A sore throat is a miserable thing to deal with. We do not realise how many times we swallow during the day until every swallow becomes a painful task. Gargling has been the age old home remedy for sore throats across the world. So much has been advocated about gargling by our elders, literature and the internet that it seems to be the infallible solution for all our throat problems. But, is this notion really correct?

The experience is teaching us something different, a difference that cannot be ignored. On one hand, we do see patients benefitting from gargling, while others may not show any benefit. Then there are patients whose symptoms even worsen with the gargling. So we are compelled to wonder:

Q: Is the age old belief really true?
Q: Is it always true?
Q: What has changed?

Continuous opening and closing vocal cord allows the air to escape intermittently. When this happens in speed, air bubbles through the liquid in throat, creating gargling.

To answer our above questions, we need to understand the basics and the science behind the gargling.

Gargling, by definition, is an act of holding a liquid in the mouth or throat and agitating with air from the lungs causing it to bubble and flurry. Such air agitation is created by continuous opening and closing of the vocal cord in high speed.

Usually it is done with warm salt water. Sometimes special gargle solutions may be prescribed by the doctor.

Benefits of gargling:

• Maintain natural pH level

Salt water helps neutralise the acids, helping the natural healthy bacteria in our throat to thrive and preventing unwanted bacteria from causing infections.

• Clears mucus

Gargling with warm salt water helps thin out this mucus build-up in the respiratory tract and nasal cavity, thus, allows easy and better clearance.

• Reduces inflammation

Gargle creates an osmosis effect where the concentration of salt draws fluids from mouth and throat tissues to relieve a painful inflammation.

• Decreases bacterial load

Gargling with salt or gargling solution allows the clearance of slough and pus pockets, thus decreasing bacterial load.

• Soothes the throat

The warmth created locally by warm water provides a soothing effect.

Problem with gargling:

• Gargling requires vigorous work by over vocal cords. Assistance is also provided by the throat mucosa and muscles. In other words, gargling requires overuse of tissues that are already inflamed.

• Overuse of vocal cord can worsen voice.

• Gargling solutions can be irritating to the throat mucosa.

• Gargling with salt water can dehydrate the throat mucosa and make it hurt even more.

We, millennials and the post millennials, have been witness to lots of changes that has happened around us. The air that we breathe, the water that we drink, the food that we eat, and the way that we live, practically everything has changed. This can be attributed to various reasons, notably, massive scale urbanisation, pollution, changes in lifestyle, overcrowding, indoor air pollution, and altered immunity.

With so much happening around us, new causes of sore throat have also emerged. Few years back, most of the sore throat were due to infections. But in todays scenario, non infectious causes of sore throat are equally important. Such causes include:

• Allergies

• Irritants: pollution/fumes/smoke

• Acid reflux

• Dryness

Sore throat due to infections usually present with throat pain and cough with excess mucus formation. They are usually associated with mucosal inflammation and pus pockets in the throat. In such cases, the benefits provided by gargling is much more than the side effects. Thus gargling helps in such cases and is usually advised.

However, in cases of non infectious sore throat, which are usually associated with constant throat irritation, dry bouts of cough and frequent throat clearing, gargling does more harm than good. In such cases the alternatives are:

• Steam inhalation

• Drinking small multiple sips of warm water

Having understood all the facts, we can hence forth say that:

• Gargling has many benefits, but has side effects as well.

• Sore throat has more than one cause. Gargling can help in some, while worsen in others.

• Do not treat gargling as ‘brahmastra’ to deal all sore throat. Gargle when its needed. Do not gargle when it is not.

• Consider doctors advice rather than blindly self treating. Let their experience help you.

• Even if are doing gargling, any worsening of throat symptoms or voice change should be the indication to stop it.

• Vigorous gargling should always be avoided. Keep it gentle.

• Steam inhalation and drinking warm sips of water are very helpful in relieving sore throat of all sorts. They are helpful with or without gargling.

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