Rimsha Shafeeq frequently suffered from cold and sore throat. At the age of seven, she was diagnosed with tonsillitis and her physician prescribed a more targeted treatment plan to help alleviate her symptoms.
“I suffered from persistent tonsillitis from a young age,” recalls Shafeeq. Her parents tried homoeopathy to reduce the frequency of antibiotics, but the relief was temporary. Over time, her tonsils enlarged, and infections became more frequent and severe, causing difficulty breathing, especially while sleeping. “At 13, doctors advised me to undergo a tonsillectomy,” she says.
Recovering from tonsillectomy was a test of patience for the Gurgaon-based HR consultant. Strict dietary restrictions refrained her from consuming cold and spicy food. She suffered from ear pain and nosebleeds due to the prescribed antibiotics. The healing process, she says, was further hindered by mouth ulcers caused by the pressure from the gag used during the procedure.
ABCs of tonsils
Tonsils are nothing but tissues in the throat that act like guards to protect our body from bacteria and viruses entering the system, says Dr Santosh Shivawswamy, consultant, ENT and head and neck surgeon, Manipal Hospital, Bengaluru. They serve as active defenders from birth until age five, but as other defense systems take over, their role decreases. Over time, tonsils can become a source of infection rather than protection, he adds.
Tonsils have a rough surface known as crypts or crypta magna that can trap food particles and get accumulated on them says Dr Shivawswamy. These food residues usually wash out when we gargle, but occasionally they get stuck and provide a source of energy for the bacteria within. This can lead to the development of tonsillitis, an infection of the tonsils, he adds.
Types and complications
According to Dr Ria Emmanuel, ENT consultant specialised in allergy and immunotherapy, Narayana Multispeciality Hospital, Bengaluru, tonsillitis can be:
- Acute tonsillitis that does not last for more than a few days
- Chronic tonsillitis that lasts for more than a month or three months
Complications of tonsillitis listed by Dr Emmanuel are:
- One can develop a localised collection of pus near the tonsil and towards its side and back. If it is not treated properly, it might require drainage.
- Bacterial infection called streptococcal can lead to rheumatic fever and glomerular nephritis that affects the heart and kidneys respectively. These problems are caused by something called immune complex deposition, which is a complication that happens even if the infection of tonsilitis is not still there.
- Tonsilitis can worsen the symptoms of psoriasis, a skin condition with itchy and dry patches.
Causes, Symptoms and treatment
“Tonsillitis can be accompanied by an upper respiratory infection such as a cold, sinusitis, or pharyngitis and a systemic inflammatory response such as infectious mononucleosis, which is a viral and rare infection,” says Dr Emmanuel.
Most cases of tonsillitis are caused by viral infections, however in some cases, bacteria, or both can be present. The severity of tonsillitis can be similar for both.
A person can get infected by being near someone with the infection or sharing food or utensils. The person with viral infection feels sick only after a few days. Some viruses have latency, which means the virus continues to exist in the body even after replication ends, sensitising some of the bacteria in the body and causing a mixed illness.
A person may have a fever, sore throat, and trouble swallowing at the onset of tonsillitis. If it is a minor viral illness, it will usually clear up on its own within two to three days. Doctors advise gargling with salt water, drinking warm liquids, and avoiding cold foods for a speedy recovery.
When someone has a mixed infection, their tonsils will become swollen, red, and have a yellowish-white substance called exudates on the surface.
When tonsillitis lasts longer than 48 to 72 hours, a person might have symptoms like bad breath, and a constant feeling of something stuck in the throat. Moreover, antibiotics become necessary as directed by the doctor. Some children and adults may have lymphadenopathy (enlarged lymph nodes).
“The removal of the tonsils is mainly preferable if they require more than two to three courses of antibiotics yearly since it appears to be more useful than keeping the tonsils and taking regular antibiotic courses,” says Dr Shivawswamy. The procedure of removing the tonsils is called a tonsillectomy.
Dr Emmanuel lists out a few situations when doctors advise this procedure if one has:
- Chronic tonsillitis or recurring tonsil infection.
- A pus collection around the tonsil in the last recurring infections.
- Obstructive sleep apnoea due to larger tonsils and adenoids (tissues behind the nose).