Tonsils and tonsillitis
By: Joanne Smith, M.D.
Tonsils. They sit on either side near the back of your throat. Officially they are called palatine tonsils, but most people know them by their shorter name.
Tonsils are part of the lymphatic system, which helps fight infections. Your tonsils provide a first line of defense against pathogens that are inhaled or ingested. When tonsils trap germs that are trying to enter the body, their battle against infection may cause them to swell and become inflamed and infected themselves. This is a condition known as tonsillitis.
Symptoms of tonsillitis include redness, swelling, fever, a white coating on the tonsils, bad breath, painful swallowing, voice changes because of swelling, fever and swollen glands (lymph nodes) in neck. If the infection is bacterial in origin, such as group A streptococcus, antibiotics may be used. Other treatment includes plenty of rest and fluids.
To prevent attacks, ensure a healthy balanced diet, regular exercise, plenty of fresh air, avoid cigarette smoke and secondhand smoke, practice good oral hygiene by brushing teeth at least twice each day.
Tonsils tend to reach their largest size near puberty and then shrink when kids hit their teens so tonsillitis is most often a childhood disease. Attacks of tonsillitis may hit their peak around school age, and then decrease in frequency over time.
In severe cases, when patients have chronic and recurring tonsillitis, surgery to remove the tonsils may be recommended. In addition to persistent tonsillitis, a doctor might recommend a tonsillectomy for a child who has enlarged tonsils, which are interfering with breathing, sleeping or swallowing.
While tonsils are part of the lymphatic system, and trap germs to help our bodies fight infection, there does not seem to be any negative effects on the immune system or health status of patients who have them removed. In fact, the effect is generally positive. Symptoms from tonsillitis can cause difficulty and pain when swallowing. This may lead to weight loss. In addition the illness can lead to time lost from school; children run the risk of falling behind.
You can still experience a sore throat and strep throat after your tonsils have been removed. In the United States, the number of tonsillectomies has declined from about one million per year in the 1970s to 250,000 per year currently. In addition, the reason for surgery has changed. Thirty years ago, approximately 90 percent of tonsillectomies in children were done for recurrent infection; now about 20 percent of surgeries are because of infection and 80 percent for obstructive sleep problems.
Most kids will experience a sore throat on occasion and enlarged tonsils without any symptoms are common among kids. In addition, it’s important to remember that the tonsils are doing the work they are meant to do when they trap bacteria and viruses from entering the body. It is only when tonsillitis is recurrent that surgery might be considered. It can be difficult for a parent to know whether tonsils are infected and in need of a physician’s treatment. If your child is experiencing recurrent and persistent sore throats or you suspect tonsillitis, contact your doctor. He or she can help you determine the best course of treatment to get your child up and running (literally) sooner rather than later.
Dr. Smith is a board certified family practice physician at Raiter Clinic in Cloquet.