A brief overview of tonsillitis

What are my tonsils and why do I need them?

Tonsillitis is something many of us have had or we know someone who has had it. It is not uncommon to have had our tonsils removed when we were children due to being prone to tonsillitis. But, what a lot of us don’t know is what exactly our tonsils are and why we need them.

Your tonsils are two lymph nodes that can be found on either side of the back on your throat. They act as a barrier of defence for your body.

They protect your body from infections that can enter through your mouth. They trap the germs and also produce antibodies to help fight infection.

Picture them as bodyguards to your body fighting off anything bad trying to get to you.

The following article will take an in-depth look at tonsillitis, what causes it, what the symptoms may be and more. It is important to keep in mind that, although this article is very informative, it is only to serve as a guideline. We do not intend for this article to act as a treatment or diagnosis for any associated condition. We would suggest that you please consult with your doctor or healthcare professional for that.

What is tonsillitis?

Sometimes your tonsils, or rather bodyguards as well call them, become infected. This happens when they are overwhelmed by viruses or bacteria, they, therefore, become inflamed and swell, this is known as tonsillitis. When this happens, your tonsils will often become red and have a coating that is yellow or white in appearance.

Tonsillitis is a common condition, especially in children. It can occur frequently or occasionally. It is mostly caused by viral infection but it can also be caused by bacteria. Some people might have to have surgery to remove their tonsils, this was once a very common practice, however, in recent times this is only conducted when all other treatments have been exhausted and the patient has not responded to any of them. It is therefore always important to consult with your doctor to get an accurate diagnosis and treatment regime should you experience recurring bouts of tonsillitis over an extended period of time.

Adults are less prone to getting tonsillitis as the tonsils immune system functionality is likely to decline after puberty, making them less prone to becoming infected as they are not working as hard as they once did to fend the body off from infection.

In addition, adults’ immune systems, in general, are stronger and they can better fend off infections using other immune systems within the body as opposed to the tonsils. Therefore, cases of tonsillitis are far less common in adults.

What are the symptoms of tonsillitis?

If you have tonsillitis, your symptoms will normally consist of the following:

  • Painfully sore throat
  • Trouble swallowing due to swelling of the tonsils
  • Croaky voice
  • Hot and cold flushes
  • High fever
  • Headaches
  • Earache
  • Painful swollen glands as well as blisters or ulcers on your throat
  • Experiencing a stiff neck
  • A sore tummy – stomach aches (abdominal pain)
  • Bad breath due to tonsils being infected
  • White and yellow spots on the tonsils
  • Tonsils are red and swollen
  • Nausea and vomiting

If your young child has tonsillitis you may also notice that he/she is easily irritated, has lost their appetite, has tummy aches which may possibly lead to vomiting and could also feel a sense of confusion due to a high fever. They may even drool a lot.

How did I get tonsillitis?

Your tonsils, being your body’s defence against infection and illness, produce white blood cells that help to fight off the germs and infections. White blood cells are the little fighters of the body and help defend it from foreign invasions of disease. When your tonsils become infected, they become inflamed and this leads to tonsillitis.

Children, being more prone to the condition, can easily contract it from others at school when coming into close contact with them. They are also exposed to a variety of viruses and bacteria, making them more vulnerable.

It is spread from one person to another through contact with the mouth, mucus or throat of someone that is infected.

It is a very contagious disease and is caused by a number of common bacteria and viruses. A virus such as the common cold can cause tonsillitis. A common bacterial infection such as the streptococcal organism is also often a cause of the condition.

What are the different types of viral and bacterial tonsillitis?

As discussed above, tonsillitis is caused by a bacterial or viral infection.

The most common bacterial infection being strep throat (streptococcal pharyngotonsillitis). This is highly contagious and is spread via airborne droplets from an infected person coughing or sneezing. It can also be spread through sharing drinks and food with an infected person. It is most common in children between the ages of five and 15. Strep throat is airborne and infects the tonsils resulting in swelling and infection.

