Symptoms of the disease
Angina:
- pain in the throat when swallowing;
- increase in body temperature;
- the presence of purulent plugs on the tonsils;
- headaches;
- enlarged lymph nodes and their pain;
- a state of general weakness.
Chronic stage of tonsillitis:
- discomfort and pain when swallowing;
- presence of bad odor from the mouth;
- excessive fatigue;
- slight increase in body temperature;
- sleep disturbance;
- enlargement and tenderness in the cervical lymph nodes.
Treatment of chronic tonsillitis in adults
It can be conservative or surgical, and the choice between these two types depends on the form of the disease, which the doctor determines during the diagnostic process.
Treatment of compensated form of chronic tonsillitis
For acute symptoms of the disease, treatment is the same as for ordinary sore throat.
Long-term simple inflammation of the tonsils in remission requires conservative therapy, including:
1. Local therapy: gargling and rinsing lacunae, while local use of antibiotics is not recommended1,3.
- Lacunae rinsing is a medical procedure during which a solution is injected into the lacunae using a conventional injection syringe or a special device under pressure, which flushes out the pus and plugs that have accumulated in them. Preparations with antimicrobial, anti-inflammatory and antiallergic effects are used as washing solutions3. A total of ten procedures are carried out once every 2-3 days.
- Gargling complements the procedure for rinsing the lacunae, but does not replace it and cannot be used as monotherapy2,3 for the treatment of chronic tonsillitis at home. Antiseptic solutions are also used for gargling, for example, HEXORAL®, approved for use in adults and children over 3 years of age5. The main active ingredient of the drug HEXORAL® is hexetidine. It is a broad-spectrum antiseptic, active against most bacteria (including group A beta-hemolytic streptococcus), some viruses and fungi that are aggressive against the lymphoid tissue of the tonsils5. HEXORAL® helps clear the tonsils and reduces throat discomfort. To do this, it is enough to rinse it twice a day - the drug can act for 12 hours5.
2.Physiotherapy
It includes UHF on the area of regional lymph nodes and a quartz tube directly on the tonsils1.
Antibiotics for chronic tonsillitis are prescribed only if the disease is streptococcal in nature. In addition to it, in cases of sharply reduced immunity, immunocorrective drugs are used 2,3.
The course of therapy is repeated 2-3 times with an interval of 3-4 months1. If there is no effect or it is insufficient, sore throats continue to recur, and the picture in the pharynx does not change for the better, the doctor recommends removal of the tonsils1,5 - tonsillectomy.
Treatment of decompensated form of 1st degree of severity
As in the case of the simple form, they begin with conservative therapy: washing the lacunae of the tonsils, gargling and physiotherapy. If after 1-2 courses (or more often within two weeks) of such treatment the doctor does not see any improvement, a tonsillectomy is performed5.
Long-term inflammation in the stage of decompensation, that is, its toxic-allergic form of grade 2 , is an absolute indication for tonsillectomy1-5.
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Possible complications of tonsillitis
- Rheumatism is the most dangerous complication, which, in turn, can affect the joints and lead to heart disease.
- Pyelonephritis.
- Peritonsillitis, peritonsillar abscess.
Causes of sore throat:
- various viruses;
- bacteria;
- hypothermia of the body;
- decreased immune system functions;
- tonsil injury;
- violation of nasal breathing;
- various inflammations in the oral cavity.
Causes of chronic tonsillitis:
- frequent sore throats and ARVI;
- diseases of teeth and gums;
- nasal breathing disorder.
- weakened immune system;
- presence of allergies.
Symptoms of chronic tonsillitis
The inflammatory process in the tonsils can spread to neighboring organs, and then the person may complain of nasal congestion, sore throat, dry cough, and these secondary symptoms may be predominant.
With chronic tonsillitis, there may also be complaints of pain in the joints (knees, elbows, wrists), especially in the evening and when the weather changes, fleeting pain in the heart, a feeling of palpitations without physical activity, pain in the lumbar region. The ECG may reveal arrhythmia and tachycardia.
Such symptoms are a serious cause for concern, since they can accompany the development of severe autoimmune diseases of the kidneys, heart, and nervous system, which are complications of tonsillitis. This occurs when inflammation in the tonsils causes the immune system to malfunction; as a result, antibodies are produced, but not to the causative agent of the disease, as it should be, but to the heart muscle, joint tissue and connective tissue. When the body's defense system is upset, it tries to destroy the body itself.
The insidiousness of chronic tonsillitis also lies in the fact that it can occur without obvious symptoms. In this case, between outbreaks of sore throat, the person does not complain of anything, although a focus of inflammation remains in the tonsils.
The main symptoms of chronic tonsillitis itself are:
Sore throat
With chronic tonsillitis, there is pain in the throat when swallowing, especially in the morning. The appearance or intensification of such pain can be caused by swallowing cold food or liquid.
Feeling of discomfort in the throat
There may be no pain as such, but there may be discomfort when swallowing, a sensation of a foreign body in the throat.
Low-grade fever
With chronic tonsillitis, there may be a temperature that does not decrease over a long time (37.2-37.5°C).
Bad breath
Inflammation in the tonsils can manifest as persistent bad breath.
General weakness
Typical manifestations of chronic tonsillitis are increased fatigue, sweating, weakness, and poor health.
