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Tonsillitis

Published by Bupa's health information team, February 2008.

This factsheet is for people who have tonsillitis, or who would like information about it.

Tonsillitis is the reaction your tonsils have to infection. Tonsillitis affects people of all ages but it's more common in children.

• About tonsillitis
• Symptoms
• Causes
• Diagnosis
• Treatment
• Further information
• Questions and answers
• Related topics
• Sources

About tonsillitis

The tonsils

The tonsils are small glands at the back of your throat. They are lymph organs and are part of the lymphatic system. The tonsils are thought to help your body fight infection when you are young. However, they are less involved with fighting infection as you get older.

The position of the tonsils

What is tonsillitis?

Tonsillitis is inflammation of your tonsils. It's caused by a viral or bacterial infection. There are many viruses and bacteria that cause tonsillitis. They include the influenza (flu) virus, the Epstein-Barr virus (glandular fever) and group A beta haemolytic Streptococcus bacteria.

Symptoms

If you have tonsillitis you may have some of the following symptoms:

• sore throat
• tiredness
• high temperature
• pain when you swallow
• bad breath
• ear pain
• headache

You may also notice that:

• you have red and swollen tonsils
• the back of your throat is red
• there are white spots on your tonsils (this is pus from the infection)
• the glands in your neck are bigger than usual

Complications

Tonsillitis can cause complications such as:

• middle ear infections (otitis media)
• an abscess on or around the tonsils which may restrict breathing (quinsy)
• inflammation of the sinuses (sinusitis)
• a lung infection such as bronchitis or pneumonia
• inflammation of the kidney (acute glomerulonephritis)
• inflammation of the joints and muscles (reactive arthritis)
• a rash, which may develop if you have a group A beta haemolytic Streptococcus bacterial infection (scarlet fever)

Causes

The virus or bacterium causing the infection can be passed between people. For example if you are in direct contact (eg kissing) with an infected person, or you are near them when they cough or sneeze. The droplets of infected mucus or saliva suspended in the air can then be breathed in by you.

Diagnosis

If you visit your GP, they will ask about your symptoms and examine you. They may also ask you about your medical history. A blood test may be done to rule out infections such as glandular fever, which is caused by a different virus.

Treatment

Self-help

Your infection may be mild and you may not need treatment. There are several things you can do to help yourself feel better.

• Rest in a quiet, warm place and try to sleep.
• Ensure you drink enough fluids as dehydration can make you feel worse.
• Sucking throat pastilles which contain a mild anaesthetic may help to soothe your throat.
• Gargling with salt water may ease the pain in your throat.

Medicines

Before taking any medicines ask your pharmacist for advice. Follow the instructions in the patient information leaflet that comes with the medicine.

Paracetamol is an effective painkiller for tonsillitis. Soluble paracetamol held in the mouth can have a longer lasting effect on pain than non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Adults and children over 14 may choose to gargle soluble aspirin.

For more information, please see Related topics.

Benzydamine hydrochloride (eg Difflam) mouthwash or spray may also help to relieve pain associated with tonsillitis.

Most sore throats will get better within a week and don't need antibiotics. If you visit your GP they may prescribe antibiotics for five to 10 days, depending on the type of infection you have. Antibiotics can only be used to treat bacterial infections. Penicillin is usually prescribed for tonsillitis; if you are allergic to penicillin, erythromycin may be given. It's important to only take antibiotics if they are needed and to complete the course prescribed to you, to prevent antibiotic resistance developing.

Surgery

If you have tonsillitis more than five times a year or you have had symptoms for more than a year, and your tonsillitis stops you doing normal activities, your doctor may suggest you have your tonsils removed. This procedure is called a tonsillectomy. Before you choose this treatment you should discuss it with your doctor as the operation also has complications.

For more information on tonsillectomy, please see Related topics.

As young children get older, throat infections occur less often so they may not need surgery. Ask your doctor for advice.

Further information

• British Association of Otorhinolaryngologists - head and neck surgeons
  020 7404 8373
  www.entuk.org


• Department of Health
  020 7210 4850
  www.dh.gov.uk

 

Related topics

• Adenotonsillectomy in children
• NSAIDs
• Paracetamol
• Tonsillectomy in children

Sources

• Acute Tonsillitis. GP Notebook. www.gpnotebook.co.uk, accessed 22 August 2007
• Antibiotics for Sore Throat. The Cochrane Library. www.cochrane.org, accessed 22 August 2007
• British National Formulary (BNF) September 2007. BMJ Publishing Group, 2007. 53
• Management of Sore Throat and Indications of Tonsillectomy. Scottish Intercollegiate Guidelines Network (SIGN). www.sign.ac.uk, accessed 23 August 2007
• Roland NJ, McRae RDR, McCombe AW. Key Topics in Otolaryngology UK Jones AS, 1995
• Recurrent Throat Infections (Tonsillitis). BMJ Clinical Evidence. www.clinicalevidence.com, accessed 23 August 2007
• Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford. 2005:914-15
• Sore Throat - Acute. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 22 August 2007
• Tonsil Surgery. The British Association of Otorhinolaryngologists. www.entuk.org, accessed 22 August 2007

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr James Quekett, Bsc MB ChB MRCGP DRCOG DFFP, partner/principal general practitioner at Rowcroft Medical Centre, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: February: 2008.