medicinal purposes. First, the marshmallow treats skin irritation due to its anti-inflammatory effect.

    It is also effective in treating coughs and colds and fighting off infections. Therefore, marshmallow is one of the components used to make cough syrups.

    Also, marshmallow roots contain mucilage which helps to loosen mucus after a cold. It also helps to provide relief to an itchy throat.

    Directions for use;

    • Put 2 cups of water in a pot.
    • Add two tablespoons of marshmallow root. Marshmallow root is readily available at the store. Cut and sift well before adding to the pot.
    • Cover the pot with a lid and bring it to a boil.
    • Simmer on low heat for 15 minutes.
    • Turn off the heat and sieve the herbs.
    • Serve in a cup, and add honey as a sweetener.

    Alternatively, one can take a piece of marshmallow root and tie it to a piece of cloth. Next, immerse it in a jar of cold water and let it soak overnight.

    Remove the piece of cloth in the morning and pour the liquid into a cup. It is okay to drink it as it is or add a sweetener such as sugar.

    Drinking marshmallow tea frequently during the day helps soothe a sore throat. Marshmallow root and leaf tea bags are also found in stores and ready to make

    Caution: Prolonged use of marshmallow root may slow blood clotting. It has also been reported to lower blood sugar levels in some people.

    9.     Echinacea Tea

    Echinacea tea for sore throat

    Echinacea is a flowering herb used for medicinal purposes, mainly in Native America. Its healing properties boost the immune system and help to fight infections.

    It also contains active ingredients with antiviral and antioxidant effects. Thus, using it reduces flu, common cold, sore throat, and fever symptoms.

    Directions for use;

    • Put two cups of water in a pot.
    • Add two tablespoons of dried echinacea root.
    • Boil the water and then reduce the heat.
    • Let it simmer for five minutes.
    • Allow the tea to cool, then strain and serve.
    • Drink plain or add honey as a sweetener.

    Drinking echinacea tea enhances air flow into the throat and reduces swelling of lymph nodes around the neck.

    Caution: Avoid drinking echinacea tea if allergic to the herb. Also, the pungent smell of the echinacea herb can trigger nausea in some people.

    Echinacea tea can also cause stomach pain when taken in excess.

    10.  Sage

    Sage tea for sore throat

    Sage is a natural herb belonging to the mint family. It has a rich aroma, making it a preferred herb in various cuisines.

    Sage is full of antioxidants that improve the body’s immune system. It also has anti-inflammatory properties, which reduce swelling.

    The herb also has antimicrobial properties that are good for oral hygiene. Therefore, sage is a perfect herb for dealing with throat infections and dental plaque.

    In addition, one can combine echinacea and sage herbs to make a throat spray at home.

    Directions for making throat spray;

    • Boil two cups of water in a pot.
    • Add a tablespoon of sage and a tablespoon of echinacea to the pot.
    • Stir, close the lid, and let it soak for half an hour.
    • Strain the mixture and put it in a spray bottle.
    • Spray into the throat after every 2-3 hours.

    This homemade spray works effectively, and there is no need to buy an antiseptic spray. Sage can also make a tea that soothes the throat during flu season.

    Caution: People who are allergic or sensitive to sage should avoid using it. Pregnant and breastfeeding moms should not take sage or sage supplements.

    11.  Chicken Soup

    Chicken soup for sore throat

    Chicken soup is the go-to meal during the flu season. It is enriched with vitamins and nutrients which strengthen the immune system.

    The broth also works effectively to cure sore throats, depending on the ingredients used to make the soup.

    The following chicken soup recipe is easy to prepare and only takes 40 minutes from the comfort of your home.

    The ingredients needed are; 2 pieces of chicken breast, one red onion, two carrots, two stalks of celery, a piece of ginger root, six cloves of garlic, one potato, rosemary herb, pepper, and salt.

    Directions for use;

    • Place the chicken on a plate and season with pepper and salt.
    • Pour cooking oil into a pot and add the chicken. Cook each side for 2 minutes until well browned, then remove the chicken.
    • Cut onions, put into the pot, and cook till golden brown.
    • Add the ginger and garlic paste, then cook for 2 minutes.
    • Cut the carrots and celery, then add into the pot, mix and fry briefly for 2 minutes.
    • Add the chicken, diced potato, rosemary herb, salt, and pepper. Mix, add water, cover with a lid, and boil for 5 minutes.
    • Reduce the heat to medium and continue boiling for 20 minutes.
    • Once the chicken is cooked thoroughly, remove and shred.
    • Add the shredded chicken back to the pot and season to taste.