Common viral infections leading to tonsillitis include:

  • The Epstein-Barr virus (EBV) is one of the most common causes of tonsillitis. This virus is part of the herpes family, it is widely known as the cause of the infection mononucleosis (mono), which is also known as glandular fever.
  • Adenoviruses are a group of viruses that can infect the tissue linings (membranes) of your throat. Most of these infections are mild.
  • The influenza virus, otherwise known as the flu virus, affects the lungs, nose and throat.
  • Human parainfluenza viruses (HPIVs) are common in young children, but it is possible for anyone to be at risk. They are known for causing illnesses of the respiratory tract. Symptoms include a running nose, fever and coughing.
  • The Herpes Simplex Virus, transmitted orally, is also a common cause of tonsillitis.
  • Enteroviruses are named after their place of residence in the body, which is the intestine, however, they can also infect the upper respiratory tract.

What are the two types of tonsillitis?

There are two types of tonsillitis, these being:

  1. When your infection causes numerous incidents of acute tonsillitis a year, this is known as recurrent tonsillitis.
  2. When your incidents of tonsillitis last longer than acute tonsillitis and you also experience symptoms of a chronic sore throat, sore lymph nodes in the neck and bad breath, this is known as chronic tonsillitis.

When should I call a doctor if I think I have tonsillitis?

Some cases of tonsillitis may resolve without medical attention, however, should you feel as though you are at risk of being infected, it is always wise to seek medical help. You should call your doctor if:

  • You have a fever that is higher than 39.5℃ (103.1℉)
  • You are experiencing unusual muscle weakness.
  • Your neck feels stiff and it is uncomfortable to move it.
  • You have had a continuously sore throat for more than two days.

When should I call a doctor if I think my child has tonsillitis?

It is very important to get immediate medical attention if your child is experiencing any of the following:

  • A sore throat that lasts for longer than 48 hours.
  • If your child is finding it hard to swallow.
  • If they are feeling extremely weak and tired, as well as displaying actions indicative of confusion.
  • If they are experiencing nausea and vomiting.
  • In some more severe cases, your child might be experiencing difficulty in breathing due to extreme swelling of the tonsils – this is an indication for immediate professional help to be sought.

How will my doctor diagnose tonsillitis?

Your doctor will most likely conduct a physical exam of your throat. He/she may immediately be able to see if there is obvious swelling and redness due to infection of the tonsils.

Tonsillitis explained

Your doctor may also use a throat swab to get a sample of the cultures of your tonsils (throat swab culture). This involves using a cotton swab and gently swabbing the back of your throat to get a sample. This will be sent to the lab for testing to find out the exact cause of your infection. A throat culture test is used to find the germs that cause the infection. If there are no germs growing there, the culture test is negative. But, if there are germs growing there, the culture test comes back as positive.

The lab test can determine whether or not a bacterial or viral infection is present and specify the exact organism that is the culprit. 

What is the treatment for tonsillitis?

It is sometimes the case that the physical examination is enough evidence to diagnose a possible bacterial infection and in these situations, antibiotics may be prescribed without the need for a swab test.

After starting a course of antibiotics, if taken orally through the use of tablets (antibiotics can also be given as an injection), symptoms will start to ease after a few days. Do not be alarmed if your doctor suggests you take a second course of antibiotics, depending on the severity of the infection you may have to.

When the infection is caused by a virus, antibiotics will not work and your body will need to try and fight the infection naturally. Here are some things you should do in order to help your body regain its strength:

  • Getting lots of rest and sleep will help to gain strength.
  • Drinking cold or warm liquids will help to ease your sore throat.
  • Using a humidifier in your room will also help in breathing easily, especially if you are congested.
  • Try gargling with warm water with some salt in it, this helps to fight off the infection.
  • Sucking on throat lozenges with mild anaesthetics in them will also help.
  • Over-the-counter painkillers may also help to relieve headaches and pain from fever and infection, ibuprofen is often a good choice but always ask your doctor or pharmacist should you feel uncertain.
  • Try to avoid smoke and cigarettes.

