What is Tonsillitis
Tonsillitis is the inflammation of the tonsils, two oval-shaped tissues located at the back of the throat. It is a common condition, especially in children, but can affect people of any age. Tonsillitis is usually caused by a viral or bacterial infection and is often self-limiting, but recurrent or severe cases may require further medical attention, including surgery known as tonsillectomy.
Tonsillitis: Symptoms and Causes
Symptoms of Tonsillitis
Sore throat.
Red, swollen tonsils, sometimes with white or yellow patches.
Difficulty swallowing or painful swallowing.
Fever.
Swollen lymph nodes in the neck.
Bad breath.
Ear pain.
Fatigue and feeling generally unwell.
Causes of Tonsillitis
Viral infections: The most common cause of tonsillitis, including cold and flu viruses.
Bacterial infections: Most notably, Streptococcus pyogenes (group A strep), which causes strep throat. Bacterial tonsillitis may require antibiotic treatment.
Management of Tonsillitis
At-home care: Most cases of viral tonsillitis resolve on their own and can be managed with supportive care such as:
Pain relief with paracetamol or ibuprofen.
Rest, hydration, and warm saltwater gargles.
Throat lozenges and warm drinks for soothing relief.
Antibiotics: If tonsillitis is caused by a bacterial infection, such as strep throat, antibiotics (usually penicillin) may be prescribed. It’s important to complete the full course of antibiotics even if symptoms improve before finishing.
Frequent or Severe Tonsillitis: If a person experiences recurrent tonsillitis (typically defined as 5 or more episodes in a year), or if the tonsillitis leads to complications such as abscesses (quinsy) or obstructed breathing, surgery may be considered.
Tonsillectomy
A tonsillectomy is a surgical procedure to remove the tonsils. It’s one of the most common surgical procedures performed on children in the UK, but it can also be done in adults who suffer from chronic or recurrent tonsillitis.
Indications for Tonsillectomy:
Recurrent tonsillitis: Defined as more than 5 episodes per year for 2 years or more, or multiple episodes of severe tonsillitis.
Chronic tonsillitis: Persistent low-grade infection causing ongoing discomfort, bad breath, or sore throat.
Obstructive sleep apnoea: Enlarged tonsils causing breathing problems during sleep.
Peritonsillar abscess (Quinsy): A collection of pus around the tonsils, which may require surgery to prevent recurrence.
Tonsillectomy Procedure:
The procedure is usually performed under general anaesthetic.
The tonsils are removed either with traditional surgery or other techniques such as electrocautery (using heat) or coblation (radiofrequency).
The operation typically lasts about 30 minutes, and most people can go home the same day.
Recovery from Tonsillectomy:
Recovery time is usually about 1 to 2 weeks.
Patients are likely to experience a sore throat, ear pain, and difficulty swallowing during the first week post-surgery.
It is important to maintain hydration, eat soft foods, and use prescribed pain relief medications to manage post-operative discomfort.
Potential Complications of Tonsillectomy:
Bleeding: A small number of patients may experience bleeding during or after surgery.
Infection: As with any surgical procedure, there is a risk of infection.
Pain: Post-operative pain can be significant but is usually well-managed with medication.