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Chest and Respiratory Problems

Tonsillitis

Home Treatment - When to Call a Health Professional

The tonsils and adenoids are tissues in the throat that assist in making antibodies to help fight infections. The tonsils can be seen on either side of the throat at the back of the mouth. The adenoids are above the roof of the mouth and usually cannot be seen.

Inflammation of the tonsils (tonsillitis) or adenoids (adenoiditis) is common in children, and the two conditions may occur separately or together. Tonsillitis and adenoiditis are usually caused by a virus. Symptoms of tonsillitis or adenoiditis are sore throat, fever, and tiredness along with cold symptoms, such as runny nose and a cough. It may be painful to swallow, and the tonsils are often bright red, spotted with pus, and swollen. The lymph nodes in the neck may also swell. Adenoiditis can also cause headache and vomiting.

Location of tonsils and adenoids

 

Tonsillectomy and Adenoidectomy

It was once common to remove children's tonsils and adenoids. Today, in recognition of the risks, costs, and limited benefits, tonsillectomy and adenoidectomy are done less often, and only when the benefits greatly outweigh the risk, inconvenience, and pain.

Tonsillectomy may be recommended if at least 1 of the following criteria is met:

  • There have been at least 4 to 6 severe tonsillitis infections caused by strep bacteria in the past year despite treatment with at least 2 different antibiotics.

  • The enlarged tonsils cause severe breathing difficulty or sleep disturbance.

  • There are deep pockets of infection in the tonsils that haven't responded to drug treatment.

    Adenoidectomy may be recommended if at least 1 of the following criteria is met:

  • The enlarged adenoids are blocking the airway, causing breathing difficulty and sleep disturbance.

  • The adenoids are believed to cause persistent ear infections, despite antibiotic treatment.

    If your doctor recommends surgery but none of the above criteria are met, it may be wise to get a second opinion.

Snoring

Up to of adults snore occasionally, and of adults are habitual snorers. Snoring is caused by blockage of the airways in the back of the mouth and nose. These airways can be blocked for many reasons, such as excess neck tissue caused by being overweight or a stuffy nose caused by allergies or a cold. Some people who snore have sleep apnea. Sleep apnea is present when a person repeatedly stops breathing for 10 to 15 seconds or longer during sleep.

Snoring can disrupt a person's sleep patterns, so he or she may be sleepy and less alert during the day. A person's snoring can also disrupt the sleep of other family members or roommates. Here are some tips for people who snore:

  • Exercise daily to maintain a healthy body weight and improve muscle tone. Avoid exercise within 2 hours of bedtime, because exercise may make it harder to fall asleep.

  • Avoid heavy meals, alcohol, sleeping pills, and antihistamines before bedtime.

  • Sleep on your side rather than your back. (Sew a pocket onto the back of your pajama top, and put a tennis ball inside the pocket. This will keep you from sleeping on your back.)

  • Establish regular sleeping patterns. Go to bed at the same time every night, even on weekends.

  • Let the person who doesn't snore fall asleep first.

If snoring becomes a problem for you and affects your family life, see a health professional. An examination of the nose, mouth, and neck may be needed. A doctor may also want to do a sleep study to see if sleep apnea is one of the reasons why you snore. Treatment will depend on what is causing you to snore.

A severe sore throat with very swollen tonsils, fever, and swollen lymph nodes in the neck can be caused by a strep or other bacterial throat infection. See Sore Throat and Strep Throat for symptoms of strep throat. Strep throat must be treated with antibiotics.

A child with chronically inflamed adenoids may breathe through his or her mouth, snore, and have a nasal- or muffled-sounding voice. In children, inflamed adenoids can block the passageway between the ears and the throat (eustachian tubes), contributing to ear infections. See Ear Infections.

Surgical removal of the tonsils (tonsillectomy) or adenoids (adenoidectomy) used to be common operations for children who had frequent sore throats. Now it is thought that these lymph tissues may be helpful in fighting infection and should not be removed unless it is necessary.

Home Treatment

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Home Treatment is usually all that is needed for mildly swollen and painful tonsils that accompany other cold symptoms. See Colds.

When to Call a Health Professional

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  • If sore throat occurs with 2 of these 3 signs of a bacterial infection in the tonsils:

    • Fever of 38.3°C (101°F) or higher.

    • White or yellow coating on the tonsils or swollen, tender tonsils.

    • Swollen lymph nodes in the neck.

  • If you develop a sore throat or tonsillitis after being exposed to strep throat.

  • If a child has at least 4 to 6 bouts of tonsillitis in 1 year despite antibiotic treatment.

  • If a child persistently breathes through his or her mouth, snores, or has a very nasal- or muffled-sounding voice.

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