SYMPTOMS, CAUSES, AND TREATMENT OPTIONS FOR TONSILLITIS

Tonsillitis refers to the inflammation or swelling of the tonsils, usually due to viral or bacterial infection.

The tonsils are small masses of tissues present around the throat. They consist of lymphatic tissues to fight infection. These act as filters against microbes, especially at a young age. When the child grows up and immunity develops, the tonsils may start to shrink as their role in immunity becomes less significant.

Tonsillitis is usually acute (starts suddenly). It subsides within a week or two. But it can recur often throughout the year. This condition is called chronic tonsillitis and requires definitive treatment. There are three major tonsillar glands and a pair of smaller tonsils.

Types of tonsils

• Palatine or faucial tonsils:-

The palatine tonsils are the only tonsillar glands that are visible when the mouth is open. These glands are the first line of defense against any microbes that enter the throat or respiratory tract. They are found bilaterally at the back of the throat and are the glands that are commonly referred to as ‘tonsils’.

• Pharyngeal tonsils:-

These glands are present close to the midline, high up in the throat at the spot where the nasal cavity meets the pharynx (throat). They are commonly referred to as adenoids when they are swollen.

• Lingual tonsils:-

The lingual tonsils are present on the posterior surface of the tongue and they are not prone to infection or inflammation.

• The tubal tonsils are present on either side at the spot where the middle ear is connected to the back of the throat.

When the palatine tonsils get inflamed, the condition is called tonsillitis. Although it can occur at any age, tonsillitis frequently affects children and pre-teens.

Symptoms of tonsillitis

The tonsils are pink under normal conditions. In response to infection, they turn red and become enlarged.

• Sore throat is the primary symptom of tonsillitis.

• The tongue and the tonsils develop a coating over their surface with white or yellow pus-filled spots.

• Nausea, vomiting, and stomach ache in young children often lead to irritability and a lack of appetite.

• Drooling, because children have difficulty swallowing their saliva.

Other commonly observed symptoms are -

• Halitosis (bad breath)

• Cough and sickness similar to a common cold or the flu.

• Pain while swallowing food as the throat is narrowed because of the enlarged glands.

• Fever, pain in the ear

• Swollen glands (lymph nodes) in the neck

• The voice may change.

When tonsillitis has a viral origin, these symptoms usually subside in four or five days.

Causes of tonsillitis

In a majority of children, tonsillitis is due to viral infection. These are mainly:

• Rhinoviruses. These also cause the common cold,

• The influenza virus, and

• In some cases the adenovirus. This also causes diarrheas'.

There are some bacteria like Group A streptococcus. These could also cause tonsillitis accompanied by a condition called strep throat.

These microbes get trapped in the tonsils of young children leading to a high viral or bacterial load. This causes the enlargement and inflammation of the tonsils.

Although tonsillitis isn’t contagious, the microbes that are responsible for the infection can spread easily through droplets when an infected person coughs or sneezes. Anyone within a couple of metres can directly inhale such contaminated droplets.

Infections can also spread indirectly when a child rubs their nose or mouth after touching a surface that is contaminated by these droplets.

Treatment options for tonsillitis

While tonsillitis can be confirmed from the symptoms and by a clinical examination of the throat, it is not possible to say whether it is a viral infection or a bacterial one. To find out, a strep test or a throat culture with a throat swab is needed. 

Most instances of tonsillitis are self-limiting, especially if they are of viral origin and not much treatment is required.

How to cure tonsils fast with supportive care:

• By ensuring that children with tonsillitis get adequate rest at home and not sending them to school.

• They should be given plenty to eat and drink to avoid lethargy and prevent headaches.

• For relief from pain, they can be given paracetamol and ibuprofen.

• Antiseptic solutions and warm salt water can be used as a gargle, and are quite effective for relieving pain due to sore throat.

• Lozenges are better avoided in small children

Foods To Avoid In Tonsils

• Hard and crunchy foods can cause more pain to a throat that is already sore.

• Citrus fruits and their juices are acidic and can worsen inflammation.

• Sour or pickled food

• Spicy items 

Instead, children can be given:

• Bananas, frozen fruit pieces, 

• Smoothies, spoonful's of curd

• Soups, warm tea, honey

• Scrambled eggs for protein intake

• Vegetables that have been boiled and become soft, like mashed potatoes and carrots

When bacterial tonsillitis is accompanied by severe symptoms that aren’t subsiding with supportive measures, antibiotics are prescribed.

Surgery is sometimes necessary to remove the palatine tonsils. The procedure is called a tonsillectomy and is performed when:

• There is recurrent or chronic tonsillitis with a sore throat.

• When it is confirmed to be of bacterial origin and doesn’t respond to antibiotics

• There is breathing difficulty, sleep apnea (breathing is affected during sleep), or there is extreme difficulty in swallowing.

• There's a localised collection of pus in the glands.

Although rare, an abscess (collection of pus) can develop around one of the tonsillar glands. This abscess is called quinsy. It is more often seen in adults. The condition requires immediate medical care as it can get worse rapidly, causing difficulty in speaking and even breathing.

Without appropriate treatment, bacterial tonsillitis can spread to infect the sinuses or the middle ear. Rarely, the infection can spread to the lungs or the kidneys.

Summary

Children are particularly prone to air-borne infections due to shared spaces in classrooms and daycare centers. They should be instructed in maintaining good personal hygiene including:

• How to wash their hands with soap after using the restroom and before eating.

• Not sharing water bottles and other utensils

• Replacing toothbrushes after an episode of sore throat. 

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