1. Do I Have Throat Herpes?
Also known as herpes esophagitis, herpes of the throat or esophagus is extremely rare, especially in otherwise healthy individuals. It is most commonly found in people with compromised immune systems, such as recipients of organ transplants, AIDS and cancer patients, and those being treated with radiation, steroids or chemotherapy.
2. What Is Throat Herpes?
Esophageal herpes can nonetheless be found in healthy people. There are two kinds of herpes: herpes simplex virus 1 (HSV-1), which is most commonly found in herpetic throat lesions, and herpes simplex virus 2 (HSV-2). HSV-1, previously known as mouth herpes, is the virus most often associated with the common cold sore, while HSV-2 is what used to be referred to as genital herpes. Today, doctors now know that either virus can infect the mouth or the genitals. What that means is, if oral sex is performed by someone with a cold sore, the recipient can in fact get herpes on the genitals. Unfortunately, most teenagers and adults still aren't aware of this.
3. What Does It Look Like?
Herpes of the throat usually appears in the form of painful, fluid-filled blisters that eventually rupture into sores. Symptoms can include burning, extreme difficulty swallowing, severe throat pain, upper chest pain when swallowing, fever, chills and (if left untreated) weight loss. Herpes lesions can be difficult to distinguish from other throat sores, and may be misdiagnosed due to their rare occurrence. Patients do not usually have other herpes sores around their mouth or lips at the same time of the throat outbreak, making diagnosis that much more difficult. A throat culture or biopsy is often required.
4. How Is It Treated?
Herpes is incurable. The medication used to attack the virus would do serious damage to the nervous system, where herpes lies dormant until an outbreak. Therefore, antiviral drugs can be used to kill off the virus only at the site of the outbreak. The most common drugs on the market to treat herpes are acyclovir, valaclovir and famcyclovir.
5. Will It Come Back?
For people with well-functioning immune systems, esophageal herpes usually runs its course naturally in a matter of three to five days. In others, it may take longer. Herpes esophagitis can also be treated with antiviral medication, though in severe cases, intravenous acyclovir may be recommended. The first herpes outbreak is almost always the worst--it's more painful and lasts longer than subsequent ones. Acyclovir has been found to reduce the virus in initial flare-ups, possibly cutting the number of recurring infections. However, recurrences of esophageal herpes are rare in patients with healthy immune systems.
