What Exactly is Tonsillitis?

The tonsils are small, oval shaped areas of glandular tissue that lies either side of the back of the mouth. These are important in fighting off infections as well as having other roles to play in the immune system.

When anyone – particularly children – gets a sore throat, a cough or other upper airway infection the tonsills become enlarged as their purpose is to help the body fight off these sorts of infections. As the cough/sore throat improves the tonsils will naturally shrink down back to their normal size. In some cases the tonsils themselves can become quite enlarged and swollen in which case tonsillitis may be diagnosed. The difference between an “ordinary” cough & sore throat and tonsillitis is really only one of degree. 

Typical symptoms of tonsillitis include:

  • Red, swollen tonsils
  • Bad breath
  • White or yellow spots on the tonsils
  • Sore throat
  • Discomfort whilst swallowing
  • Fever or temperature
  • Enlarged, tender glands in the neck
  • A hoarse or throaty voice
  • Headache

Younger children are often less able to describe their symptoms clearly and signs of tonsillitis in very young children may include:

  • Drooling due to difficult or painful swallowing
  • Tummy ache
  • Refusing to eat

Whilst uncomfortable, tonsillitis is usually a relatively mild illness which will usually resolve on its own. However, in some people it can become a problem that keeps coming back every few months, causing recurrent bouts of illness and lost days from school or work. If that is the case tonsillectomy may be advisable.

What causes tonsillitis and how is it treated?

Tonsillitis is usually caused by a viral infection and will settle on its own over a few days. In this case you don’t need antibiotics and simple painkillers such as paracetamol and cool drinks will help. However tonsillitis may on occasion be caused by bacterial infections – you may have heard of a “streptococcal sore throat” – and in these cases antibiotics may be advisable.

Do I need my tonsils removed?

In the majority of cases, no. However if you have repeated bouts of tonsillitis or have had complications of tonsillitis (such as a quinsy – an abscess within the tonsil) then tonsillectomy may be advisable. Unfortunately this is a procedure which is infrequently done in the NHS and you may need to be seen privately to have it done.

What happens during a tonsillectomy?

Tonsillectomy is performed under a general anaesthetic as a day-case procedure which means you can go home on the same day. It takes around 30 minutes and there are no stitches that need to be removed at a later date. The operation is carried out through the mouth so there are no scars or cuts anywhere else on the face or neck.

Once you have recovered from the anaesthetic you will be given something light to eat and a drink. Eating and drinking will be uncomfortable for several days whilst the area heals but is usually controlled well with simple painkillers such as paracetamol and ibuprofen. It is important to continue eating and drinking as normally as possible – you may well find ice cream and cold drinks helps with any discomfort.