Enlarged Tonsils

The tonsils are two lumps of tissue on both sides of the back of the throat that act as the immune system’s first line of defense against bacteria and viruses that enter the mouth. This function makes tonsils vulnerable to infection and swelling, or tonsillitis.

Signs and symptoms

Tonsillitis most commonly affects children between preschool ages and the mid teenage years. Common signs and symptoms of tonsillitis include:

• Red, swollen tonsils
• White or yellow coating or patches on the tonsils
• Sore throat or painful swallowing
• Fever
• Bad breath
• Headache

Inflammation or enlarged tonsils can also cause complications such as:

• Disrupted breathing during sleep (sleep apnea).
• Infection that spreads into surrounding tissue.
• Infection that results in a collection of pus behind the tonsil.

Treatment

At-home care strategies can promote better recovery for your child. If a virus is the expected cause of tonsillitis, these strategies are the only treatment.

• Rest and get plenty of sleep.
• Drink adequate fluids. Drinking plenty of water helps to keep the throat moist and prevent dehydration.
• Provide comforting foods and beverage. Warm liquids — broth, caffeine-free tea, or warm water with honey — and cold treats like ice pops can soothe a sore throat.
• Prepare a saltwater gargle. A saltwater gargle of 1/2 teaspoon (2.5 milliliters) of table salt to 8 ounces (237 milliliters) of warm water can help soothe a sore throat. Gargle the solution and then spit it out.
• Humidify the air. Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat or sit for several minutes in a steamy bathroom.
• Offer lozenges. Children older than age 4 can suck on lozenges to relieve a sore throat.
• Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat.
• Treat pain and fever. Talk to your doctor about using ibuprofen or acetaminophen to minimize throat pain and control a fever. Low fevers without pain do not require treatment.

Tonsillectomy

Surgery to remove tonsils (tonsillectomy) may be used to treat frequent or recurring tonsillitis. Frequent tonsillitis is generally defined as:

• At least seven episodes in the preceding year.
• At least five episodes in the past two years.
• At least three episodes a year in the past three years.

The procedures may also be recommended if:

• A bacterial infection causing tonsillitis doesn’t improve with antibiotic treatment.
• An infection that results in a collection of pus behind a tonsil doesn’t approve with drug treatment or a drainage procedure.

A tonsillectomy is performed in an outpatient setting under general anesthesia. The surgery is done through the child’s open mouth with no cuts through the skin and no scars. The procedure usually takes about 20 – 30 minutes. Most children can go home the same day as the procedure.

The typical recovery takes 10 – 14 days of mild discomfort and pain which may include sore throat, runny nose, noisy breathing, and bad breath.