    Enjoy the chicken soup while still hot. Garlic has antibacterial and anti-inflammatory properties making it perfect for colds and sore throats.

    Chicken soup is a good meal when one feels under the weather and provides the body with much-needed fluids.

    The leftover chicken soup can be stored for later. However, it should be consumed within five days to ensure safety.

    Caution: It is vital to make sure the chicken is well cooked when making chicken soup. Consuming undercooked chicken has various side effects, such as diarrhea, vomiting, and abdominal pain.

    12.  Chamomile Tea

    Chamomile tea for sore throat

    Chamomile is a favorite herbal tea in many households.

    Studies about the chamomile herb have proven that it has anti-inflammatory benefits, which reduce swelling. Its antioxidant properties are helpful in soothing throat pain and reducing hoarseness.

    More studies have proven that chamomile tea has a calming effect on sleep and promotes better healing.

    Dried chamomile flowers and teabags are readily available at the local store.

    Directions for use;

    • Boil two cups of water in a pot.
    • Add the dried chamomile flowers, mix, and cover the pot. Let the chamomile steep for ten minutes.
    • Strain the tea and pour it into a cup.
    • Add a sweetener of your choice, such as honey, and enjoy.

    Chamomile also helps soothe stomach upset and infuses relaxation, which reduces anxiety.

    The leftover chamomile tea should be consumed within four days.

    Caution: Chamomile should not be mixed with alcohol because it can cause drowsiness. It can also trigger allergic reactions in some people.

    13.  Turmeric Tea

    Turmeric tea for sore throat

    Turmeric is a natural ground spice famously known for its bright yellow color. It adds flavor and color to various meals, especially curries.

    Additionally, turmeric has anti-inflammatory properties, which help reduce swelling. Also, the anti-oxidative properties of turmeric improve memory.

    Overall, turmeric boosts the body’s health and helps to reduce pain.

    Directions for use;

    • Put two cups of water in a pot.
    • Take a piece of raw turmeric and cut it into thin pieces.
    • Add the turmeric to the pot of water, mix, and simmer for five minutes.
    • Strain the mixture and pour it into a cup.
    • Add a tablespoon of honey as a sweetener (this is optional).

    To add more flavor to turmeric tea, add a stick of cinnamon or a thin slice of ginger.

    Caution: Turmeric easily stains surfaces and clothes; therefore, it should be handled carefully.

    Taking too much turmeric can also cause nausea and diarrhea.

    14.  Licorice Tea

    Licorice tea for sore throat

    Licorice is a herbal root used to treat various ailments for a long time.

    Research shows that licorice was used in traditional Chinese and Greek culture to treat stomach upsets and respiratory problems.

    Licorice root has antimicrobial and antibacterial properties, which aid in fighting off infections such as sore throat.

    Extracts from the licorice root are also used to relieve heartburn.

    Directions for use;

    • Pour two cups of water into a pot and boil.
    • Add ground licorice root and steep for 10 minutes.
    • Strain the mixture and pour it into a cup.

    Research about licorice has shown that it significantly reduces the risk of throat pain when taken before surgery.

    Caution: when taken excessively, licorice can lead to shortness of breath, headache, and high blood pressure.

    15.  Slippery Elm Tea

    Slippery elm tea for sore throat

    Slippery elm belongs to the elm tree species found in North America. It is used in traditional medicine to soothe a sore throat and aid digestion.

    Slippery elm coats the throat with a protective layer of mucilage, preventing further irritation.

    Directions for use;

    • Put two cups of water into a pot and boil.
    • Add two tablespoons of powdered elm bark.
    • Mix and let it steep for five minutes.
    • Pour into a cup, leave it to cool, then gargle for 2 minutes.
    • Repeat thrice a day for better results.

    Recent studies have also proven that slippery elm can help reduce inflammation in the airways.

    Slippery elm is also available in various forms, including; tablets, capsules, lozenges, powder, and tea bags.

