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TonsillitisIntroduction Tonsillitis is an infection of the tonsils, which are the small glands found at the back of the throat behind the tongue. The function of these glands is not entirely clear but research suggests that they help to fight infections. The main symptom of tonsillitis is a sore throat, but there may be several other symptoms including coughing, headaches and a fever. Tonsillitis often clears up on its own without the need for treatment, but in severe, or recurring cases, the tonsils may be removed in a procedure called a tonsillectomy. Tonsillitis can be caused by either a virus or by bacteria, although most cases of the condition are viral. Children between 5-15 years of age are most likely to get tonsillitis, but it can affect anyone. Tonsillitis can spread from person to person through throat or nasal fluids - this includes saliva, hand contact, or airborne droplets. The incubation period (the period between picking up the infection and symptoms starting to appear) is usually between 2-4 days. Symptoms The main symptom of tonsillitis is a sore throat. However, other common symptoms that you may have include: red and swollen tonsils, pain on swallowing, fever (which can be very high in young children), coughing, tiredness, pain in your ears, or neck, white pus filled spots on your tonsils, and swollen lymph nodes (glands) in your neck. Less common symptoms of tonsillitis may include the following: vomiting, a 'furry' tongue, bad breath, and difficulty opening your mouth. Younger children may also complain of a tummy ache which can be caused by the swelling of the lymph nodes (glands) in the abdomen (stomach). The symptoms of tonsillitis may vary depending on whether the infection is caused by a virus or by bacteria. If your tonsillitis is caused by a virus, such as the flu virus, you may have other flu symptoms, such as a runny nose, and aches in your body. If your tonsillitis is caused by bacteria, you may have a skin rash, or a flushed face Causes Tonsillitis is most commonly caused by a viral infection, but it can also be caused by bacteria. The viruses that cause tonsillitis are often the ones that frequently affect the respiratory (breathing) system. They include the flu (influenza) virus, the parainfluenza virus (which causes laryngitis and croup), as well as the adenovirus, the enterovirus, and the rhinovirus. In rare cases, tonsillitis can develop as a result of the Epstein-Barr virus which is the virus that causes glandular fever. If this is the case, it is likely that you will feel quite ill. You may have swollen lymph nodes (glands) throughout your body and an enlarged spleen. Bacterial tonsillitis may be caused by a number of different bacteria, but the most common ones are streptococcus group A bacteria. In the past, serious bacterial infections, such as diphtheria, and scarlet fever, have caused tonsillitis, but this is now very rare, due to improved immunisation and treatment. Diagnosis If you think that you have tonsillitis, you should see your GP. They will examine your throat and ask you questions about your symptoms. Based on your symptoms, the appearance of your throat and tonsils, and the presence of swollen glands in your neck, your GP will decide whether your tonsillitis is viral or bacterial. Sometimes your GP will use a throat swab (which looks like a long cotton bud) to take a small sample of mucus from your tonsils. This will be taken for laboratory analysis but the results can take a few days to return. Samples are mainly used for patients in high-risk groups (such as those with damage to their immune system) or if previous treatment has failed. A throat swab may also be used to tell if tonsillitis is caused by streptococcal bacteria, but it can often be difficult to ascertain whether the person is a carrier of the infection, or is actually infected. In some cases, your GP will also do a blood test to check your blood count, or a Monospot test, which is a blood test that checks for glandular fever. Treatment If you have tonsillitis, there are a number of things that you can do to help yourself. Make sure that you: get plenty of rest, and have plenty to eat and drink - even if you find it painful to swallow (becoming hungry and dehydrated can make other symptoms, such as headaches and tiredness, worse). Whether your tonsillitis is caused by a virus or by bacteria, it is likely that your immune system will clear the infection within a few days. Treatments, such as painkillers and antibiotics (in cases of bacterial tonsillitis), may help to ease your symptoms. However, if your symptoms are particularly severe, and you have recurring bouts of tonsillitis, surgery may be an option. Treating viral tonsillitis As most cases of tonsillitis are caused by a virus, they do not respond to antibiotics. They will usually go away on their own, but you can take paracetamol or ibuprofen to ease symptoms such as pain, headaches and fever. When taking medication, you should always follow the instructions on the packet to ensure that you are taking the correct dosage at the right time intervals. This will ensure that it is effective in controlling your symptoms. You should not take ibuprofen if you have a history of stomach ulcers, indigestion, asthma, or kidney disease. If you are pregnant, do not take ibuprofen and only take paracetamol as instructed by your GP, or midwife. Children under 16 years of age should not take aspirin. There are also treatments available from pharmacies that can soothe a sore throat, such as lozenges and oral sprays. Some people find that gargling with a mild antiseptic solution can help to relieve a sore throat, although research regarding the effectiveness of gargling as a treatment method is limited. Treating bacterial tonsillitis Antibiotics can be used to treat bacterial tonsillitis, such as that caused by streptococcal bacteria. However, research has shown that the effects of using antibiotics to treat the symptoms of a sore throat are limited. The results of a clinical study showed that the maximum benefit was seen by day three, and that, on average, the illness time was only reduced by about one day. Surgery If you have recurring bouts of tonsillitis (five or more in a year) or it is severe enough to interfere with your everyday life, your GP may suggest removing your tonsils. This is done in an operation known as a tonsillectomy. A tonsillectomy is done under a general anaesthetic which means that you will be asleep during the procedure. Your mouth will be held open so that your surgeon can see your tonsils, and no cuts will be made in your skin. Your surgeon will then use special scissors to remove your tonsils before closing the wound with dissolvable stitches. In some tonsillectomies, newer methods may be used to remove the tonsils, such as laser surgery, ultrasound, or freezing. If surgery is recommended, your surgeon will discuss the options with you. As is the case with any type of surgery, there are risks associated with a tonsillectomy, such as excessive bleeding, and the effects of anaesthesia. However, many thousands of tonsillectomies are performed every year without any problems. Although surgery can help people with severe, or recurring tonsillitis, having your tonsils removed will not guarantee that throat infections will be prevented in the future. Self treatments which can help the sufferer are steam inhalations with essential oils such as Thyme, Lavender and Benzoin and massaging with Tea Tree diluted in carrier oil. Also try garlic tables, large amounts of Vitamin C and improving diet as often repeated attacks can lower the persons resistance to infection. |
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