Understanding Tonsillitis

Although tonsillitis is most common in children, it can develop in anyone.

The tonsils are a pair of soft tissue masses located on either side of the back of the throat. The tonsils help to trap bacteria and viruses as they enter the body through the throat. Tonsillitis is an inflammation of the tonsils and occurs frequently in children, especially between 3 and 7 years of age, but tonsillitis can develop in anyone.

The inflammation due to tonsillitis may involve the back of the throat, including the adenoids (2 tissue masses at the back of the throat). Tonsillitis can range from mild to very severe, and the treatment depends on the cause. Enlarged tonsils and adenoids are also major causes of sleep apnea (a breathing problem during sleep), especially in children.

Causes

Tonsillitis is most often caused by common viruses, but bacterial infections can also cause tonsillitis. Strep throat is due to common bacteria that can cause tonsillitis.

Symptoms

The symptoms most commonly associated with tonsillitis include:

• Red and swollen tonsils
• Sore throat
• Fever
• Ear pain
• White or yellow coating or patches on the tonsils
• Difficult or painful swallowing
• Headache
• Halitosis
• Hoarseness of the voice

Diagnosis

If you think that you have tonsillitis, your doctor will conduct a physical examination, examine your throat, check for swollen glands in your neck, and ask about your symptoms. Your doctor may also perform tests such as a throat swab or blood work to rule out infections.

Treatments

The treatment of tonsillitis depends on the cause and severity of the tonsillitis. If your tonsillitis is caused by bacteria, your doctor will prescribe an antibiotic for you. It is important that you complete the entire course of antibiotic therapy and take the antibiotic as directed to avoid re-infection.

Tonsillitis due to strep throat is contagious, but the contagious period is typically over after the first 24 hours of antibiotic therapy has been taken. In general, strep throat begins to show signs of improvement after 2 to 3 days of antibiotic therapy, but you must finish the entire course of therapy.

If your tonsillitis is caused by a virus, your body will fight off the infection on its own. Your doctor may suggest ways that you can ease the pain, such as drinking warm or very cold fluids or gargling with warm salt water.

Your doctor will determine the best course of treatment to suit your individual needs. For frequent episodes of tonsillitis or for enlarged tonsils that hinder breathing, such as in sleep apnea, your doctor may recommend surgery to remove the tonsils. This surgery is called a tonsillectomy. Most people go home within hours of the surgery and typically recover in 7 to 14 days.

Prevention

While all cases of tonsillitis cannot be prevented, you can decrease your chance of getting tonsillitis by frequently washing your hands with warm water and soap to prevent the spread of infection. Alcohol-based hand sanitizers can be used when water is not available. Good infection control measures include disinfection of household surfaces.

Recovery

The following lifestyle measures can help you recover from tonsillitis:

• Get plenty of rest.
• Use nonprescription anesthetic lozenges or sprays to ease throat pain.
• Make sure you are adequately hydrated to keep your throat moist and to prevent dehydration.
• Eat foods and drink fluids that help soothe your throat (eg, drink warm liquids such as tea or clear broth; eat cold treats such as ice cream, frozen yogurt, or popsicles; let ice chips melt in your mouth).
• Gargle with warm salt water.
• Use an air humidifier to eliminate dry air, which can irritate the throat.
• Avoid irritants such as cigarette smoke, fragrances, and household chemical cleaning products that can irritate the throat.
• Use an OTC analgesic (pain reliever) to help manage pain or reduce a fever. Discuss the use of an analgesic with your doctor or pharmacist to ensure that it is appropriate and to avoid drug interactions or contraindications, especially in young children or in individuals with preexisting medical conditions or who are taking other medications.

If you have worsening symptoms, difficulty breathing, a high fever, or signs of infection, immediately seek medical care from your primary health care provider.

Ms. Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.