Swollen Tonsils

At times, the tonsils can be infected and begin to swell as they fight the infection, and such infection leads to what is known as tonsillitis or swollen tonsils. The infection may be caused by bacteria or virus. Children tend to have swollen tonsils although adults may also have them. The condition may occurs in different patterns, for example, you can have it occurring occasionally or it may recur frequently. ^1,2

Causes

Since tonsils act as a line of defense of the body against illnesses, they are essential in ensuring that pathogens and microbes such as bacteria and virus do not cause harm to the body. These tissues produce white blood cells that in turn help fight infections in body. They combat microbes like viruses and bacteria, which enter the body through the mouth. Tonsils can also be vulnerable to infections from the same bacteria and virus they combat.

Among the leading causes of swollen tonsils are bacterial infections like strep throat. The American Academy of Family Physicians says that about 15 to 30 percent of cases of tonsillitis arise due to bacteria and in most cases, it is as a result of strep bacteria. Among the viruses that may cause tonsillitis include Epstein-Barr virus that is also linked to a condition known as mononucleosis.

The reason why children tend to be more susceptible to having swollen tonsils is because they are exposed to different bacteria and viruses as they interact and play in school.^1,2,3,4

Other common causes of swollen tonsils include:

• Influenza virus
• Adeno virus
• Parainfluenza viruses
• Herpes simplex virus
• Enteroviruses

Symptoms 

If you have swollen tonsils or tonsillitis, you may have symptoms such as:

• Fever
• Chills
• Severe sore throat
• Bad breath or halitosis
• Scratchy sounding voice
• Difficulty swallowing
• Painful swallowing
• Earaches
• Stiff neck
• Headaches
• Stomachaches
• White or yellow spots occurring on the tonsils
• Red or swollen tonsils
• Jaw and neck tenderness arising due to swelling of the lymph nodes
• Loss of appetite
• Ulcers on throat
• Blisters on the throat

In children, swollen tonsils may be accompanied by other symptoms such as abdominal pain, vomiting and nausea.^1,2,3,4

Diagnosis

A doctor will do a physical exam to the throat to feel or see signs that may indicate a patient has swollen tonsils. The doctor will feel the neck area where tonsils are found and see if they are swollen- appear as lamps of tissue that are enlarged or not looking the normal way. Apart from the physical examination, a doctor may also do other kinds of tests to determine the exact cause.

Throat Culture

This involves gently swabbing the area at the back of the throat to take the culture which is send to a lab to help identify the cause of an infection.

Usually a throat swab culture or rapid strep test will detect the presence of a bacterial infection, but will not show a viral infection. A doctor may at times, assume that when the test does not show a bacterial infection, it is then a viral infection.²

Treatment

To get treatment for swollen tonsils, a doctor will have to determine the cause. If the swelling of tonsils is caused by something minor such as a cold due to virus, it may not require treatment.

Antibiotics

If the tonsils are swelling because of a bacterial infection, antibiotics may be prescribed. A patient should ensure that they complete the whole course of antibiotic they have been prescribed even when the symptoms subside.

Tonsillectomy

Use of a surgery procedure known as tonsillectomy was common in the past. However, today, this procedure is only recommended if a patient has recurrent tonsillitis or chronic tonsillitis. Tonsillectomy is intended to remove tonsils and it can be helpful if other forms of treatment have failed to show positive response or if the condition results in other complications.

Tonsils are important in helping the immune system and their removal should be done with a lot of considerations and caution. If you have swelling tonsils that are recurring and becoming persistent, or if they have enlarged and are causing difficulties in eating or obstructing the airways, then surgical removal may be opted. While most of the tonsillectomies tend to involve use of a conventional scalpel to get rid of the tonsils, there are however many alternatives to this kind of procedure. Doctors are using other methods such as radio waves, lasers, electrocautery and ultrasonic energy to aid in cutting, burning, or evaporating away the enlarged tonsils.

Pain medication

A patient may need to take pain medication to help ease a very sore throat.

Intravenous fluids

A person who experiences dehydration as a result of tonsillitis may need to get intravenous fluids to help replenish the lost water in body.

If a patient does not take the antibiotics as required or if the antibiotics are incapable of warding off the bacteria, complications may develop such as poststreptococcal glomerulonephritis and rheumatic fever. Sometimes, people who have swollen tonsils or chronic tonsillitis may have other problems like obstructive sleep apnea because the airways have swollen and that is preventing the person from having good sleep.

At other times, an infection of the tonsils may spread to other parts of body and this is known as tonsillar cellulitis. Also, when there is spread of the infection, it could lead to buildup of pus in the area behind the tonsils something known as peritonsillar abscess. If this happen, it may require drainage and use of surgery to treat the complication.

When swollen tonsils is caused by virus, using antibiotics may not help cure the condition. The body will fight the viral infection on its own and therefore, you need to do everything possible to help in self healing of the body from such an infection. There are home care tips that a patient may need to follow to help get better when they have sore throat that is causing swollen tonsils, and these include:

• Drinking plenty of water and fluids
• Using throat lozenges
• Avoiding smoke
• Gargling the mouth and throat with warm salt water at least several times in a day
• Getting plenty of rest
• Using humidifiers to help moisten the air in the home
• Using OTC medications such as ibuprofen and acetaminophen to help in easing pain. 

Reference List

1. Tonsillitis: Symptoms, Causes, and Treatments. http://www.webmd.com/oral-health/guide/tonsillitis-symptoms-causes-and-treatments#1
2. Tonsillitis. http://www.healthline.com/health/tonsillitis
3. Swollen tonsils (tonsillitis) causes, symptoms, and home remedies. http://www.belmarrahealth.com/swollen-tonsils-tonsillitis-causes-symptoms-and-home-remedies/
4. Tonsillitis: What Causes Swollen Tonsils? https://www.verywell.com/what-causes-swollen-tonsils-1192012