    Caution: Applying slippery elm on the skin can trigger allergic reactions. Pregnant women should consult their doctors first before consuming slippery elm.

    16. Hot toddy

    Hot Toddy for Sore Throat

    A hot toddy is a simple home remedy made using three ingredients. These are water, lemon and honey.

    These three ingredients have proven to treat sore throats and flu infections when used separately. Therefore, combining them offers a quick and effect relief for sore throats.

    The magic of a hot toddy is hidden in the drink’s temperature. The drink should be hot so that it can clear nasal airways.

    Additionally, the vitamin C found in lemons helps the immune system fight against common cold.

    Directions for use;

    • Put two cups of water in a pot and boil.
    • Add two tablespoons of honey into a glass.
    • Add half a piece of lemon.
    • Pour the boiled water into the mug and mix well before drinking.

    It is recommended to drink it while still warm for best results. Also, most people add alcohol when making hot toddy but it is not safe.

    Caution: Avoid adding alcohol while making hot toddy because it dehydrates the body. When fighting infections such as sore throats, hydration is key for normal functioning of the immune system.

    17.  Lozenges

    Lozenges work and cure sore throats because they provide a cooling effect. Most lozenges are bought over the counter in local stores.

    However, one can use natural herbs to make lozenges in the comfort of their home kitchen. When making lozenges at home, the best herbs are marshmallow root and slippery elm.

    Directions for use;

    • One cup of water in a pot.
    • Add a tablespoon of powdered marshmallow root and mix.
    • Put two tablespoons of honey in a glass.
    • Add the marshmallow root solution and mix.
    • Put half a cup of slippery elm powder into a bowl. Add the solution of marshmallow root and honey to the bowl.
    • Knead the ingredients to form a smooth dough. Cut the dough into a small shapes like lozenges.
    • Dust the finished lozenges with slippery elm powder to avoid stickiness.
    • Put them on a plate and dry them for 24 hours.
    • Wrap the finished lozenges with waxed paper and store them in a cool, dry place.

    These lozenges can be stored for several months. It is best to make lozenges before the flu season to be ready whenever a sore throat occurs.

    Caution: Lozenges should not be used as a substitute for flu medication. If the sore throat persists, it is best to consult a doctor.

    18.  Fluids

    A dry, itchy throat usually accompanies a sore throat. In such cases, it is very easy to feel dehydrated.

    Therefore, drinking water and fluids make the throat feel much better. Fluids help to moisten the mucus membranes of the throat, which promotes healing.

    Also, drinking tea, soups, and warm beverages helps to thin mucus around the throat.

    19.  Steam Shower

    Taking a steam shower at home help in the humidification of the throat. When one has a sore throat, the throat tends to get dry and scratchy.

    The steam shower helps to moisten the mucus membrane in the throat area, which provides a soothing effect.

    20.  Rest

    When dealing with a sore throat, it is important to rest as much as possible. The vocal cords need to relax to reduce hoarseness.

    Therefore, avoid talking too much since it will make your sore throat hurt more.

    It is better to speak in low tones but not whisper because it will strain your voice and add to the soreness.

    21.  Use a Humidifier

    Turning on the home humidifier helps moisten dry air, which usually irritates the throat. Cleaning out the humidifier before turning it on is essential to eliminate any bacteria that may have accumulated.

    Moist air loosens the mucus membranes around the throat and nose. It also helps to reduce swelling around the throat, which provides a soothing effect on the throat.



    James, a 12-year-old boy, is propped up in bed. He is visibly struggling to catch a breath. The shortness of breath has been worsening progressively over the last couple of weeks.

    Basic activities such as walking to the bathroom, and washing his face leave him gasping for breath – like a person who just completed a two-hundred-meter sprint.

    His feet and stomach are massively swollen. The doctor said that a lot of fluid is accumulating in his body.

    A few meters away from him, his distraught mother is making endless phone calls. She is appealing to friends and family members to help her raise millions of Kenyan shillings that James needs for a valve replacement surgery.

    James has been diagnosed with Congestive Heart Failure (CHF) secondary to Rheumatic Heart Disease (RHD) – a disease that starts in the throat.

    James is just one of more than 30 million people across the world who are living with Rheumatic Heart Disease. More than 200, 000 people die annually from this preventable disease.


