What Is Tonsillitis?

Tonsillitis refers to inflammation of the tonsils. This typically occurs due to an infection caused by a virus or bacteria. The tonsils are two lymph nodes located on each side of the back of the throat. These lymph nodes mainly function as a defense mechanism, protecting the body from infection. Infected tonsils are called tonsillitis.

The tonsils are known to produce white blood cells, which help the body fight infection. Any bacteria or virus which enter via the mouth have to first deal with the tonsils.

Tonsillitis is a very common illness, mostly affecting children. One can encounter multiple instances of tonsillitis throughout their life. It is a contagious condition mainly caused by the streptococcal bacteria, which causes strep throat. If tonsillitis caused by strep throat is not treated on time, it can lead to further serious complications.

Tonsillitis can be easily diagnosed based on its symptoms, which usually go away within a span of seven to ten days.

Causes of Tonsillitis

The tonsils mainly serve as the first line of defense from any respiratory infections, however, there are instances when they become infected by bacteria or a virus. Below are the common causes of tonsillitis:

• Herpes simplex virus
• Adenoviruses
• Streptococcus, or strep bacteria
• Epstein-Barr virus
• Influenza virus
• Enteroviruses
• Common cold   
• Parainfluenza virus

Studies have shown that almost 15%–30% of tonsillitis cases are due to bacteria, mostly strep bacteria. Children are usually exposed to these bacteria and viruses when they come into contact with other children at school or playgrounds. This makes them vulnerable to the germs that cause tonsillitis.

Types of Tonsillitis

Tonsillitis is divided into two types bearing different or, at times, similar symptoms:

• Acute tonsillitis: In this instance, the person has multiple cases of tonsillitis in a year.
• Chronic tonsillitis: In this instance, the person has tonsillitis that lasts longer than acute tonsillitis. There are also other symptoms which accompany it, such as a chronic sore throat and tender lymph nodes.

Symptoms of Tonsillitis

Tonsillitis is accompanied by a host of other symptoms as well, including:

• Cough
• Sore throat
• Chills
• Sneezing
• Fever
• Tenderness in the jaw or neck due to swollen lymph nodes
• Hoarse or scratchy voice
• Swollen tonsils
• Bad or smelly breath
• Small red or purple spots on the roof of the mouth
• Enlarged lymph nodes
• Difficulty swallowing
• Pain in the ears
• Sudden fever and chills
• Headache
• Tonsils with white or yellow spots
• Weakness in the muscles
• Difficulty talking
• Fatigue or dizziness
• Stiffness in the neck

When a person has tonsillitis, the tonsils appear coated with yellowish-white pus. Small children suffering from tonsillitis would also show signs of irritability, loss of appetite, nausea, vomiting, abdominal pain, or excessive drooling from the mouth.

What Does Tonsillitis Look Like?

Tonsillitis will look different when it is caused by bacteria or a virus:

• Bacterium tonsillitis: In bacterium tonsillitis, the throat will turn red with whitish spots and red, swollen tonsils. The tongue will have a gray, furry patch, and the uvula will also swell.
• Viral tonsillitis: In viral tonsillitis, the tonsils will look red and swollen, along with redness in the throat.

During tonsillitis, the tonsils swell and redden. Pus may develop as white spots on the tonsils, as well.

Diagnosis of Tonsillitis

To determine what has caused the tonsillitis, the doctor will perform a rapid strep test or a throat swab culture. In both tests, the doctor will gently swab the back of the throat, close to the tonsils, with a clean cotton swab. After, a lab test will determine if it’s a bacterial infection. If the cause of tonsillitis is viral infection, it will not show up in the test. A negative bacteria test indicates a virus being the cause of infection.

To rule out the possibility of glandular fever, the doctor may also conduct a blood test. This would be done only if symptoms do not go away after a few days of treatment.

Treatment of Tonsillitis

If a person is affected with a bacterial infection, it can be treated with antibiotics. The symptoms associated with bacterial tonsillitis go away within twenty-four hours once the medication is started. The doctor will usually not prescribe antiviral medications in such cases, since, unlike antibiotics, antivirals do not kill a viral infection, but only slow down the spreading of the virus. People suffering from mild tonsillitis usually do not require any treatment, especially if it is caused by a cold.

At times, steroids may also be given to reduce the condition, but this is rare, only in severe cases, since steroids have certain side effects. Antibiotics will be suggested by the doctor if the tonsillitis is caused by a bacterial infection. However, one should complete the dosage in the given format as well as the whole course to avoid recurrence.

Medications such as ibuprofen or acetaminophen can also be given to adults suffering from tonsillitis. However, in children, check with the doctor before giving any medicines. The doctor will prescribe antibiotics as a single shot or orally, to be taken for ten days. There are very few cases wherein the person needs to go in for a second course of antibiotics to completely get rid of the infection and avoid recurrence.

