Kathmandu

At the back of your throat or oral pharynx, there are two lymphatic tissue masses called Palatine tonsils or simply tonsils. What is their purpose, you might think. But a group of tissues in the pharynx including these tonsils serve an important protective mechanism for removing small inhaled particles when we eat or take in air. As tonsils are a protective mechanism, Dr Jayendra Pradhananga, Clinician/Manager, Kathmandu ENT Hospital, Purano Buspark, Kathmandu says there are chances for them to suffer from infection. That is referred to as tonsillitis.

When you are suffering from one, there is an inflammation in the tonsils. Symptoms include “sore throat, difficulty in swallowing, painful lymph node, body ache, fatigue and weakness”.

So how does infection occur in tonsils? 

Tonsillitis occurs due to viral and bacterial infection. Tonsillitis can be caused by a virus, such as the common cold or “bacterial infection by Group A beta haemolytic streptococci, that also causes rheumatic heart and kidney diseases,” explains the doctor.

There are many factors that infect tonsils. From low immunity to where one lives, one is prone to tonsillitis; it might get complicated if it is not taken care of.

Prone to infection 

Tonsillitis is common in people who have lower levels of immunity.

“Whenever the immune mechanism of your body is lowered, there are chances for infection,” informs the doctor citing, bacteria that can easily attack tonsils on such an account.

Environment too plays an important role for tonsillitis. Dr Pradhananga sees air pollution as one of the major reasons for the occurrence of tonsillitis because “it has bacteria”.

With increase in air pollution of the Capital, he has witnessed a rise in the number of tonsillitis patients. He shares, “In 10 years of practice, there used to be one or two patients with throat infection per week, but these days the number has increased to two to three cases per day.”

As such in the Valley which is covered in dust and pollution, he recommends to “protect oneself by wearing face masks”.

And if you have problems of sinusitis or have infection of the upper respiratory tract, be careful. The doctor says, you are more prone to the infection because the infections are anatomically very near to the tonsils.

Common in children

Tonsillitis affects children and young adults, but Dr Pradhananga says it is more common in children.

“In children up to six years of age, the tonsils are larger which make them prone to tonsillitis while adults have smaller tonsils. Children aged 12-13 years are prone to the infection as this age group likes eating ice-cream, panipuri and titaura,” Dr Pradhananga informs. “It is usually low in people above 50 years of age.”

Enlarged tonsils do not always mean tonsillitis. If your children has one but “if you don’t have sore throat, fever or other common symptoms of tonsillitis, then you don’t need to worry,” points out Dr Pradhananga. Also every sore throat or pain in throat is not tonsillitis.

If it is tonsillitis, it shouldn’t be ignored because “repeated infections could lead to rheumatic heart diseases”.

And don’t aggravate it. According to the doctor, speaking for longer hours will stress the vocal cord which increases the inflammation on tonsils, while certain food items (hot, cold and sour) trigger inflammation. So you and your children must “speak less when you have tonsillitis and limit the intake of sour, cold and hot food items and wear face masks to protect oneself from dust and smoke,” he suggests.

Further complications

Don’t take tonsillitis for granted.

The doctor says that if left untreated, it can lead to serious complications such as tonsillitis stone, tonsillitis cyst and there are chances for one to suffer from peritonsillar abscess — bacterial infection that usually begins as a complication of untreated streptococcal infection or tonsillitis.

“Pus is collected around the tonsils which will lead to complications and can become life threatening too,” he warns.

Sometimes, it hampers your daily life. Due to tonsillitis, there is discomfort in throat, difficulty in swallowing or sleep apnoea — obstruction in breathing in children.

Gargling is the best way to alleviate the condition; if not, you have to see a doctor. In some cases surgery is the answer.

“If there are recurrent episodes of infection — six to seven episodes of tonsillitis in one year, four to five episodes consecutively in the second year, and three to four episodes consecutively in the third year, surgery to remove tonsils is chosen,” Dr Pradhananga reveals.

Surgery is also performed whenever there is a malignancy in the tonsils. But there is a myth that the tonsillitis reoccur after surgery and it affects your voice, to which the doctor says, “There aren’t chances for recurrence and the surgery of tonsillitis has nothing to do with one’s vocal cord.”

Precautions for tonsillitis

• Improve your diet
• Rinse your mouth after eating
• Wear face masks
• Treat your infections
• Do not take antibiotics
• Gargle with warm salt water for three days
• Drink hot fluids
• If painful, you can take paracetamol tablets
• Do not ignore recurring tonsillitis