Tonsillitis: When eating and drinking become a pain

If you’ve ever suffered a bout of tonsillitis or had to take care of someone suffering from the illness, you probably know how uncomfortable it can be. The awful feeling in your throat makes taking food or medicine nightmare, yet you must do both to recover.

What you need to know:

  • In most cases, tonsillitis occurs as a result of infection by a common virus, although bacterial infections can also cause tonsillitis.
  • The most common bacterium that causes tonsillitis is streptococcus pyogenes, which also causes strep throat (bacterial infection of the throat).
  • A range of respiratory viruses, particularly those that cause colds and flu, contribute to most cases of tonsillitis.

Tonsillitis is an inflammation of the tonsils. The tonsils are two oval-shaped pads of tissue located at the back of the throat, with one on each side.

Tonsillitis occurs when the tonsils get infected. Some of the common symptoms of tonsillitis are sore throat, pain when swallowing, swollen tonsils, and tender lymph nodes (bean-shape glands distributed all over the body, and are a part of the lymphatic system) on the sides of the neck.

Dear Doc,
Kindly explain the causes of tonsillitis and who is at risk?
Jason

Dear Jason,
In most cases, tonsillitis occurs as a result of infection by a common virus, although bacterial infections can also cause tonsillitis.

The most common bacterium that causes tonsillitis is streptococcus pyogenes, which also causes strep throat (bacterial infection of the throat).

A range of respiratory viruses, particularly those that cause colds and flu, contribute to most cases of tonsillitis.

The tonsils are responsible for producing antibodies that help fight infections, and are thus the first line of defence for the immune system against viruses and bacteria that enter the mouth. This function thus makes them susceptible to inflammation and infection.

Notably, the role played by the tonsils in the body’s immune system declines after puberty. This might explain why cases of tonsillitis are less prevalent among adults.

If food particles accumulate in the pits on the surface of the tonsils, they can cause inflammation. The major risk factor for tonsillitis is age. Tonsillitis occurs mostly in children, ranging from those in preschool to those in their mid teens.

One of the reasons for this is that their immune system is still developing. Another risk factor is exposure to a variety of germs.

School going children are often in close contact with their peers and schoolmates, so they are frequently exposed to bacteria or viruses that cause tonsillitis.

Besides, children sometimes do not practice good dental hygiene, making them susceptible to tonsillitis.

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Dear Doc,
My year-old son has been suffering frequent bouts of tonsillitis. Are there any complications that can occur?
Susan

Dear Susan,
In most cases, tonsillitis goes away in three to four days, with other symptoms like fever subsiding in about a week. However, in some people the symptoms might not subside; if anything, they can get worse after this period.

The swelling or inflammation of the tonsils as a result of chronic or frequent tonsillitis can lead to complications such as difficulty breathing, disrupted breathing when sleeping, and other infections (tonsillar cellulitis), which can spread deep into adjacent tissue.

If tonsillitis is caused by group A streptococcus or any other strain of streptococcal bacteria is left untreated, or if antibiotic treatment is not completed, the child might be at an increased risk of rare disorders like post-streptococcal glomerulonephritis, which is an inflammatory kidney disorder that results in insufficient removal of waste and excess fluids from the blood.

It can also cause rheumatic fever, which is an inflammatory disorder affecting the joints, heart, and other body tissues. An abscess (pus-filled sac) develops in some people after they develop the symptoms of tonsillitis.

The abscess normally forms between the back of one tonsil and the wall of the throat, and not on the tonsil itself. An infection of the tonsils can spread to the middle ear and cause middle-ear infection or otitis media.

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Dear Doc,
When should I have a tonsillectomy?
Melvin

Dear Melvin,
The tonsils are a very important part of the immune system. It is thus best to avoid having them removed, unless it is the last option.

However, if your tonsillitis becomes persistent or recurrent, fails to respond to other treatment such as antibiotics, or if your tonsils become enlarged and make swallowing difficult or cause obstruction in the upper airway, then surgical removal (tonsillectomy) might be necessary.

Before opting for surgery, however, consult an ENT specialist to assess your situation and determine whether it is really necessary to have them removed.

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Dear Doc,
How can you cure tonsillitis?
Owen

Dear Owen,
The treatment depends on the cause. A doctor can determine the cause by performing a throat swab culture or strep test. The process involves the doctor gently wiping the back of the throat near the tonsils using a cotton swab.

The sample is then taken for a lab test to see if there is a bacterial infection. The test might not show a viral infection, but it may be assumed to be viral if the bacteria test is negative.

If the test reveals a bacterial infection, it will be treated using antibiotics. Though the symptoms might improve within a day or two after starting the antibiotic treatment, it is very important to complete the prescribed medication to ensure that the bacteria have been completely eliminated.

If the tonsillitis is caused by a virus, antibiotics will not work, and the body will fight the infection on its own.

However, irrespective of the cause, there are things one can do to feel better, such as getting adequate rest and consulting a doctor on the use of over-the-counter pain killers like ibuprofen or acetaminophen.

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Dear Doc,
Should I kiss if I have tonsillitis?
Anonymous

Dear Anonymous,
Just like any other infection, tonsillitis infection is contagious. Therefore, if you kiss when you have tonsillitis, you risk passing the infection to the person you kiss.

It is best to avoid kissing, and to take precaution and cover your mouth when sneezing or coughing, particularly when you are in the public, to avoid spreading the infection.

Also ensure to wash your hands regularly for example, before preparing meals or handling a baby.

If your child is suffering from tonsillitis, keep them at home for at least the first two days of treatment so that they do not spread of the infection to other children.

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