    Strep throat

    Strep throat

    “Strep throat” is a sore throat that is caused by a bacterium – Streptococcus pyogenes, also called Group A Streptococcus (GAS).

    When the bacterium attacks the throat, it leaves you with a painful throat that makes swallowing difficult. It can also leave you with a dry scratchy throat.

    Strep throat is most common in children aged between 5 and 15 years because:

    • Their ability to fight off infections (immunity) is not yet fully developed.
    • Community settings such as schools, and daycares promote the spread of streptococcus bacteria.
    • They are less likely to adhere to hygiene practices that reduce the spread of the streptococcus bacterium when compared to adults.
    • They have larger tonsils that make it easy for the bacterium to attack the throat.

    Strep throat is also common in immunocompromised people (people whose immunity has been lowered) such as:

    • People living with HIV and AIDs.
    • People on long-term steroid therapy.
    • Post-organ transplant people who are on immunosuppressive therapy.
    • People with both solid and hematological cancers.
    • People undergoing chemotherapy, or radiotherapy.
    • The elderly people, especially those living in nursing homes.

    Strep throat is just one of the causes of a sore throat. Other causes of sore throats include:

    1. Viral infections like common cold, influenza virus (flu), corona virus (COVID -19). Viral infections are associated with other symptoms such as nasal stuffiness, a running nose, headaches, and generalized body aches.
    2. Gastroesophageal reflux disease (GERD) – the acid in the stomach travels up the esophagus and corrodes the throat.
    3. Irritants such as chemicals, spicy foods, extremely hot or cold foods, alcohol consumption, tobacco smoking, and smoke.
    4. Allergies.

    Strep throat symptoms

    Strep throat symptoms

    Sore is the most common symptom of a strep throat. Other symptoms include:

    • Odynophagia, or painful swallowing. This occurs because the throat, and tonsils – that lie at the back of the mouth – become red, and swollen.
    • White patches, or streaks of pus, may be visible on the swollen, and reddened tonsils.
    • A fever of more than 101 F (38 degrees Celsius).
    • Chills.
    • Generalized body malaise.
    • Headaches.
    • Lymphadenopathy – Swollen lymph nodes at the neck region.
    • Nausea and vomiting may occur, especially in children who are aged less than 5 years.

    How is strep throat spread?

    Streptococcus pyogenes is a highly contagious bacterium. As a result, it is common in community settings such as schools, daycares, camps, and nursing homes.

    It is spread from one person to another though air droplets mainly. Droplets are released into the environment when an infected person, or a carrier coughs or sneezes. A carrier is a person who carries the Streptococcus pyogenes bacterium in their throat or skin, but do not show any signs or symptoms.

    Coughing is one of the main way through which strep throat is spread from one person to another. Photo by Towfiqu barbhuiya

    Strep throat is also spread through direct contact. Activities such as shaking hands, hugging, and kissing are common ways for spreading strep throat. Any form of skin-to-skin contact with an infected person or carrier facilitates the spread of strep throat.

    When infected people and carriers cough, the droplets are transferred to surfaces. Therefore, strep throat can be spread through contact surfaces such as door knobs. It can also be spread by sharing personal items such as drinking glasses, plates, and spoons.


    Strep throat progresses into congestive heart failure through three main stages:

    Stage 1: Development of rheumatic fever (RF).

    Stage 2: Development of rheumatic heart disease (RHD).

    Stage 3: Development of congestive heart failure (CHF).

    Development of rheumatic fever (RF)

    A strep throat infection develops into rheumatic fever if it is untreated or if it is undertreated.

    When the Streptococcus pyogenes (GAS) attacks the throat, it prompts the body to produce antibodies (chemicals that help the body to fight off an infection).

    Streptococcus pyogenes (GAS) contains a protein called M-protein. The structure of the M-protein mimics the structure of proteins found in the heart valves. It also mimics the structure of some proteins found in the brain, joints, and the skin.

    When the body produces antibodies against Streptococcus pyogenes, the antibodies mistakenly attack the heart valves, and other organs that contain proteins whose structure looks like the structure of M- protein in Streptococcus pyogenes.

    Rheumatic fever develops between one week, and one month of developing a strep throat infection.

    How do you know that your strep throat infection is developing into a rheumatic fever?

