Treatment of hypertrophy of the palatine tonsils

Chronic tonsillitis is a disease of the palatine tonsils, which is characterized by exacerbations and periods of remission, the duration of which largely depends on the state of the patient’s immune system, as well as on the adequacy of therapy. The symptoms of chronic tonsillitis are vague, and therefore patients cannot independently diagnose the presence of this disease. If you feel even the slightest discomfort in your throat, this is a reason to immediately consult a doctor for advice. Timely conservative treatment will help avoid surgery and numerous systemic complications.

Description and symptoms of chronic tonsillitis

Chronic tonsillitis occupies a leading place among inflammatory diseases of the throat. Throat diseases reduce the quality of life and lead to complications. Chronic inflammation of the tonsils is often observed in children starting from 3 years of age and in young people.

Types of tonsillitis

1. Acute tonsillitis (tonsillitis) is an infectious disease with local manifestations of acute inflammation of the components of the lymphatic pharyngeal ring, most often the palatine tonsils, which is caused by streptococci or staphylococci, less often by other microorganisms.
2. Chronic tonsillitis is a long-term inflammation of the pharyngeal and palatine tonsils. Develops after a sore throat and other infectious diseases accompanied by inflammation of the mucous membrane of the pharynx (scarlet fever, measles, diphtheria), or without a previous acute illness.

There are two stages. Compensated and decompensated stages:

1. The compensated stage is a dormant focus of infection. There is no visible reaction from the whole body, no repeated sore throats. The barrier function of the tonsils and the reactivity of the body are not impaired. The edges of the palatine arches thicken, cicatricial adhesions appear between the tonsils, plugs form in the lacunae of the tonsils, liquid purulent discharge forms, and the submandibular and cervical lymph nodes enlarge. One of the problems of the compensated form of tonsillitis is bad breath, which occurs as a result of the formation of plugs in the lacunae.
2. During decompensation, frequent sore throats are a concern; complications of tonsillitis in the form of abscesses, inflammatory diseases of the ear and sinuses, as well as damage to other organs (heart, kidneys) are often observed. Exacerbation of chronic tonsillitis is also called tonsillitis.

Symptoms of chronic tonsillitis

• discomfort and pain when swallowing, especially in the morning;
• dryness, sore throat; sensation of a foreign body in the throat
• cough;
• bad breath;
• increased fatigue, weakness and sweating;
• decreased performance;
• low-grade fever 37.2-37.5°C
• deterioration of sleep;
• decreased appetite;
• pain in the cervical lymph nodes.

Causes that can lead to chronic tonsillitis

The following factors have a particularly strong influence on the chronicity of the process:

• Frequent sore throats, especially in the absence of adequate treatment;
• Impaired nasal breathing, which can be a consequence of both a deviated nasal septum and chronic rhinitis and sinusitis. If rhinitis is of an allergic nature, then it is advisable to do an allergen test and undergo appropriate treatment;
• Low body immunity.

Chronic tonsillitis develops due to a number of factors

• Intoxication - due to the absorption of bacterial toxins and products of chronic inflammation in the tonsils. Intoxication explains symptoms of chronic tonsillitis such as fatigue, weakness, headache, low-grade body temperature, etc.
• The formation of plugs in the tonsils irritates the nerve endings and causes moderate pain in the throat and heart area, cough, and bad breath. Nerve endings undergo degenerative changes, which can cause neurosis and other disorders of the nervous system.
• The body develops sensitivity to bacterial and tissue antigens - an allergy develops. Therefore, chronic tonsillitis is also of an autoimmune nature.

Chronic tonsillitis with complications can lead to functional disorders of cardiac activity, acquired heart defects. Chronic tonsillitis is associated with pathologies such as rheumatism, infectious arthritis, diseases of the urinary system, prostate gland, meninges, etc.

