Introduction
Tonsils are two masses of lymph nodes located on either side at the back of the throat that serve as the first line of defence against microbes like bacteria and viruses that enter the body. They help fight infections by producing antibodies that neutralise the microbes.
What is tonsillitis?
Tonsillitis is an inflammation of the tonsils and can be caused by a bacterial or viral infection. Although it can occur in people of all ages, it is most common in children. In most cases, tonsillitis resolves on its own, but medical intervention may be necessary. Treatment options include antibiotics or other medications and, in severe cases, surgical removal of the tonsils (tonsillectomy). Studies have shown that removing tonsils in children does not harm their immune systems, and the tonsils do not regrow after removal. However, if any part of the tonsils is left behind after surgery, it increases the risk of infection and enlargement. To prevent tonsillitis, it’s important to practise good hand hygiene, avoid close contact with infected individuals, and keep sick children at home.
Tonsillitis types:
Characterised by symptoms lasting from 3 to 4 days, but can persist for up to 2 weeks in some cases
If an individual experiences multiple tonsil infections in a year, it is called recurrent tonsillitis
Refers to a persistent tonsil infection lasting for a prolonged period of time
Tonsillitis symptoms and causes:
An individual with tonsillitis may experience:
- Sore throat
- Fever
- Difficulty in swallowing
- Bad breath
- Ear pain
- Red and inflamed tonsils
- White patches on the tonsils
- Loss of appetite
- Nausea
- Fatigue
- Swollen glands
- Change in voice
- Stomach ache
- Headache
- Excessive drooling
Tonsillitis can be caused by:
- Bacterial infections – such as Strep throat
- Viral infections – including the common cold caused by rhinoviruses and influenza virus, parainfluenza leading to laryngitis and croup, adenovirus leading to diarrhoea, rubeola virus causing measles, and Epstein-Barr virus causing glandular fever
Risk factors for children:
Since tonsillitis mainly affects children, the following are the risk factors for them:
- Young age -Children between the ages of 5 to 15 are at a higher risk of developing bacterial tonsillitis
- Frequent exposure to germs – School-aged children have close contact with their peers and are repeatedly exposed to viruses and bacteria that can cause tonsillitis
Can tonsillitis go away without treatment?
Tonsillitis usually improves on its own within a week without medication. Pain relievers and rest are recommended to help manage symptoms. Consult a paediatric ENT specialist and get treated with tonsillitis.
When should tonsils be removed?
A tonsillectomy (removal of tonsils) may be necessary if you:
- Suffering from frequent tonsillitis
- Experience breathing difficulties
- Have had 7 or more episodes of tonsillitis in the last year
- Experience difficulty with daily activities
- Suffer from sleep disorders like snoring, sleep apnea, sinusitis, ear infections, or dental abnormalities
- Have developed complications from infections such as neck abscess, peritonsillar abscess, rheumatic heart disease, or glomerulonephritis
Tonsillitis treatment
The treatment for tonsillitis will be determined by the ENT doctor based on the cause of the infection. In severe cases, the doctor may suggest a tonsillectomy, a surgical procedure to remove the tonsils. The procedure typically takes 20 to 30 minutes and is performed under general anaesthesia. There are various surgical methods including surgical instruments, diathermy, coblation, radiofrequency ablation, CO2 laser, and microdebrider.
After a tonsillectomy, patients may experience side effects such as nausea, pain, earache, stiff neck, difficulty swallowing, changes in voice, and changes in taste, which can be managed with medication to ensure comfort.
Home care for tonsillitis:
To manage tonsillitis symptoms at home, one can try the following:
- Get plenty of rest
- Drink plenty of fluids
- Eat soothing foods and beverages
- Gargle with saltwater
- Use a humidifier
- Take pain and fever medication
- Drink warm tea with honey and lemon
- Try using throat sprays
- Avoid irritants
- Avoid straining your voice
How to prevent tonsillitis:
To reduce the risk of developing tonsillitis, one can:
- Practise good hand hygiene
- Avoid sharing food, drinks, utensils, etc.
- Replace your toothbrush after being diagnosed with tonsillitis
- Keep children home when they are sick
Consult Dr.Shree Cuddapah Rao paediatric ENT specialist, and a superspecialist microsurgeon in Otology and Cochlear implant surgeries. With 10 years of deep domain experience in medical and surgical ENT. Dr. Shree Rao holds a Fellowship in Cochlear Implant surgery and took advanced training in the same from Padmashri awardee Dr. Milind V Kirtane. She underwent specialized training in Rhinoplasty and Facial Plastic Surgery at Singapore General Hospital, Singapore.