    • Left sided chest pain – Left sided chest pain is due to carditis (swelling of the heart tissues) due to attack by the antibodies.
    Left sided chest pains
    • Migratory joint pains – You will start to experience pain that moves from one joint to another. Often, one joint begins to feel better before the pain moves to another joint.
    • You may experience nodules under your skin. Skin nodules caused by rheumatic fever are painless, and freely mobile. They can be as small as a grain of finger millet, or as big as a marble. Typically, they occur at the back (along the spine), at the elbow, at the knee, and over the knuckles.
    Subcutaneous nodules for rheumatic fever
    Subcutaneous nodules at the back, along the spine
    • A skin rash on the arms, legs, and the trunk. The rash is usually spherical, reddish in color, and contains a white or pink center.
    Erythema marginatum
    Erythema marginatum, a rash associated with rheumatic fever.
    • Chorea – Purposeless, and uncontrollable jerky movements of the arms, legs, and the face.
    • Prolonged fever.

    Development of rheumatic heart disease (RHD)

    If rheumatic fever is not treated adequately, it leads to development of rheumatic heart disease (RHD). RHD occurs when there is permanent damage to the heart valves. The damage occurs due to attack by the antibodies that the body produces against Streptococcus pyogenes.

    The damage to heart valves is permanent. Valve replacement surgery is the only option for reversing rheumatic heart disease. Medications prescribed to rheumatic heart disease (RHD) patients are meant to relieve the symptoms of congestive heart failure.

    Development of congestive heart failure (CHF)

    Congestive heart failure occurs when the heart is incapable of pumping enough blood to all the tissues in the body. CHF happens when a part of the heart (in this case the heart valves) is not working properly.

    Some of the signs and symptoms of congestive heart failure include:

    • Difficulty in breathing/ Shortness of breath.
    • Exercise intolerance.
    • Persistent coughing and wheezing, especially with activity, or when lying down flat.
    • Bilateral lower limb swelling.
    • Palpitations, or an irregular heart rate.
    • Swelling of the abdomen.

    How do I prevent strep throat from progressing to congestive heart failure?

    Preventing yourself from contracting, and spreading strep throat

    Strep throat infection is a very common, and highly contagious disease. However, there are measures that can help you reduce the risk of contracting the infection.

    These measures include:

    • Personal hand hygiene. Streptococcus pyogenes can be found on contact surfaces such as door knobs, and tables that we touch every day. It is spread to the throat during eating and drinking. Washing hands with clean water and soap before handling foods reduces the risk of contracting the bacteria from contact surfaces.
    Hand washing
    Hand washing reduces spread of strep throat infection.
    • Washing your hands also prevents you from transferring the bacteria to contact surfaces if you are sick (You could also be a carrier).
    • Fruits, and other foods that are consumed raw should be washed with clean water and soap to kill the bacteria.
    • Avoid sharing drinking glasses, cups, plates, and spoons. Utensils should be washed with clean water and soap before they are used by another person.
    • Cover your mouth while coughing, or sneezing. This prevents spread of Streptococcus pyogenes through air droplets.
    Cover your mouth when coughing, or sneezing.
    • If you are infected, stay away from community settings such as schools, and daycares until your fever goes away.
    Masks help prevent transmission of streptococcus pyogenes bacteria
    Wear a face mask if you have been diagnosed with a strep throat infection.

    Adequate treatment of strep throat infection

    Strep throat infections should be treated with a course of antibiotics. The antibiotic of choice for treatment of strep throat infections is penicillin, or amoxycillin.

    Other antibiotics that are used for the treatment of strep throat infection include azithromycin , and cephalosporins such as cefotaxime and cefuroxime.

    The goal of treatment is to relieve symptoms, kill the streptococcus pyogenes bacteria, and prevent development of complications. Talk to your doctor about the diagnosis of strep throat infection, and the right antibiotic for you.

    Antipyretics like aspirin, acetaminophen, and ibuprofen will help you reduce fevers, and the pain caused by strep throat infection.

    You will feel relief 24 to 48 hours after starting your antibiotic treatment. However, antibiotics should be taken for the duration that has been prescribed by your doctor to prevent the development of antibiotic resistance.

    Strep throat infection is the only type of sore throat that needs antibiotic therapy. Other types of sore throats can be managed by painkillers, antipyretics, and home therapies.

