Drink
warm or cold fluids
|
Eat
soft, bland foods
|
Gargle
with warm, salty water (adolescents and adults)
|
Use
acetaminophen or ibuprofen for pain relief and fever reduction
|
Use
throat lozenges or eat hard candy (not recommended for young children)
|
Get
plenty of rest
|
Drink
plenty of fluids to prevent dehydration.
|
Your doctor is the
best source of information on the drug treatment choices available to you.
Surgery to remove the
tonsils, known as tonsillectomy, is performed infrequently, and mainly in cases
where a patient has repeated, severe episodes of tonsillitis, or if bacterial
tonsillitis does not respond to antibiotics. Having one's tonsils removed was
once a childhood rite of passage. Today, however, tonsillectomies are rarely
done because effective new drugs are now available for treating bacterial
tonsillitis. In addition, doctors have developed a better understanding of the
role of tonsils in the body's immune system, and no longer believe they should
be routinely removed if they become infected.
A tonsillectomy may be
recommended for an individual with chronic tonsillitis. A tonsillectomy may be
necessary if you experience frequent episodes of tonsillitis within a year
(five to seven episodes is usually the benchmark), or have five episodes a year
for two straight years.
The tonsils may also
be removed if they are large and are blocking the throat. Tonsils that are too
large can cause breathing problems for children or adults, and a tonsillectomy
is sometimes recommended to relieve this problem. Enlarged tonsils also may be
removed if they seem to be causing a problem known as obstructive sleep apnea,
which is a condition wherein breathing is blocked during sleep when the airway
pulls shut. It can occur in children as well as in adults.
If tonsillitis is not
effectively treated, it may lead to a condition called peritonsillar abscess,
and require a tonsillectomy. A peritonsillar abscess is a collection of pus or
infected material around the tonsils. It can occur when one or both of the
tonsils become infected, and pus spreads from the tonsils to surrounding
tissues. The condition can develop when antibiotics fail to cure an otherwise
ordinary case of tonsillitis, or when tonsillitis improves, and then gets worse.
Peritonsillar abscess may spread to the roof of the mouth, the neck, and the
chest. The airway could then become obstructed, a situation requiring emergency
treatment, which may include removing the tonsils. Peritonsillar abscess is
infrequent, and is more common in adolescents and young adults than in
children.
A tonsillectomy can be
performed in the hospital or at an outpatient surgical facility. A
tonsillectomy is usually done by an ear, nose, and throat specialist, or a
general surgeon, often as same-day surgery. After administration of general
anesthesia, the patient's mouth is held open to expose the tonsils. The tonsils
are then grasped with clamps, pulled forward, cut free of surrounding tissue,
and removed. The doctor will seal the blood vessels to stop the bleeding. The
doctor may also remove another set of tonsillar tissues, called the adenoids,
from the back of the upper part of the throat. The combined procedure is
referred to as tonsillectomy and adenoidectomy.
In most cases,
patients can go home several hours after surgery, although very young children
(age three or under) or those with other medical problems typically require an
overnight stay. The most common complication is bleeding, which may occur
immediately after surgery or several days later. If bleeding occurs while you
are at the hospital or outpatient center, you will be taken to the operating
room for additional care. If minor bleeding occurs at home, try rinsing your
mouth with ice water. Call the doctor or go to the emergency room if bleeding
becomes excessive.
Side effects such as a
sore throat, fever, nasal congestion, earaches, and moderate pain are likely
for several days after a tonsillectomy. Consume easily swallowed foods and
liquids such as custard, gelatin, pudding, ice cream, popsicles, and iced
drinks for about a week after surgery. Gradually introduce more solid foods,
but avoid crispy or sharp-edged foods such as bacon, toast, or chips until the
throat is fully healed. Drink plenty of liquids to prevent dehydration, but do
not serve citrus juices or acidic fruits that can cause irritation. Your doctor
may prescribe antibiotics to prevent infection. For pain relief, the doctor may
suggest acetaminophen or prescribe a pain medication. Do not use ibuprofen or
aspirin, as they can increase the risk of bleeding.
A full recovery takes
about two weeks. Children should rest in bed for several days, and gradually
resume a normal schedule. During the recovery period, the pain may fluctuate.
Contact your doctor if pain and other symptoms do not improve.
If eating is painful,
you may experience weight loss. If your throat hurts, use the pain medication
recommended by your doctor, and consume only easily swallowed foods. Any weight
lost during the recovery period will usually be regained quickly once a normal
diet is resumed.
Acupuncture may be
used to treat tonsillitis pain. Acupuncture treatment may provide relief from
the pain of tonsillitis, according to The World Health Organization, and may be
one option to consider if conventional forms of treatment have not been
successful. Many doctors can make referrals to certified acupuncturists, or
identify organizations that can provide information and referrals. Although
acupuncture is widely used in many parts of the world to treat a range of
health problems, including tonsillitis, it is not known how widely acupuncture
is used in the United States. Consult your doctor if you are considering
acupuncture therapy to relieve the pain of tonsillitis.
With proper medication
and self-care, most cases of tonsillitis will resolve within a week or two.
Tonsillitis generally is cured within a week or two, particularly with plenty
of rest and fluids. Chances of a full recovery are also increased when the
full, 10-day course of antibiotics prescribed for bacterial tonsillitis is
taken as directed. If bacterial tonsillitis is not treated, or if it is
undertreated because all medication was not taken, there is an increased risk
of rheumatic fever or kidney disease.
It probably will not
be necessary to see a doctor for a follow-up visit unless complications
develop, or if you or your child have had a tonsillectomy. If you or your child
had a tonsillectomy, your doctor may want to follow up in a few weeks to make
sure that healing has progressed. Since most cases of tonsillitis resolve on
their own, however, you probably will not need to follow up with your doctor if
you didn't have surgery. Call the doctor's office if your or your child's
symptoms do not improve after a few days, or if the symptoms become worse.
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