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Tonsillitis: Symptoms, causes and treatments

At the back of your throat, two masses of tissue called tonsils help the body to fight infection. However, sometimes the tonsils themselves become infected. Overwhelmed by bacteria or viruses, they swell and become inflamed, a condition known as tonsillitis.

Tonsillitis is common, especially in children. The condition can occur occasionally or recur frequently.

Causes and symptoms of tonsillitis

Treatments for tonsillitis

Treatment for tonsillitis will depend in part on the cause, the symptom severity and the individual patient’s circumstances. To determine the cause your doctor may perform a throat swab culture. This test involves gently swabbing the back of the throat close to the tonsils with a cotton swab. A lab test can detect a bacterial infection. A viral infection will not show on the test, but may be assumed if the test for bacteria is negative.

Even if tests reveal bacteria antibiotics may not always recommended for bacterial tonsillitis because in most cases antibiotics won’t speed up recovery. In certain circumstances, for example if symptoms are severe or are not improving, antibiotics are recommended, and although symptoms are likely to improve within two or three days after starting the antibiotic, it's important to take all of the medication your doctor prescribes to make sure the bacteria are gone.

If the tonsillitis is caused by a virus, antibiotics won't work and your body will fight off the infection on its own. In the meantime there are things you can do to feel better, regardless of the cause. They include:

  • Get enough rest
  • Drink warm or very cold fluids to ease throat pain
  • Eat smooth foods, such as flavoured jellies, ice cream or apple puree
  • Use a cool-mist vaporiser or humidifier in your room
  • Gargle with warm salt water
  • Suck on lozenges (for example containing benzocaine or other anaesthetics)
  • Take over-the-counter pain relievers such as paracetamol or ibuprofen

When tonsillectomy is needed

If tonsillitis is recurrent or persistent, or if enlarged tonsils cause upper airway obstruction, difficulty eating or affect school attendance, surgical removal of the tonsils, called tonsillectomy, may be necessary. Most tonsillectomies involve using a conventional scalpel to remove the tonsils; however there are many alternatives to this traditional method. Increasingly doctors are using techniques such as lasers, radio waves, ultrasonic energy or electrocautery to cut, burn or evaporate away enlarged tonsils.

As with all operations, each of these has benefits and drawbacks. When considering the procedure it's important to discuss your options with the surgeon to select the most appropriate one for your child.

What to expect after surgery

Tonsillectomy is performed under general anaesthesia and typically takes between 30 and 45 minutes. It is most commonly performed in children.

Most children require a week to 10 days to recover from it. They should remain off school for two weeks to avoid infections. Almost all children will have throat pain, ranging from mild to severe, after surgery. Some may experience pain in the ears, jaw and neck. Your child's doctor will prescribe or recommend medication to ease the pain.

During the recovery period it's important for your child to get enough rest. It's also important to make sure your child gets plenty of fluids; however, you should avoid giving your child acidic drinks as these can sting the throat. Although throat pain may make your child reluctant to eat, the sooner your child eats, the sooner he or she will recover.

For several days after surgery, your child may experience a low-grade fever and small specks of blood may be visible from the nose or in saliva. If the fever is greater than 38°C or if you see bright red blood, seek medical advice straight away. Prompt medical attention may be necessary.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on November 05, 2014

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