    Strep throat infection
    Reddened and swollen tonsils, with white patches.

    Difference between strep throat, and other types of sore throats:

    • Strep throat comes with a sore throat without a cough, and cold symptoms such as a running nose, nasal stuffiness, and itchy eyes.
    • Strep throat causes red spots on the roof of the mouth.
    • Strep throat makes the tonsils at the back of the mouth red and swollen. The tonsils may also have a few white patches.

    Treatment of rheumatic fever

    The goals of treating rheumatic fever include: (a) Relieving symptoms (b)Treating a current strep throat infection (c) Preventing recurrence of strep throat infections and (d) preventing progression to rheumatic heart disease (RHD).

    Aspirin, and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are used to reduce pain, fever.

    Antibiotics (Penicillin, and amoxycillin) are used to treat strep throat infections.

    Steroids such as prednisolone are used to reduce the swelling (inflammation) caused by the attack by antibodies on heart valves.

    Secondary prophylaxis with intramuscular benzathine penicillin injections monthly for at least 5 years.

    Living with rheumatic heart disease (RHD)

    Rheumatic heart disease occurs when heart valves (especially the mitral valve) are permanently damaged. This damage occurs because the antibodies that our bodies produce attack both the Streptococcus pyogenes bacteria that causes strep throat infection and normal tissues such as the valves in our hearts.

    A diagnosis of rheumatic heart disease (RHD) may come as a shock, and leave you at a loss – not knowing what to do next.

    I do not know exactly what it feels like to receive a diagnosis of rheumatic heart disease; but having diagnosed and treated a few patients with rheumatic heart disease, I can offer a few tips that can help you navigate this difficult phase of your life.


    Your doctor will prescribe diuretics – to help your body get rid of excess fluid. When your heart is not working properly, fluid always accumulate in your body. This accumulation of fluid may make your feet, and abdomen swell from time to time. It may also accumulate in your lungs, making it difficult to breath – and make you lose your breath.

    While these drugs may not heal your heart valves, they help in preventing further deterioration of the condition of your heart. Therefore, it is important that you adhere to your doctor’s prescription to prevent your heart from further damage.

    In addition to the diuretics, your doctor may also prescribe anticoagulants. When your heart valve has a defect, you are at a high risk of forming blood clots in your heart. These clots could leave your heart when blood is being pumped out, and lead to more complications such as strokes.

    You will need a close follow-up at a cardiology clinic near you. Also, contact your doctor whenever you develop a symptom – however small. Avoid taking over-the-counter medications without contacting your doctor.

    Secondary prophylaxis

    Your doctor will recommend a monthly injection. The intramuscular benzathine penicillin injection prevents your body from other strep throat infections.

    Depending upon the severity of your rheumatic heart disease (RHD), you might need the monthly injection for life. If you have undergone surgery for rheumatic heart disease, or you were diagnosed with severe rheumatic heart disease, you will need the injection for a lifetime.

    When you adhere to these monthly injections, you reduce the risk of recurrent strep throat infections, and further damage to your heart.

    Joining a support group

    You may consider joining a support group. Support groups will connect you to other people who are living with RHD. These connections enable you to: (a) learn from first hand experiences of other victims (b) learn coping strategies, and (c) receive emotional support.

    However, be wary of taking medical advice from social support groups. Always discuss any medical decision with your doctor before hand.

    Also, contact a professional counsellor whenever you feel overwhelmed. You can schedule either an online or in-person consultation.

    Heart surgery

    If your heart failure symptoms are very severe, or are not responding to treatment, your doctor may recommend heart surgery. The heart surgery involves repairing the damaged valves, or replacing the damaged valve entirely with a prosthetic valve.

    Patients who have undergone valve replacement therapy must be on secondary prophylaxis with monthly penicillin injections for life. This prevents infection of the prosthetic valves, or repaired valve.

    Avoid strenuous activities

    If you have congestive heart failure (CHF) secondary to rheumatic heart disease (RHD) your doctor will exempt you from strenuous activities such as running, and heavy manual work.

    Your doctor will also exempt you from strenuous activities if you have undergone valve replacement surgery, or any form of open heart surgery.



About Me

A passionate medical doctor with special interest in research, surgery, and medical entrepreneurship. Loves writing!