Mentioned below are certain home remedies to treat swollen tonsils:

• Gargling warm salt water at least three to four times a day is advisable.
• Keep yourself hydrated and, in between, have warm beverages to calm the irritation.
• As mentioned above, use over-the-counter medications if the inflammation or pain worsens.
• Avoid certain activities that aggravate the throat like screaming or yelling.

To protect oneself from tonsillitis, ensure to follow the below habits:

• Frequently wash your hands with mild soap or liquid.
• Avoid sharing any foods, drinks, or utensils to prevent the spread of the virus or bacteria.
• If you have been diagnosed with tonsillitis, change your toothbrush.
• Get lots of rest
• Keep yourself away from those infected with swollen tonsils.
• Avoid smoking

If the tonsillitis becomes severe, the doctor may suggest surgery to remove the tonsils. This process is called a tonsillectomy. Previously, this procedure was quiet common, but now, it’s mostly recommended for people with chronic tonsillitis.

Surgery would also be recommended if the tonsillitis does not respond to any existing treatment, antibiotics, or steroids. However, one should note that the tonsils are an important part of the body and help fight off infections, so one should avoid removing them, if possible.

There are cases where the tonsils become enlarged enough to cause a blockage in the upper airway, making it difficult to eat; in such cases, surgery would be recommended as well. A tonsillectomy involves the use of a conventional scalpel through which the tonsils are removed.

This has been the traditional method, however, there are now many new methods to remove the tonsils. Doctors are now using techniques such as lasers, electrocautery to cut or burn the enlarged tonsils, ultrasonic energy, and radio waves.

One should note, though, that every surgery and medication has its pros and cons. It is important to discuss and take opinions on various options available, after which one can proceed with the chosen treatment.

Tonsil surgery usually lasts around thirty to forty-five minutes under general anesthesia. This surgery has been most commonly performed on small children, since they are the ones who are often affected.

About four hours after the tonsil operation, the patient is sent home. It then takes at least ten days to recover. After surgery, one will likely complain of throat pain, which can become severe at times.

Some patients may experience pain in the ears, neck, and jaw. To ease the pain, the doctor will usually recommend a painkiller. During this recovery phase, the patient should receive ample rest along with good intake of fluids, including water. For the first twenty-four hours, the patient should not consume milk or milk products. The patient may be a bit reluctant to eat due to the throat pain, however, the sooner they start eating, the sooner it will help them recover.

For a few days after the surgery, the patient will experience mild fever and small specks of blood from the nose or saliva. However, if the fever goes up to 102 degrees Fahrenheit, or if there are bright red blood spots, it’s best to check with the doctor immediately.

Below are a few home remedies which can speed up the healing process:

• Water and orange juice mixture: Add one part water to three parts orange juice and drink it daily until the symptoms subside. Orange juice being rich in vitamin C helps boost immunity and fight infection in the tonsils. Water also keeps you hydrated and flushes out the infection from the body.

• Chicken soup: Chicken soup in itself has anti-inflammatory properties which help soothe the symptoms and avoid further complications. One can also add garlic and parsley to not only increase the taste, but also restrict the replication of the organisms causing the infection.

• Honey and garlic mixture: One tablespoon of honey along with four cloves of garlic crushed nicely can be diluted in lukewarm water. This mixture should be consumed at least three to four times a day for four days continuously.

• Turmeric and honey mixture: Turmeric is a strong defense against inflammation, and the combination of both turmeric and honey can de-materialize the tonsil infection. Make a paste of raw honey and turmeric and consume it at least three times a day for quick relief from the infection.

Complications Associated with Tonsillitis

Mostly, the symptoms associated with tonsillitis are quite troublesome, but require less or at times no intervention. The tonsils may become so swollen that they start affecting one’s breathing or swallowing pattern. At times, it may also cause obstructive sleep apnea. Sleep apnea is a very serious condition wherein a person suddenly stops breathing for a brief period of time while sleeping. This will result in fatigue during the day, mood swings, depression, and other serious health conditions, such as altered blood pressure or heart disease.

This condition is also known as tonsillar cellulitis. Due to the infection, there are chances that a person will develop a build-up of pus behind the tonsil area, also known as a peritonsilar abscess. In such cases, the person would require drainage or another surgery to treat it.

Complications may also arise if a person does not complete the full course of antibiotics or medications prescribed by the doctor. Some of the complications are rheumatic fever and post-streptococcal glomerulonephritis.

There are chances that, if the tonsils are not treated on time or are left untreated, the infection can spread to other parts, causing ear, sinus, or chest infections. One of the other complications is infectious mononucleosis, which is caused by the virus called the Epstein-Barr virus. This virus tends to cause severe tonsillitis as well as other symptoms.