Tonsillitis: The Breakdown of Your Throat’s Filter

Different structures throughout the body exist to protect important organs and tissues from damage, and in the throat, these structures are called tonsils. The tonsils act as filters in back of your throat, stopping germs before they reach your airways and put you at risk of an infection. The tonsils also create antibodies to help fight infections when they do occur.

It’s possible for the tonsils themselves to become infected—a condition called tonsillitis. Tonsillitis can cause pain and swelling in the throat, and may also lead to complications.

Causes

Tonsillitis is especially common in children between ages 5 and 15—puberty reduces the role of the tonsils in the immune system—but can also occur in adults. It can be caused by a variety of bacterial and viral infections, and the most common of these is Streptococcus pyogenes, the same bacterium that leads to strep throat. Other causes include:

• Flu virus
• Epstein-Barr virus
• Adenoviruses
• Parainfluenza viruses
• Enteroviruses
• Herpes simplex virus

The biggest risk factor for tonsillitis is age. Frequent exposure to germs—school-age children are commonly exposed to more germs—can also increase risk.

Symptoms and Complications

The two primary symptoms of tonsillitis are inflammation and swelling in the tonsils, which can occasionally become so severe that they block the airways and cause difficulty breathing. Other symptoms include:

• Pain or tenderness in the throat, and scratchy vocal chords
• Redness in the tonsils, or a white or yellow coating
• Headache or ear pain
• Loss of appetite
• Painful blisters or ulcers in the throat
• Trouble swallowing or breathing through the mouth
• Bad breath
• Fever or chills
• Swollen glands in the neck and jaw
• Stomach ache, especially in smaller children

Children may also experience extreme symptoms like nausea or vomiting, or they may drool if swallowing is painful or difficult for them. If your child is experiencing any of these symptoms, especially if they’re having trouble breathing or swallowing, get them medical care right away.

Complications of tonsillitis can include:

• Trouble breathing, especially during sleep
• Spreading infection, often resulting in pus collection
• Strep infection, leading to rheumatic fever or poststreptococcal glomerulonephritis

Treatment

The first step in treating tonsillitis is determining whether it was caused by bacteria or a viral infection. This is done using a simple throat swab—positive results indicate a bacterial infection, and negative results likely signal a viral infection.

Antibiotics are the primary treatment of tonsillitis caused by bacteria. These may be in the form of a single shot or in a pill taken over a period of time. If you’re prescribed an antibiotic pill, be sure to take them for the entire prescribed time, even if your symptoms go away—an absence of symptoms doesn’t always guarantee that the infection is gone.

If the cause of tonsillitis is a virus, antibiotics won’t be effective. In this case, treatment is focused on taking care of the body and managing symptoms by:

• Drinking hot and cold fluids to soothe the throat
• Getting enough sleep and rest
• Eating smooth, easy-to-swallow foods like ice cream or applesauce
• Gargling with warm salt water
• Using lozenges containing mild anesthetics
• Taking painkillers like acetaminophen or ibuprofen
• Using a humidifier or cool-mist vaporizer

Tonsillectomy

Tonsillectomy, the removal of tonsils, is best avoided when possible due to the tonsils’ important role in the immune system, but there are cases where tonsillectomy is necessary, especially in children. Situations requiring tonsillectomy include recurring cases of tonsillitis or symptoms that consistently obstruct the airway or the ability to eat.

There are several different ways to perform a tonsillectomy, including the use of lasers, radio waves, ultrasonic energy and the traditional scalpel removal. Tonsillectomy is done under general anesthesia, and usually lasts around 30 to 45 minutes. Your doctor will discuss your options with you, and talk about what your child will need after the surgery.

If you or your child is showing the symptoms of tonsillitis, speak to your family doctor about treatment.

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Sources:

“Tonsillitis: Symptoms, Causes, and Treatments.” WebMD. http://www.webmd.com/oral-health/guide/tonsillitis-symptoms-causes-and-treatments#1

“Tonsillitis.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/tonsillitis/basics/definition/con-20023538