I have some more questions about tonsillitis

Do I have to have my tonsils removed?

Having your tonsils removed through surgery is known as a tonsillectomy. This is the case when all possible treatments have been exhausted and you are not responding to them. It is not as common as it used to be due to the improvement of medicine and doctors wanting to explore all possible avenues before surgery.

However, surgery is necessary when you are suffering from chronic tonsillitis or a bacterial infection that is unresponsive to treatment. Your doctor may also recommend surgery when your tonsillitis is disrupting your sleep (sleep apnea) and creating difficulty breathing and eating.

Frequent tonsillitis is when:

  • You experience more than three episodes of tonsillitis a year over a period of three consecutive years.
  • You experience more than seven episodes over one year.
  • You experience over four to five episodes a year over two preceding years.

How are my tonsils removed and what can I expect after surgery?

Your surgeon may use a conventional scalpel to remove your tonsils while you are under a general anaesthetic. With the improvement of technology, doctors also have the option of using lasers, ultrasonic energy, radio waves, or even electrocautery to burn or cut out the tonsils. Electrocautery uses a heated electrode to destroy the tissue.

The surgery tends to last about 30 minutes to an hour. Most people can go home on the same day, about four hours after surgery. It will take about a week to 10 days to recover for children and possibly longer for adults. You may suffer from mild to severe throat pain and it is recommended that you rest and drink plenty of fluids and stay away from solid foods until your throat heals. You will be allowed to slowly introduce very soft foods during recovery.

Am I at risk of getting tonsillitis and what are the complications?

To lower your risk of getting the infectious disease, avoid people who have it and always wash your hands after going to the toilet or touching potentially infected surfaces, and particularly someone who has the condition.

Children are more at risk of getting the disease, but it is not common in those younger than two years of age. It is most common in children between the ages of five and 15. Frequently being exposed to germs in schools and common areas will increase your child’s risk of contracting tonsillitis.

It is sometimes possible that the infection may spread to the surrounding tonsillar tissue and cause tonsillar cellulitis. This happens with the infection is not treated or worsens due to lack of care and medical help. When this happens, you will need to see your doctor immediately. If your tonsillitis is caused by strep throat, or you have not completed your course of antibiotics, it is likely that the infection will worsen and can result in the complications below:

  • Rheumatic fever - affects the joints, heart and other tissues.
  • Poststreptococcal glomerulonephritis - when your kidneys become inflamed which results in waste and excess fluids from the blood not being removed properly. This is often marked by swelling of the face and body, a throat infection and raised blood pressure. 

Tonsillitis can also cause a build-up of pus at the back of the tonsils, this is called a peritonsillar abscess. This may result in more surgery or a drainage of the puss by a medical professional.

Is there a cure for tonsillitis?

Antibiotics will often cure the bacterial infection of tonsillitis. A viral infection will be dealt with through the body's own system of defence, namely the immune system and treatment is often led through self-care such as getting lots of rest, drinking fluids and avoiding people so as to not infect them too.

Sometimes surgery is the answer as discussed above.

Is eating ice cream good for my tonsillitis?

Eating and drinking fluids that help soothe your sore throat can include:

  • Ice cream
  • Frozen yoghurt
  • Jelly
  • Custard
  • Tea
  • Soup

So yes, ice cream can help soothe your throat, but it is not able to take away your tonsillitis. You will need to consult with your doctor for that.

Can I give tonsillitis to someone else?

Yes. Tonsillitis is contagious and easily passed on from one infected person to another through sneezing, coughing and sharing food and drink with an infected person.

Should you feel that you may be at risk, consult with your doctor. If you have been diagnosed with it, then it is best to stay at home and avoid close contact with others until you have been treated and the condition has improved. However, it is always best to seek medical advice.

Disclaimer - is for informational purposes only. It is not intended to diagnose or treat any condition or illness or act as a substitute for professional medical advice.