How Do You Know If You Have Tonsillitis?

First off, it’s not caused by eating a lot of sweets.
PHOTO: istockphoto

When I was younger, I used to think tonsillitis was caused by eating an insane amount of sweets. So like most children, I tried to avoid candies in the hopes of never contracting the disease. But guess what? I still found myself with swollen tonsils. 

So I asked Dr. Ray U. Casile, M.D. to tell me more about tonsillitis.

What is tonsillitis?

According to Dr. Casile, tonsillitis is the inflammation of the tonsils—aka the pair of tissues found on the sides of the uvula or the small finger-like flesh hanging in the middle at the back of your mouth.

What causes tonsillitis?

Most cases of tonsillitis are caused by infection and in these cases, Dr. Casile says that usually, the whole upper respiratory tract is inflamed—including the nose, throat, sinuses, and the voice box. He says, “During the infection, the surfaces of these structures swell as a response,” and the sometimes, the tonsils react more than other structures which leads patients to “only notice the painful throat and swollen tonsils.” 

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What are the symptoms you should look out for?

According to Mayo Clinic, the tonsils are “the immune system's first line of defense against bacteria and viruses that enter your mouth.” It’s common for children and teenagers because the tonsils’ immune system function declines after puberty, which makes the illness quite rare for adults. 

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However, tonsillitis in adulthood are still possible and may exhibit the following symptoms:

  • Red, swollen tonsils
  • White or yellow coating, patches on the tonsils
  • Sore throat
  • Difficulty in swallowing
  • Enlarged, tender lymph nodes in the neck
  • A scratchy voice and bad breath
  • Fever, headache, and stiff neck

Dr. Casile says that even though the infecting organism colonizes the upper respiratory tract, it’s still a systemic (whole body) disease: “For this reason, the patient feels other symptoms beyond the respiratory tract—fever, headache, body weakness and muscle pains.

However, if only one side of the tonsils is inflamed, Dr. Casile says “the doctor must be suspicious of why the problem is localized to one side and investigate further.” This usually means there are new growths in the area that can be benign or malignant. 

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How do you treat tonsillitis?

If the disease is caused by an infection, Dr. Casile says it’s best to treat it directly. “Since the most common cause of infection are viruses—to which antibiotics or antimicrobials are ineffective—we support the body with rest, lots of fluid intake and [increase] the body's source of energy.”

Doctors may also prescribe medicines to treat other symptoms accordingly—they may give you antipyretics, such as acetaminophen or paracetamol, for fever. These meds can also address the headaches and body pains. Aside from this, you may also take decongestants or cold medications for the blocked nose.

Is tonsillitis contagious? If yes, how does it spread?

Since it is an upper respiratory tract infection, it can be transmitted through droplets, which, according to the microbiology department of Mount Sinai Hospital “can be generated when an infected person coughs, sneezes, or talks.” 

You can reduce droplet transmission by washing your hands regularly, covering your mouth and nose when coughing or sneezing, and using a face mask to avoid bodily fluids from spreading.

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How do you know if you need surgery for tonsillitis?

Before doctors decide if a patient needs tonsillectomy (aka surgery to remove the tonsils), Dr. Casile says there are two major signs to look out for:

  1. When the enlarged tonsils are causing breathing problems, specifically when air can’t pass through the throat because of it. The obstruction must be addressed and sometimes the practical solution is to remove the tonsils. Take note: Other tissues in the throat can also result in a tight airway so tonsillectomy may not always be the absolute solution for the airway obstruction.
  2. When one tonsil is larger than the other. The most logical way to find out if the patient needs to undergo surgery is to take tissue from the tonsil and send it to the pathologist to find out what’s causing the infection. It’s possible to take only a part of the tonsil but it is more complicated that removing the tonsil itself.
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How is tonsillitis different from a sore throat?

Again, tonsillitis is a medical term that means inflammation of the tonsils. Dr. Casile explains that it's our body’s response to infection, trauma, or new growths. The events include formation of new blood vessels in the area, seeping of fluids and blood components to the outside of these blood vessels, and an attempt to eliminate or fix the infection, trauma, or new growth.” While sore throat on the other hand, is the term people usually use “for the symptoms brought about by the inflammatory events.”

How do you prevent tonsillitis?

Since tonsillitis is caused by viral bacteria and infection, the best way to prevent it is by practicing proper hygiene. Always remember to wash your hands properly and thoroughly, especially after going to the restroom and before eating. 

Dr. Ray U. Casile, M.D. is an Ear, Nose, Throat - Head and Neck Surgery consultant at St. Luke's Medical Center Q.C. and an Associate Professor at the St. Luke's Medical Center College of Medicine.

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