Treatment of tonsillitis in the clinic
To prescribe high-quality and effective ENT treatment, the doctor must accurately determine the nature of the inflammation (acute, chronic), its type (with or without purulent content), and the type of pathogen (virus, fungus). If tonsillitis is chronic, it is important to determine whether conservative treatment will be sufficient or surgery is indicated.
Conservative treatment involves washing the tonsils, removing plugs with pus, gargling, drinking plenty of warm fluids, and taking anti-inflammatory drugs.
In no case should you self-medicate - it is better to consult a specialist who, after an examination, will prescribe you the correct treatment.
Acute tonsillitis in pregnant women
The pregnancy period is always accompanied by a physiological decrease in immunity due to complex hormonal changes, therefore, during the period of colds, the body's susceptibility to bacteria and viruses increases or activation of any chronic foci of infection, including chronic tonsillitis, is possible.
throat or acute tonsillitis are extremely undesirable diseases during pregnancy, since treatment of this group of patients can be difficult due to restrictions on the use of most medications, especially antibiotics. Therefore, the prevention of colds during the period of influenza and ARVI is of great importance: avoid crowded places, avoid contact with people with sore throat, thoroughly wash your hands, ventilate rooms, walk in the fresh air.
Pregnant women suffering from chronic tonsillitis without exacerbation are recommended for local treatment in the form of gargling with herbal solutions at home.12
The use of ANY medications, including dietary supplements, is permissible only after consulting your obstetrician-gynecologist!
Surgery. Do I need to have my tonsils removed?
Surgical intervention includes partial tonsillotomy or complete removal of the tonsils - tonsillectomy.
The presence of chronic tonsillitis does not mean that surgery is needed in 100% of cases. Increasingly, ENT doctors are trying to treat patients conservatively.
If frequent tonsillitis is accompanied by the development of paratonsillitis or paratonsillar abscess, then this is a direct indication for tonsil removal.
The tonsils can become so large that they interfere with the patient's swallowing and breathing, so either partial or complete removal of the tonsils is performed.
It is worth noting that the operation should be carried out without an exacerbation!
Treatment of tonsillitis
Treatment of this disease requires mandatory medical supervision, since tonsillitis is a bacterial infection and is treated with the use of antibacterial drugs. Courses of antibiotics are quite long - 7-10 days. It is very important to maintain the full course of taking medications, even despite the possible rapid restoration of good health. The bacteria must be completely destroyed with antibiotics. If this does not happen, relapses of the disease are possible and the risk of complications is very high.
In addition, in the treatment of tonsillitis, a variety of rinsing options with antiseptic solutions (iodine, salt and baking soda, chamomile decoction, etc.) are often used. The purpose of rinsing is to remove plaque from the tonsils, wash out all the contents from the gaps (indentations) of the tonsils and, thereby, speed up recovery.
At elevated body temperatures, antipyretic drugs are used, and warm, generous fluids are recommended. An important point in the treatment of sore throat is adherence to strict bed rest throughout the febrile period. That is, while the child has an elevated body temperature, walking on the street and outdoor games are strictly prohibited. Failure to comply with bed rest, as well as failure to comply with the duration of the course of antibiotics, very often leads to complications.
In order to monitor the occurrence of complications and the effectiveness of antibacterial therapy at the beginning and at the end of treatment for acute tonsillitis, a number of laboratory tests are required. This is a general blood test and a general urinalysis, and at the end of treatment, in addition to these, an electrocardiogram and a biochemical blood test are prescribed.
If the child has recovered (i.e. normal temperature, normal blood tests), then a few days after the end of the course of treatment it is possible to visit a preschool or school institution, but with a mandatory limitation of physical activity for two weeks.
In case of acute tonsillitis, there are no pronounced dietary restrictions, except that food should not injure the inflamed tonsils (it is better to exclude solid foods such as crackers, crackers, and cookies). Of course, be sure to drink plenty of fluids to detoxify the body. Depending on the age and body weight of the child, there are recommended volumes of fluid, which, as a rule, should be increased by 30% during the period of illness.
Complications of tonsillitis
Acute streptococcal tonsillitis is terrible for its complications. With streptococcal infections, the main group of complications are the so-called rheumatoid diseases (connective tissue diseases), which cause damage to the valvular apparatus of the heart with the formation of heart defects and kidney damage with the formation of glomerulonephritis and possible renal failure.
Prevention of tonsillitis
Measures to prevent bacterial tonsillitis logically follow from the factors that cause this disease:
- You should try to avoid contact with patients in the acute phase of the disease. If there are several children in a family and one of them suffers from acute tonsillitis, then even the children’s toys should be separated or sanitized (washed with hot water and soapy water);
- strictly observe basic hygiene rules;
- avoid hypothermia. In the cold season, the neck should be covered, you need to ensure that children do not eat snow, do not lick icicles and do not eat ice cream in large pieces.
- If there is chronic tonsillitis in the family (parents), it is necessary to conduct an examination for the carriage of microbes in the nasopharynx and use individual dishes.
Director of the private unitary enterprise “Dechko and K” (trademark “Good Doctor”), first category doctor A.V. Dechko.
The conversation was conducted by a correspondent from the magazine “Malyshok”
Anastasia SHUNTO
