Back in the 1950’s and 60’s, removal of a child’s tonsils was standard fare. Many practitioners ignored evidence as to their usefulness, and thought they didn’t serve much of a purpose, if any. Thus, if infections of the tonsils became a problem, as is very common in children, out they would come in one of the most popular pediatric surgeries of the time. Thankfully, tonsillectomies are not performed nearly as often these days, and for good reasons. The tonsils play an important role as a filter for the body, and to help stimulate our immune system. But infections of the tonsils can lead to serious consequences, especially if strep bacteria is the cause. If not surgery, what is the best way to handle tonsillitis? Let’s find out how this organ works, and what can be done to deal with it when infection occurs.
What Are Tonsils?
The tonsils are actually masses of lymph gland tissue that are located on both sides of the back of the throat, just above the base of the tongue. They are similar in structure and purpose to the adenoids, which are also composed of lymph tissue. The tonsils are visible in the back of the throat if you look in a mirror. The purpose of the tonsils is to act as a filter to trap bacterial and viral invaders that are inhaled into the body through the mouth and nose. They also alert the immune system to release white blood cells when infectious agents are present. So the tonsils are put there by our creator to serve a definite and crucial need. They are not disposable, and they certainly weren’t included in the design of the body as an afterthought. Tonsils are particularly vital in young children, whose immune systems are still developing, and who have not been exposed to a lot of the germs that adults have been and therefore have not yet had time to develop immunity to them.
Research as far back as the 1930’s and beyond indicated the importance of the tonsils at fighting disease. Evidence has been uncovered which points to the detoxifying effects of the tonsils in such ways as purifying the blood and other major body systems. As part of the lymph system, the tonsils are more important to overall health of the body than we may even be aware of. The tonsils have the unique ability to expand and contract as needed to handle more invaders at any given time if necessary. They actually act as kind of a “gatekeeper” to guard against and disarm intruders. One German doctor, who was a strong opponent of the common practice of removing the tonsils, was credited with the following quote in 1934. Referring to the function of the tonsils, he said: “An able innkeeper throws out of the house those who make themselves obnoxious.” Perhaps we can consider the tonsils to be the “bouncer” for the body. It is important to remember that removal of the tonsils is only a short-term solution to recurring infections. However, this action weakens the overall immune system, and can come back to haunt children and adults later in life.
What is Tonsillitis?
As critical as the tonsils are to our health, they themselves can become overwhelmed by the very germs they are defending against. When this happens, the tonsils become infected, and the result is tonsillitis (inflammation of the tonsils). When viruses or bacteria infect the tissues of the tonsils, they can become inflamed and swollen. Typical symptoms of tonsillitis include:
- Severe sore throat
- Swollen glands (lymph nodes in the jaw and neck)
- Difficulty swallowing
- Muscle aches
- Visual examination of the tonsils may reveal swollen, red tonsils, often with white or yellow spots, and a thin mucous coating.
The vast majority of tonsillitis cases are found in children from the ages of 5-10 years. However, it can occur at any age, and will rarely show up in adults.
What Causes Tonsillitis?
Tonsillitis is caused by either a viral or bacterial infection. The most common culprit is a bacterium called Streptococcus pyogenes, the same bug that causes strep throat. The second most common source of tonsillitis infections is the virus that causes mononucleosis (Epstein-Barr virus). About a third of mononucleosis patients will develop tonsillitis as well. Tonsillitis is very contagious, and can spread easily amongst people, especially kids, in close quarters. School and daycare centers are prime areas for the infection to breed and be passed on.
We will discuss treatment in a moment, but suffice it to say that if the source of tonsillitis is viral, it pretty much must be allowed to just run its course, which is usually 1-2 weeks. However, if the strep bacterium has caused the tonsillitis, it becomes a more serious situation. Left untreated, strep infections can lead to dangerous complications such as kidney damage and rheumatic fever, which can affect the heart, nervous system, and joints. When your child comes down with tonsillitis, it is critical to determine whether strep is present, and if it is to treat it immediately with antibiotics.
