Tonsillitis; painful throat

Tonsils are located in the throat, part of the pharynx in the throat and nose, where they serve as first line barrier against infectious and harmful agents entering the body. They are part of the immune system of the body, i.e. system which helps fight against diseases in the body.  Inflammation of the tonsils is known as tonsillitis.

Tonsillitis is mostly caused due to bacterial or viral infections. There is pain and swelling over tonsils, with associated high fever, running of nose or blocked nose and cough, difficulty in breathing, one or more or all of these symptoms. This causes pain during swallowing and speaking.  Painful swallowing impairs intake of food. In severe cases, one may have problem in swallowing liquids also.  

The infection is mostly acquired by germs present in droplets in the atmosphere, brought about when another person brings them out through coughing, sneezing or talking. Infection of the ears or nose   can also spread to the tonsils. Curettage of the throat done by indigenous healers is yet another source of infection to the tonsils. There can be acute onset of inflammation in the tonsils, which mostly subsides within five to seven days, more so in case of viral infections. Some people have recurrent infections, whereas some suffer from chronic tonsillitis, where the inflammation is chronically present, making the person to suffer more.

An individual of any age or gender can suffer from acute or chronic tonsillitis. Persons with depressed immune system like HIV affected individuals, diabetics, and etcetera, are more susceptible to develop chronic tonsillitis.

Tonsillitis is not the benign temporary suffering   alone, as perceived by most people. Untreated or severe or persistent tonsillitis can lead to several complications. In case of recurrent or chronic tonsillitis, pockets of pus can form around tonsils which become difficult to treat and also aggravate   the problem. It can reach the ears causing chronic ear pain and discharge which can impair hearing. Infection can spread via blood stream to the body, causing septicemia. It can also travel to brain causing inflammation of the coverings of the brain or abscess in brain substance. This can manifest as severe headache, convulsions, paralysis of limbs, and etcetera. Only thing is, one may not suspect the tonsils as a source of infection, thus delaying the treatment.

Tonsillitis caused by Group B-hemolytic streptococcus viridians (a kind of bacteria), is known to cause Rheumatic fever which causes damage to the heart valves as a sequel. It can also damage the kidneys and lead to renal failure.

It is wise to prevent tonsillitis, rather than suffering from it. One should avoid very cold drinks or food, particularly if one is not sure if they are fresh and safe to take. Somebody having recurrent cough or cold due to allergy should try to control it by suitable measures, lest infection sets in and spread to the tonsils. Innocent village folks should be educated about the risks involved with the curettage of throat done by traditional practitioners.  By doing so, they are exposed to risk of acquiring not only acute tonsillitis but also HIV and Hepatitis B and C infections.

It is very easy to diagnose tonsillitis just by seeing the inflamed tonsils.  Cultures and drug sensitivity tests can help to know the type of causative germ    and a suitable antibiotic which would be curative. Anti-inflammatory drugs are needed to reduce the inflammation and pain. Along with drugs, drinking large quantities of warm liquids also helps in providing relief in tonsillitis. Hot saline gargles and or steam inhalation are other non-pharmaceutical measures used to soothe the aching throat in tonsillitis. Chronic or recurrent tonsillitis needs surgery for its correction. Formation of pockets of pus is yet another indication for surgery.

To remain absolutely healthy one should be prudent enough to avoid problems like tonsillitis. Even if it occurs, it is wise to treat it in time to avoid complications.   

Dr Rachna Pande,                                                    

Specialist, internal medicine

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