Features of the disease in children

Intensive development of the lymphoid ring begins in infancy - in the second year of life. Immediately after birth, the tonsils are underdeveloped and do not yet function fully. A feature of the tonsils in children 1-3 years old is deep lacunae, as well as narrow, densely branching orifices, which can extend to the capsule. Sometimes the lacunae turn sharply and extend under the integumentary epithelium instead of going deep into the tonsils. At the end of narrow passages there are characteristic expansions that contribute to the development of the inflammatory process.

A feature of younger age is hypertrophy of lymphoid tissue, which, along with an increase in the number of lymphoid follicles, leads to the growth of tonsils. The latter reach their largest size by 5-7 years. At this age, children are most susceptible to infectious diseases and most need protection from infections. Representatives of this age category are recommended to receive preventive vaccinations aimed at mobilizing lymphoid tissue to develop immunity.

The cause of hypertrophy of lymphoid tissue is the intensive formation of active immunity, which is accompanied by local production of antibodies in response to the penetration of an infectious agent. With age, by the age of 9-10, antibodies accumulate in the body, the immune system improves, which leads to age-related involution of lymphoid tissue. Part of it degenerates and is replaced by connective or fibrous.

The causes of childhood respiratory diseases are fungi, bacteria and viruses. If a child gets sick too often, the tonsils are regularly attacked, so the body does not have time to fully defend itself. This becomes the main reason for the development of chronic tonsillitis, along with incorrectly prescribed antibiotic treatment.

Chronic tonsillitis in a child turns into a constant source of infection, depleting the immune system. Quite often, the disease leads to serious complications, especially if timely help is not sought.

Symptoms

Unlike adults, in children the disease develops quickly, occurs in an acute form and is quite obvious. An obvious indication of chronic tonsillitis may be the following local reactions:

• redness of the tonsils;
• their increase, looseness;
• purulent discharge;
• enlarged cervical lymph nodes.

Frequent sore throats, bad breath, and discomfort during swallowing may also indicate the chronic nature of tonsillitis. Some patients experience sleep problems, headaches, and a subfertile temperature (37-37.5 °C).

Chronic tonsillitis in a pregnant woman

Symptoms of the disease in a pregnant woman are fever, general weakness, dry cough, sore throat, which is accompanied by a sensation of a foreign body. This is due to the fact that the tonsils withstand the attack of tonsillitis and respond to it with pain.

Not everyone knows that even a mild sore throat can harm the unborn child, as well as the woman herself. Sometimes the disease causes early miscarriage, and sometimes causes the development of late toxicosis, which negatively affects the development of the fetus. Since the presence of a chronic infection in the body weakens the immune system, a pregnant woman is at risk of developing other diseases.

Clinical studies have confirmed that chronic tonsillitis has repeatedly caused poor labor and premature birth, so women with this diagnosis are often recommended to have a cesarean section. Sometimes a disease that is not treated during pregnancy leads to the development of a heart defect in the child.

Causes of chronic tonsillitis in pregnant women

• sore throat, which has become a latent chronic form;
• hypothermia;
• deficiency of vitamins and nutrients;
• weakened immunity;
• problems with nasal breathing caused, for example, by a deviated nasal septum, polyps or adenoids;
• untreated caries;
• sinusitis.

To avoid undesirable developments, pregnant women are advised to eat well, avoid hypothermia, visit the dentist and generally monitor their health.

Why is chronic tonsillitis dangerous?

Regardless of the form of its occurrence, chronic tonsillitis can cause allergization and infection of the body. In the absence of medical control, the disease can lead to serious complications - frequent exacerbations in the form of a sore throat, recurring up to 6 times a year.

Another serious complication is phlegmon of the neck, which occurs against the background of severe forms of peritonsillar abscess. In addition, weakening of the tonsils leads to the penetration of infection into the underlying respiratory tract and the development of pharyngitis and bronchitis. In general, chronic tonsillitis either itself becomes a source of concomitant diseases or complicates their course.

An infection that has entered the body finds “weak” spots and can cause diseases of any of the systems - bronchopulmonary, urinary, cardiovascular. A chronic focus of infection has a negative effect on the blood coagulation system, metabolic and endocrine processes, the adrenal cortex, and the course of allergic conditions. Inflammation of the palatine tonsils causes epileptic attacks and aggravates the course of encephalitis and cerebral rheumatic vasculitis. The most dangerous is the decompensated form, which provokes changes in internal organs.