What Treatments Are Available for Tonsillitis?
As mentioned above, the first step is to find out if the infection is viral or bacterial. Most sore throats in children are caused by viruses, however most tonsillitis infections are caused by strep. The best way to confirm the source of the infection is to have a throat culture taken. A sterile swab is used to take a sample from the tonsils. Results may be available immediately, or within 24-48 hours, depending on the lab capabilities of your provider. If strep is present, treatment with antibiotics is recommended immediately. You should also be aware that if the Epstein-Barr virus is found to be present, your child might have mononucleosis (mono) along side of tonsillitis. Mono lasts much longer than tonsillitis, usually about 6 weeks, so it the tonsillitis drags on, mono may be responsible.
- Viral tonsillitis is an illness that the body will rid itself of in time, usually a couple of weeks or less. Some ideas to make your child more comfortable include:
- Plenty of fluids. Water is great and necessary. But mild soups, such as broth, or herbal teas can help soothe the sore throat.
- Gargling with salt water can also bring relief. Use about a ½ teaspoon of salt in 8 oz. of warm water.
- Tea with honey and lemon is also helpful for irritated throats. The lemon will help to reduce mucous. Just be aware that the use of honey (or anything with corn syrup in it) is not recommended for infants under the age of one.
- Echinacea and garlic are also helpful to boost the immune system, and encourage faster healing. This applies whether the infection is viral or bacterial.
Give the patient plenty of rest, and an extra dose of TLC, and they will soon be back to normal. The fever should dissipate within a few days. If it doesn’t, or it is over 102 F, have your child be seen by a health practitioner. The infection could be a sign of a more serious condition.
- If a culture indicates the presence of strep, you have another situation on your hands. Its not time to panic, but strep is nothing to mess around with. A strep infection, especially in a young child, is one time that treatment with antibiotics is usually justified. The best course of action is to take the medication for the entire 10-14 days as prescribed, even if you feel better after a couple of days. Antibiotics can cause other problems, such as disturbing the balance of good bacteria in the digestive tract and other parts of the body, but in the case of strep it is best to use them to knock it out. I recommend the use of a quality probiotic to help replace the good bacteria that the antibiotics may kill. A high quality yogurt with live active cultures can also be a great help. Try freezing yogurt with a popsicle stick in it to make “yogurt pops” for your kiddos. The yogurt will help replace bacteria, and the cool treat will soothe their aching throats.
What Complications Can Occur From Tonsillitis?
Strep infections are the biggie that you have to watch out for. However, there is one more major complication that can occur, and it may be one of the only conditions that can justify a tonsillectomy.
Peritonsillar abscess is a condition whereby a tonsillitis infection produces pus between one or both tonsils and the soft tissues surrounding it. When this happens, the result is an acculmulation of infectious material known as an abscess. Sometimes abscesses may swell and grow so large as to cause the roof of the mouth and the tongue to meet, and airflow may be obstructed, as well as making swallowing difficult. Abscesses can also spread infection to other parts of the body, if the poison is allowed to enter the bloodstream. While a rare occurrence, this can be a very serious situation. Some individuals, both children and adults, seem to have a propensity for abscesses to form during repeated tonsillitis infections. If this is the case, it may be best to have the tonsils removed to avoid further and more critical complications. However, I would consider your options carefully before surgery. Some folks with compromised immune systems may open themselves up to other recurring infections if the tonsils are removed. It is best to get the advice of a health care practitioner that knows you and your body well, if at all possible.
Any Other Self-Care Tips That Might Help?
Give yourself (or your kids) time to rest and recoup. Create the best atmosphere you can to help the body heal itself.
- Keep the air moist with a humidifier.
- Stay away from smoke and other pollutants.
- Rest your voice. Laryngitis can often be avoided by simply taking a sabbatical from talking except when absolutely necessary.
The best defense is a strong offense, as they say. Staying healthy via good diet and lifestyle choices will protect you from most infections, including tonsillitis. A strong immune system will help you heal quickly if you are infected occasionally. So, you see, health begins before you get sick. Staying well is much easier than getting well.