What is tonsillitis? How serious can it be ? When to consider surgery ?

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Tonsils are two in number, situated inside our mouth. It provides natural defence (immunity) against several infections. Usually till the age of 6-7years, they grow in size and then later on gradually shrinks in size. However they are present in adults as well.


It is the infection of the tonsils with some bacteria that lead to inflammation of the tissue & its surrounding structures. This condition is called as TONSILLITIS. There is a similar kind of tissue known as Adenoid situated in the upper part of throat behind the nasal cavity. Many a times Adenoid tissue also get inflammed and enlarged during Tonsillitis.

COMMON SYMPTOMS:

~Throat pain

~Pain while swallowing

~Difficulty in swallowing

~Fever

~Throat irritation

~Neck swelling

These are the common symptoms seen. Sometimes there can be an accumulation of fluid in the middle ear secondary to this and can lead a medical conditon called 'serous otitis media' and cause ear pain ( mostly seen when there is adenoid enlargement as well). 

Adenoid enlargement can cause mouth breathing, snoring,nasal blockage and sometimes nasal bleeding as well.

WHAT TO DO?


At the earliest, you should get an ENT doctor consultation and start treatment. This condition can be very well managed if we are starting treatment early. 

Your doctor will give you antibiotics(to control the infection), analgesics (to control pain), antipyretics (to control fever), decongestants (to control congestion/inflammation) and some gargles to provide a soothing effect and to cleanse the tonsils and surrounding tissue from pus and other food debris.

WHAT NOT TO DO?


Do not ignore and avoid consultation. Stop taking over the counter medications. Instead get done a thorough consultation and start proper treatment.

Do not take any cold drinks, ice creams and other cold food items.

Do not hesitate to do gargles. If you are not at all comfortable with the medicated gargles. At least do mild warm saline gargles.

WHAT HAPPENS IF YOU DO NOT TAKE PROPER TREATMENT?


Stopping treatment in the midway is almost equivalent or more dangerous than not taking treatment. Because half treatment will only arrest the infection temporarily, which may later flare up with severe symptoms. Also half treatment will lead to resistance of the involved bacteria against the commonly used antibiotics making it ineffective during next episode.

If proper treatment is not taken, there can be several complications associated.

•Chronic tonsillitis- Improper clearance of bacteria can lead to frequent re infection of the tonsils leading to chronicity. 


•Pus collection(Abscess)- Delay or improper treatment can lead to further growth of infective organisms and may lead to pus formation.


•Middle ear infections - Infections in throat region can ascend to ear as well through eustachian tube ( pharyngotympanic tube ) which connects middle ear with upper part of throat behind nasal cavity. 


•Joints, muscles, heart and kidney diseases - a particular group of bacteria ( Streptococcus ) which cause tonsillitis has potential to affect & damage your joints, muscles and heart ( Rheumatic fever) and Kidneys ( Glomerulonephritis ). 

•Sleep disorders - Persistent infection and inflammation of tonsils and adenoid can adversely affect your sleep. Frequent sleep disturbances and arousal can have serious problems in your mental and physical health.


So, don't take tonsillitis lightly. Get an ENT Consultation. Take proper treatment and lead a healthy life.

WHAT ABOUT SURGERY ? WHEN TO ? HOW TO ?


Even though there are several guidelines which tells when the surgery is required based on number of episodes per year or 2 years or 3 years, it will be your doctor who will make a call on whether you actually require a surgery or not. Sometimes with less number of episodes if severe symptoms & complications are there and not responding very well with medicines, a surgery may be required. Sometimes even though several episodes are there but still getting managed with medicines and not affecting day to day activities, then surgery may not be required for the time being.

The surgical procedure is called Tonsillectomy. Usually surgery is considered only once the acute infective stage has subsided. It is done under General Anesthesia. Mostly if everything is going well, the patient will be discharged next day itself.  

There are different methods for doing tonsillectomy surgery. Conventional dissection method, Laser assisted method, Coblator method, etc. 

Adenoid if enlarged significantly are removed usually along with tonsillectomy in the same surgery.

So which one is good ? Should you run for a specific method for surgery ? No. In expert hands all the methods are equally good. Believe in your doctor. When all the methods are available, your doctor will choose the best one for you. 

AFTER SURGERY:


After a successful surgery, patient will be advised to start medicated gargles frequently. After about 4-6 hours patient can take liquids. Cold drinks are advisable to be taken during this time. It will help to reduce the throat pain and will create a soothening effect. After about 1/2 hours later patient can take Ice cream ( for pain relief ) and gradually start soft diet. From next day usually regular diet can be started. Initially throat pain will be there. Required medications and gargles are important. Pain will reduce gradually when patient starts taking food properly. If everything is going well, patient will be discharged next day after surgery. Patient will be asked to come for review checkup usually after 5-7 days.


LIFE AFTER TONSILLECTOMY


Ofcourse life is going to improve after the surgery because you were having an enlarged tonsils before which was a pocket for repeated infections. Now the child's sleep will be better. General activities improve. Overall performance and food in take improves. Growth also becomes better. 

So are tonsils not necessary at all? 

Yes it is. Tonsils perform a prime role in body immunity. But when it becomes a seat of repeated infection, it is better to get removed. Body has various immunity maintenance mechanisms. Rest of the things will take care of immunity.

RISKS ASSOCIATED WITH SURGERY

There is no surgery in the body which is not associated with any risks. So this surgery also has a few associated risks. Your Doctor will explain it to you before the surgery. But for an expert Doctor, the complications will be very minimal or nil. 

Hope the article helped to provide an overview regarding tonsillitis and it's management. 

In case of any doubt, feel free to comment.

Thank you.

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