The tonsils are compact bodies of lymphoid tissue found at the back of the mouth and the top of the throat. Their function is to remove bacteria and other microorganisms to prevent infections in the body. When these nodes become inflamed, tonsillitis occurs, which is characterized by a severe sore throat, fever, and red tonsils.
The tonsils are the immune system’s first line of defense against bacteria and viruses that enter the mouth. This makes them vulnerable to infection and inflammation.
“Along with the adenoids, the tonsils are part of a ring called Waldeyer’s ring, which is lymphoid tissue that helps us protect our body and fight pathogens. They are important because they produce immunoglobulins and are part of the production of B and T cells that form our immune system,” explains Heidi Morales, an otorhinolaryngologist.
A viral or bacterial infection causes the lymphatic tissue on both sides of the throat to become inflamed and tonsillitis occurs. “The inflammation can spread to the adenoids or the lingual tonsil because it is all lymphoid tissue. The most important pathogen of this disease is group A beta-hemolytic streptococcus,” adds the professional.
Tonsillitis can be caused by viruses such as the herpes simplex virus, Epstein Barr virus, or adenovirus, although the most common is the streptococcus virus. Thirty percent of cases are caused by bacterial infections and the most susceptible are children under two years of age; when the cause is the streptococcus virus, it occurs in children and young people from 5 to 15 years of age.
Inflammation of the tonsils occurs when a virus or bacteria enters through the mouth or nasal passages of the person and settles in the lateral area of the oropharynx, the middle part of the throat located behind the mouth. Because the tonsils are lymphatic tissue, they contain active lymphocytes ready for the entry of any infectious molecule, so when the virus or bacteria enters the tonsils are activated and become inflamed as an immune response of the body.
Tonsil function declines after puberty. This may be a factor in why fewer cases of tonsillitis occur in adults, the Mayo Clinic website says.
Types of tonsillitis
There are several types of tonsillitis, which differ in symptoms, development, and treatment. Acute tonsillitis is the most common in young children and adolescents, while chronic tonsillitis is the least common and is characterized by longer periods, explains Vivian Castañeda, an otorhinolaryngologist.
Acute tonsillitis
Acute tonsillitis is the most common type of tonsillitis, which is seen in both children and adults. Symptoms may include sore throat, very red tonsils with a yellowish coating covering them, dysphagia (difficulty swallowing, meaning the body needs more time and effort to move food or liquid from the mouth to the stomach), tenderness in the cervical lymph nodes in the neck, fever, headache, general malaise, and fatigue. These symptoms last one or two weeks, depending on the treatment. They do not occur intermittently over six months.
Recurrent tonsillitis
It is also usually caused by the streptococcus virus and the symptoms are the same as those of acute tonsillitis. However, this is characterized by the fact that the person can have up to seven tonsillitis infections per year, five infections in the last two years, or three infections per year in the last three years. Having this frequency of tonsillitis is considered to be “recurrent”.
Chronic tonsillitis
Chronic tonsillitis presents the symptoms of acute tonsillitis, but may also include halitosis (bad breath), respiratory obstruction, sleep disorders, and pauses in breathing at night.
This type of tonsillitis is characterized by very recurrent symptoms, which occur at least every six months. The person may even have a history of sore throat, halitosis, lymph nodes in the neck that remain swollen for a long time, or the tonsils may trap food debris.
“Among the complications of poorly treated or untreated tonsillitis are peritonsillar accesses, which consist of the bacteria generating a buildup of pus, which expands towards the soft tissue. This causes excessive pain, fever, and difficulty opening the mouth,” explains Dr. Morales.
When should tonsils be removed?
Because tonsils are easily accessible, a doctor can easily diagnose this disease. Treatment for tonsillitis caused by streptococcus should last ten days to ensure that the medication has worked or that it has fought the virus.
In addition to the basic treatment, which is usually penicillin or amoxicillin, doctors recommend painkillers to help with fever. However, the doctor must be the one who makes the diagnosis and prescribes the medicine.
Specialists say that tonsillectomy (removal of the tonsils) is recommended when tonsillitis is very recurrent. That is, if you have had seven episodes of this disease in the last year; or if you have had five episodes in the last two years; or if you have had three episodes in the last three years.
Tonsils are also removed when the patient is intolerant to the treatment.
Home remedies for tonsillitis
Along with the medication, some actions can help reduce inflammation of the tonsils, which will help reduce pain and burning in the throat. According to naturopath Eduardo Mendoza, this should not be done instead of taking the medicine prescribed by the doctor.
- Saltwater gargle: Gargling or rinsing with warm salt water will help to relieve a sore throat. Ideally, dilute half a tablespoon of salt in a glass of warm water.
- Tea with honey: Warm drinks will help soothe sore throats, and adding honey will enhance the antibacterial properties. It is recommended to drink ginger and chamomile tea, as these strengthen the properties of honey.
- Eat cold and soft foods: Cold foods are good for treating inflammation and reducing pain. Ideally, they should be soft foods, so as not to strain the throat. It is recommended to eat yogurt, ice cream, ice cubes, and frozen smoothies, and drink cold water with ice.