The American Academy of Family Physicians has long recommended that patients with strep throat avoid taking aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) until their strep throats are treated. If you have ever taken an NSAID, you know how painful these medications can be.
But what do these medications actually do?
What happens when you take them? And what happens if you don’t treat your strep throat?
How does oral pain relief work?
Aspirin is the most common type of NSAID, but not all NSAIDs are created equal. Aspirin itself doesn’t cause significant stomach bleeding or damage; it works by inhibiting a specific enzyme called cyclooxygenase, which is involved in production of certain inflammatory mediators. Inhibition of this enzyme means less inflammation, so taking aspirin relieves pain from arthritis or muscle strains without causing any major side effects.
By contrast, ibuprofen (Motrin) was developed as a stronger analgesic agent than aspirin. It’s also known for its ability to inhibit the same enzyme that aspirin helps to activate. However, there are some key differences between the two. First, only half of the dose of Motrin inhibits the enzyme (as opposed to one-third of the aspirin dose), so if you take two Motrin tablets instead of three aspirin tablets, you’ll likely get the same degree of pain relief. Second, Motrin works on more enzymes than just the COX-1 enzyme — including the COX-2 enzyme, which is important in maintaining healthy mucosal lining of the gastrointestinal tract. This means that while Motrin may relieve pain after surgery, it could also increase the risk of intestinal ulcers.
So why did the AAFP make such a big deal about avoiding NSAIDs when they were treating strep throat?
Many people who come into urgent care centers for treatment of strep throat report having already used NSAIDs before coming in for treatment. While it’s true that NSAIDs can help reduce the severity of symptoms of strep throat, they don’t cure it. They might even worsen it. So, unless you absolutely need them, doctors generally recommend against using them.
Why should you avoid taking NSAIDs when you have strep throat?
If you have been prescribed an NSAID, you’ve probably been told to wait at least 2 hours after your last dose before you go to the doctor. The reason is because the drugs are absorbed through the lining of the stomach and small intestine, and they work by blocking the activity of COX-1, which is found throughout the body. Since the bacteria responsible for strep throat thrive in the upper respiratory tract, where the lining of the throat is made up of cells that produce COX-1, the bacteria will be able to continue their growth right under the surface of your skin, too.
The danger lies in the fact that if you have an infection like bronchitis or pneumonia, then the NSAIDs will interfere with your immune system’s ability to fight off the infection. This can lead to further complications, such as superinfections.
To illustrate the point, here’s a chart showing the relative risks of developing serious complications of strep throat versus those of bacterial pneumonia:
Streptococcal pharyngitis: 1 in 500
Bacterial pharyngitis: 1 in 10,000
Streptococcal pneumonia: 1 in 100
Bacterial pneumonia: 1 in 200
While the risk of complications is higher for strep throat than for pneumonia, the difference isn’t huge. When it comes to strep throat, your odds of complications are still better than those of a cold. But when it comes to bacterial pneumonia, your odds of experiencing complications are significantly worse.
When you can’t wait to go to the doctor
Although antibiotics are usually safe to use during the earliest stages of strep throat, if you start to experience complications, the first line of defense is often an antibiotic like penicillin V or erythromycin, especially if you have allergies to beta lactam antibiotics. Your doctor will give you instructions for using over-the-counter decongestants or cough suppressants, but these medicines won’t necessarily help you feel better, so make sure you keep taking them until you feel better or see improvement.
If you really need something stronger than over-the-counter medications, consider calling your physician’s office and asking whether he or she can prescribe something like prednisone. Even though these steroids are powerful anti-inflammatories, they aren’t as potent as NSAIDs, and they’re less likely to lead to problems such as GI bleeding.
How can you tell if you have mistreated strep throat?
If you’ve had strep throat long enough to develop complications, you’ll notice that your throat feels thick and uncomfortable. You might also have difficulty swallowing, soreness or a burning sensation in your mouth, and/or fever. If you have any of these symptoms, you may want to call your physician immediately. He or she will determine whether your symptoms are due to complications of untreated strep throat and may decide to add another antiviral drug to your regimen or change the course of therapy.
In addition, if you have been taking NSAIDS regularly, you may find yourself developing a sore throat that comes back repeatedly and refuses to heal. In this case, your doctor may refer you to an otolaryngologist (ear, nose and throat specialist). Otolaryngologists are trained to perform procedures that can relieve blockage of the Eustachian tube. This condition can occur as a result of prolonged inflammation or scarring in the throat, so your doctor may recommend removing the tonsils or adenoids along with your tonsillectomy.
Finally, if you’ve had repeated episodes of strep throat, your doctor may recommend that you receive routine vaccinations, such as the pneumococcal vaccine. These vaccines protect against Streptococcus pneumoniae, a gram-positive bacterium that causes a number of different diseases, including meningitis, bacteremia (bloodstream infections), sinusitis, otitis media, pneumonia, sepsis and rheumatic fever. Because S. pneumoniae rarely affects adults, the pneumococcal vaccine is considered very effective and safe.
There are very common symptoms of strep throat which are throat pain, pain while swallowing, fever, rashes and many more. If you ever see any of these issues in your body then for you it is must to have a proper check up by a professional doctor. The doctor will give you medicines and you have to take them regularly on perfect time.