Consequences of chronic tonsillitis

1. The disease in a certain way affects the course of collagen diseases - rheumatism, systemic lupus erythematosus, scleroderma, polyarthritis, dermatomyositis, periarthritis nodosa.
2. The cause of frequent sore throats is heart disease - arrhythmias, endocarditis, myocarditis, acquired defects. Since there is a close connection between the lymphatic system of the heart and the ducts of the tonsils, even people under the age of 30 are diagnosed with cardialgia.
3. Chronic intoxication has an adverse effect on blood vessels, especially capillaries. Patients complain of increased fatigue, weather sensitivity, headaches including migraines, and dizziness (Meniere's syndrome).
4. The consequence of the chronic form of tonsillitis can also be diseases of the gastrointestinal tract - gastritis, colitis, duodenitis, stomach and duodenal ulcers.
5. Against the background of chronic tonsillitis, skin pathologies and diseases of the subcutaneous fatty tissue often develop - psoriasis, neurodermatitis, acne, microbial eczema, atopic dermatitis, polymorphic exudative erythema. It makes no sense to treat them until the source of infection is eliminated.
6. Chronic tonsillitis often causes lung diseases - bronchial asthma and chronic bronchitis, and also contributes to the exacerbation of chronic pneumonia. According to pulmonologists, the number of complications with such diagnoses can be reduced by 2-3 times if the source of infection is carried out in a timely manner.
7. The disease also has a negative effect on the accommodative apparatus of the eye. Early sanitation can, according to ophthalmologists, prevent the development of myopia, as well as prevent relapses of conjunctivitis and blepharitis.
8. The liver and the biliary system are also targeted by infection: cholecystitis, cholangitis and cholangiocholecystitis develop against the background of tonsillitis.
9. Weakening of the functions of the pancreas due to focal infection in the tonsils contributes to the formation of diabetes mellitus. The thyroid gland also suffers, and its hormone-forming function is disrupted (thyrotoxicosis).
10. Against the background of tonsillitis, there are disorders in the reproductive sphere: potency in men decreases, and in women of childbearing age, uterine bleeding, endometriosis, uterine fibroids, hypomenstrual syndrome and infertility are observed. Cases of pathological pregnancy - threats of miscarriage and premature birth - are not uncommon.
11. Another serious consequence is kidney damage (pyelonephritis, glomerulonephritis, nephritis, etc.).

Symptoms

Loose tonsils are a consequence of the development of the inflammatory process as a result of a variety of reasons. This in itself is not a disease, but its manifestation. Doctors do not diagnose “loose throat” - this is a visual manifestation of a concomitant illness. In addition, the following signs of the disease can be observed:

• Painful sensations when swallowing food and liquid.
• Deviation of body temperature from normal. In this case, the temperature can be either very high or not exceed the threshold of 37.3 degrees.
• Headache as a result of the toxicological effects of the breakdown of waste products of pathogenic microorganisms.
• General malaise. Lethargy, fatigue, weakness, body aches are a consequence of the development of infectious processes in the body.
• Hoarse voice. Appears after infection penetrates the vocal cords.
• Painful sensations and enlargement of the submandibular and cervical lymph nodes.
• External changes. Red throat, pronounced vascular network, protruding palatine tonsils, rashes on the tonsils, larynx and palate.

And also an unpleasant smell. In the absence of dental problems, this smell indicates the process of decomposition of lumps of food stuck on the surface of the tonsils. If food debris is not removed in time, inflammation of the lymphoid tissue is guaranteed.

Do not assume that such signs can appear at the same time. The presence of an inflammatory process in lymphoid tissue may be indicated by the presence of one or two symptoms.

Many dangerous and insidious throat diseases are difficult to recognize. Self-medication can lead to serious consequences for the body, as well as the development of chronic diseases.

