A red and raw throat
Situated at both sides of the throat at the base of the tongue, the tonsils have a vital role to play in preventing pathogens from penetrating into the body.
When the body is attacked by an infection, the tonsils need to work harder to cope with the growing number of germs and become enlarged and painful.
The first signs of tonsillitis are similar to throat inflammation and include coughing, phlegm, and nasal mucus. The throat will be very painful on both sides and the tonsils red and enlarged. In serious cases, pus will be found on the tonsils and the lymph nodes at neck will be swollen.
In mild cases, the tonsillitis resolves itself without medication. The patient should rest, drink plenty of water and eat healthily. More serious cases require a visit to the doctor for a proper diagnosis. Antibiotics and possibly some analgesics and a gargle will be prescribed and the situation will resolve in 3 to 7 days.
Certain pathogens, especially streptococcal tonsillitis, are dangerous and can cause pus around the tonsils that can spread and block the airways. In some cases, the inflammation may have an effect on the blood circulation, causing malfunction of the heart and kidneys. Patients who frequently experience tonsillitis may have unusually narrow airways, which become easily blocked. Symptoms can be observed during sleeping, especially in children, and cause loud snore and abrupt waking.
As the tonsils are the immune system’s first line of defence against ingested or inhaled foreign pathogens, removing them surgically is usually only advised when the tonsils become so large that they block the respiratory system, peritonsillar abscesses develops or pus collects next to the tonsils and fails to respond to treatment and if there is any suspicion of cancer.
A doctor may also decide to have the tonsils removed in mild cases if a patient experiencing 6 to 7 bouts of tonsillitis a year, has bad breath resulting from chronic tonsillitis, or has streptococcal tonsillitis.
There is no limit on the ages at which tonsils may be removed and provided there are no conditions unfavourable to the surgery, the operation will be quick, safe and without major side effects. The tonsils are removed through the mouth under general anaesthetic though other newer methods such as radiofrequency and laser ablation can reduce the pain more effectively after surgery.
Patients may experience some post-operative bleeding as well as mild pain resulting in difficulty swallowing so it is important that they stay in hospital overnight for observation. Other side effects that may possibly occur include fever, dehydration and a change in voice. However, complications resulting in fatalities are very rare.
The day after surgery, patients should consume only very soft and cold food, such as sweetened drinks, ice cream, yoghurt or jelly in order to prevent any bloating of the wound or bleeding. Slightly more solid and warmer foods can be enjoyed 2 to 5 days after surgery with a return to the normal diet in a week. Examination by a doctor one week after the operation is recommended to make sure that the wound is completely healed and there is no bleeding.
Even after the tonsils have been removed and the immune system becomes weaker, the tissues of the tongue and throat can still function sufficiently well to provide immunity to disease.
Prevention of tonsillitis is the same as for most other disease: eating a healthy diet, drinking plenty of water and ensuring adequate rest and exercise.
DR YONGYUTH WASINWONG is an otolaryngologist at Samitivej Sukhumvit Hospital. Call the Ear, Nose, and Throat Clinic at |(02) 711 8777-8 or 3mail [email protected].
