How to recognize chronic tonsillitis

Most people experience sore throat , an acute form of tonsillitis. Its symptoms go away quite quickly, on average in 3–4 days . But inflammation of the tonsils – the two oval pads of tissue at the back of the throat – can be something else. Less noticeable, but extremely dangerous.

What is chronic tonsillitis

Chronic tonsillitis is a long-term inflammation of the tonsils, in which symptoms persist for more than two weeks. This disease occurs more often in adolescents and adults and almost never occurs in children under two years of age.

A chronic condition develops if, after experiencing a sore throat, the body for some reason was unable to completely defeat the infection.

Tonsillitis itself is not contagious . The diseases that cause it are contagious: for example, flu and colds.

What are the symptoms of chronic tonsillitis

When chronic tonsillitis develops, the symptoms may appear very mild: sometimes a person does not even realize that he is sick. The most common signs of the disease are :

• constantly inflamed, enlarged tonsils;
• chronic sore throat, which either disappears or gets worse again;
• bad breath;
• plugs in the tonsils – this is the name given to pieces of debris that have hardened and accumulated on the surface of the tonsils;
• permanently enlarged lymph nodes in the neck .

When to go to the doctor

If you often get acute tonsillitis, you should discuss the possibility of a chronic form with your doctor.

It is worth making an appointment with an ENT specialist or therapist if, during an exacerbation, a sore throat persists for four days, and also if white spots appear on the tonsils.

If a child is sick, you should consult a doctor in a situation where the sore throat lasts more than 48 hours, there is a fever, weakness, fatigue or fussiness.

Call an ambulance if you or your child have difficulty breathing and swallowing or begin to drool profusely, or if pus appears on the tonsils and the pain is so severe that you cannot drink or eat.

Where does chronic tonsillitis come from?

As in the case of sore throat, the cause of chronic inflammation of the tonsils is most often viruses or bacteria, for example :

• pathogens of influenza and parainfluenza;
• adenoviruses;
• enteroviruses;
• cytomegalovirus;
• herpes simplex virus;
• Epstein-Barr virus;

A chronic form of tonsillitis can develop if the acute form of tonsillitis is not treated or if the infection was caused by bacteria that are resistant to antibiotics . Another probable cause is immunity disorders: asthma, allergic rhinitis, autoimmune diseases, immunodeficiencies. The risk of chronic tonsillitis is also increased in people who have undergone radiation therapy.

Why is chronic tonsillitis dangerous?

Without treatment, the disease can cause complications that affect your overall health and quality of life.

1. Sleep apnea

Apnea is a condition when a sleeping person stops breathing. Not for long, just a second or two or so. But apnea attacks are repeated, sometimes many times during the night.

Inflamed tonsils are a common cause of so-called obstructive sleep apnea . It can be recognized by the characteristic snoring that accompanies each episode of respiratory arrest.

Due to apnea, the body does not receive enough oxygen. In addition, every time the brain wakes up to give the signal: “Breathe!” The sleeper himself does not remember these awakenings. But they cause serious harm to health, causing :

• constant feeling of fatigue during the day;
• decreased performance, rapid fatigue;
• unstable mood, even depression;
• problems with heartbeat: arrhythmia, tachycardia;

If apnea (more precisely, the causes that caused it) is not treated, over time it can lead to the development of chronic heart failure and acute cardiovascular diseases, including heart attack .

2. Shortness of breath

Constantly swollen tonsils partially block the flow of air into the airways. This means that in order to get the required amount of oxygen, a person has to breathe more often (take more breaths). And shortness of breath in this case occurs at the slightest physical exertion.

3. Ear infections

The infection may spread to the ear because it is nearby. This increases the risk of otitis media .

4. Infections of surrounding tissues

For example, a peritonsillar abscess is a large and painful collection of pus in the subcutaneous pockets around the tonsil. Sometimes the abscess spreads to the throat, neck, or jaw.

5. Autoimmune diseases and diseases of internal organs

In a more complex form of chronic tonsillitis caused by bacteria (most often group A streptococcus ), toxins released by microbes enter the bloodstream. Together with the bloodstream, they spread throughout the body and destroy tissues of internal organs, including the heart, liver, and kidneys.

Toxins can also lead to the development of allergies and autoimmune diseases: rheumatoid arthritis , rheumatic carditis (inflammatory heart disease), glomerulonephritis, autoimmune thyroiditis and others.

How to treat chronic tonsillitis

Before doing anything, it is important to find out what causes tonsillitis. Treatment will depend on the cause.

It is difficult to distinguish bacterial tonsillitis from viral tonsillitis on your own; for this it is better to consult a doctor.

There is no specific medicine for the treatment of viral tonsillitis – doctors advise simply relieving the symptoms and waiting for the body to cope with the exacerbation.

• If your throat hurts , use gargles, sprays, lozenges.
• For other types of pain, try taking ibuprofen or paracetamol.
• Drink more fluids – water, tea, broths.
• Eat enough. To reduce pain when swallowing, choose warm broths and soft foods, such as purees.
• Don’t smoke – cigarette smoke irritates your throat.
• Get plenty of rest.

In case of a bacterial infection, a course of antibiotics may be required in addition to these measures. It is important to go through it completely, even if the disease subsides a couple of days after the start of treatment.