Diagnosis of chronic tonsillitis

Diagnostic measures begin with an examination of the patient by a doctor who is interested in the appearance of the tonsils, as well as the presence of purulent or other contents in the lacunae. If this is detected, then it is necessary to conduct a bacteriological analysis of the discharge, followed by testing for sensitivity to antibiotics. A similar procedure is performed even if surgical removal of the tonsils is indicated to prevent postoperative infectious complications.

Often diagnostic measures include consultation with a cardiologist, nephrologist and so-called rheumatic tests. This allows you to determine how far the process has gone and whether there is systemic autoimmune damage to the target organs, such as the heart, kidneys and joints.

If there are indications for surgical removal of the tonsils, the patient must undergo additional examination, which includes:

• Blood test for hepatitis and HIV infection;
• Blood sugar test, since diabetes mellitus is a contraindication to such an operation;
• Cardiogram;
• Consultation with a therapist.

Treatment methods

Complex treatment of loose tonsils is based on identifying the cause of the pathology. In most cases, the appropriate therapy is prescribed by a doctor.

It is possible that to make a correct diagnosis you will need a laboratory blood test, a smear or scraping from the larynx and tonsils.

Collection of material is necessary to determine the sensitivity of pathogenic bacteria to a particular group of antibiotics.

Next, the doctor will take into account the general condition of the child, his age and the severity of the disease.

If a bacterial infection is detected, the following complex action is applied:

• Taking antibiotics. The drug, dosage and duration of use are determined only by the doctor.
• Use of anti-inflammatory sprays and tablets.
• Gargling with decoctions of medicinal herbs, medical compositions.
• Taking vitamins.
• Warm drink.
• Bed rest.

For a speedy recovery, physiotherapy may be prescribed:

• quartz;
• ultrasound;
• inhalation;
• magnetotherapy.

The presence of a common cold or viral infection requires adequate therapy, since untreated can result in pharyngitis or sore throat. Warm drinking, rinsing, taking antiviral drugs, and frequent ventilation of the room will help avoid complications.

In the absence of pain in the throat and accompanying signs of the disease: fever, cough, rash on the tonsils. It is important to monitor oral hygiene and prevent the development of inflammatory processes. You should wash the child’s nose and mouth with specialized solutions and sprays, spend more time in the fresh air and moisten the room.

Treatment of chronic tonsillitis

Treatment of chronic tonsillitis is traditionally carried out in two directions.

Conservative treatment

This therapy is relevant if pathological changes in the tonsils are compensated. This treatment effectively combines pharmacotherapy with physiotherapeutic methods and pursues the following goals:

• Physical elimination of infection from the surface of the tonsils;
• Relieving swelling and reducing the size of the tonsils;
• Elimination of symptoms of an allergic nature;
• Increasing local immunity, including through the inclusion of the tonsils themselves in the work.

Conservative treatment includes:

• Sanitation of the tonsils using ultrasound, which ensures a deep degree of cleaning of the lymphoid tissue;
• Anti-inflammatory laser therapy;
• Irrigation of the oral cavity with special medicinal solutions that increase local immunity and have bactericidal properties;
• Pharmacotherapy.

Surgical treatment involves complete or partial removal of lymphoid tissue, which can be carried out either traditionally or using a laser. Tonsillectomy has a significant list of contraindications, so the attitude of doctors towards it in recent years has been more wary than in previous decades.

Treatment of chronic tonsillitis in a child

Proper treatment of sore throat in most cases leads to a successful cure, while ignoring symptoms or incorrect actions can lead to the disease becoming chronic. In this case, exacerbations are possible almost once a month.

The treatment regimen for chronic tonsillitis in a child depends on the course of the disease and can be completely different, especially for periods of exacerbations and remission. In a state of remission, it is important to extend this period as long as possible, for which purpose anti-relapse therapy is prescribed at least twice a year, taking into account the individual characteristics of the patient.

General treatment includes non-sedating antihistamines, immunomodulators, vitamin therapy and homeopathy. Local methods include massaging the tonsils, washing the lacunae with medications, rinsing with antiseptics and treating the tonsils with agents that have antiseptic, anti-inflammatory and regenerating properties.

Physiotherapeutic methods are aimed at improving microcirculation in the tissues of the tonsils. These include:

• microwave therapy;
• ultrasound;
• laser therapy;
• Microwave and UHF;
• inductothermy;
• magnetic therapy;
• electrophoresis;
• inhalation;
• ultraviolet irradiation of the tonsils;
• mud therapy, etc.

If the disease has entered a protracted form, the approach to treatment changes radically - bacteriophages are used. We are talking about viruses that destroy streptococci and staphylococci as the main causative agents of the disease. This method has shown excellent results in the treatment of infections of the oral cavity and nasopharynx, which are accompanied by frequent relapses.

Home methods for treating chronic tonsillitis are allowed only under the supervision of a doctor. These include:

• ingestion of herbal tea from medicinal plants - St. John's wort, peony, calendula, chamomile, dill, coltsfoot, thyme, sage, eucalyptus, etc.;
• gargling with the above herbs;
• ingestion of propolis with honey.

Only regular treatment for two years can achieve positive dynamics. If exacerbations have not been observed for five years in a row, they speak of improvement. Compliance with all instructions often leads to a decrease in the number of relapses, however, if this result cannot be obtained, extreme measures are resorted to - tonsillectomy, or complete removal of the tonsils. Surgery has a number of contraindications.

Prevention of chronic tonsillitis

In order to prevent exacerbations, the tonsils need not only protection from adverse factors, but also hardening. To do this, doctors recommend periodically eating ice cream and drinking cold drinks in small portions - only during the period when the person is completely healthy.

It is important to eliminate all factors that can cause a sore throat, that is, take care in advance of the treatment of the nose and oral cavity, as well as the free breathing of the child. Rinsing with antiseptic agents helps clear the tonsils of bacteria. It is useful to gargle twice a day after meals with a solution of furatsilin, a decoction of sage, chamomile or calendula. The course is carried out for a month, then take a break.

Another effective remedy is tonsil massage. Perform it before going outside and before eating cold food. The procedure consists of light stroking in the area under the chin in the direction from the jaw to the chest. If the disease has become protracted, treatment should be more intensive.

Tonsillitis is a rather dangerous disease that can haunt a person throughout his life from early childhood and cause the most unexpected complications. Therefore, it is so important not to let the disease take its course, but to seek help in time.

Main causes

If you notice loose tonsils in a child, which clearly stand out with their rounded shapes, you should not panic and buy all the pharmaceutical drugs intended for the treatment of throat diseases. This condition indicates the onset of the development of the inflammatory process.

The tonsils began to form local protection so that the pathogenic microbes that got on them did not penetrate further into the body.

Interesting: in young children, the tonsils produce special enzymes that help break down food in the mouth.

The main culprit of looseness is a change in the functioning of the gland on the tonsils. In certain cases, the tonsils cannot cope with the effects of external infections. To fight microbes, a large number of lymphocytes are produced, but they are not always enough. As a result, painful processes begin to develop in the throat and nasopharynx.

There are several main reasons for the appearance of loose tonsils.

Entry of pathogenic viruses or bacteria into the oral cavity and nasopharynx. The production of plasmacides, microphages and lymphocytes begins in the follicles and lacunae. If the immune defense fails, the development of diseases such as tonsillitis, pharyngitis and others begins.

A decrease in the child’s immunity after suffering from infectious diseases as a result of the glands on the tonsils does not work correctly and the tonsils remain voluminous and loose.

Severe hypothermia or cold.

A residual phenomenon after suffering from acute respiratory viral infections or acute respiratory infections.

The presence of chronic diseases in the oral cavity (carious tooth decay, periodontitis, long-lasting wounds, etc.). The lymphatic system has to regularly suppress pathogenic microflora, which results in swelling of the tonsils.

In the case of frequent severe throat diseases, especially sore throats, damage to the lymphoid tissue begins as a result of which the mucous surface of the tonsils remains deformed forever.