Chronic tonsillitis is a disease of any age

Chronic tonsillitis: symptoms and treatment at home

Chronic tonsillitis is an inflammatory process localized in the palatine tonsils, which has taken on a sluggish, protracted form. The form of the disease is characterized by periodic relapses (recurrence at certain intervals in the presence of predisposing factors for acute episodes of the disease).

Considering that we are talking about an important organ that plays a decisive role in the chain of formation of the immune and physiological types of defense of the body, the importance of diagnosis and effective mechanisms for treating pathology among doctors is beyond doubt. This is an article prepared by our specialists based on materials from the work of practicing otolaryngologists.

What it is?

Chronic tonsillitis is a long-term inflammation of the pharyngeal and palatine tonsils (from the Latin tonsollitae - tonsil glands). 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.

Causes

Factors that contribute to the development of chronic tonsillitis in adults and children:

• allergic rhinitis;
• deviated nasal septum;
• decreased local and general immunity;
• frequent runny nose;
• inflammatory diseases that develop in other ENT organs;
• caries;
• the presence of foci of chronic infection in the human body;
• allergic mood of the body.

Chronic tonsillitis is an infection-dependent inflammatory process that develops as a result of the pathogenic activity of microorganisms. Normally, the tonsils in the body exist to trap infectious agents and prevent them from penetrating deeper into the respiratory tract. If there is a decrease in local or general defenses of the body, then pathogenic microorganisms that linger on the tonsils begin to actively develop and multiply, provoking the progression of the disease.

Features of the chronic form of the disease

Chronic inflammation of the tonsils can have several clinical variants:

• Latent form, when the patient does not experience significant discomfort in the throat and does not experience signs of exacerbation of the disease. Such people consider themselves healthy and are not aware of the dormant infectious-inflammatory focus in their throat.
• Periodically relapsing type of disease. Sluggish exacerbations and episodes of clearly defined inflammation of the tonsil itself, adjacent palatine arches and the pharyngeal wall are possible. Between periods of exacerbation, the inflammatory process subsides, but is not completely eliminated.

In chronic tonsillitis, the drainage and natural self-cleaning of crypts (folds) and lacunae (recesses) are disrupted in the tonsils; pus, living and dead bacteria, and toxins are constantly stored in their depths. This maintains constant inflammation, overstimulates sentinel immune cells, and provokes toxic-allergic reactions.

The immune response that forms during chronic tonsillitis is not sufficient to completely suppress the infectious process; it only restrains the activity of pathogens. Disruption of this delicate balance leads to exacerbation of the disease or triggers immune disorders.

Symptoms

Chronic tonsillitis in adults occurs with periods of remission and periods of exacerbation. With the development of an exacerbation, signs of tonsillitis (acute tonsillitis) develop:

• a sharp increase in body temperature to febrile levels (39-40 degrees);
• intense sore throat;
• regional lymph nodes enlarge;
• purulent plaque appears on the tonsils;
• There may also be purulent follicles on the mucous membrane of the tonsils.

During the period of remission, the patient may have the following symptoms of chronic tonsillitis:

• discomfort in the throat;
• feeling of a lump in the throat;
• slight pain in the morning;
• bad breath;
• plugs on the tonsils;
• small accumulations of pus in the lacunae.

Also, in addition to the signs of tonsillitis itself, there may be symptoms of concomitant diseases - chronic pharyngitis, rhinitis, sinusitis.

With the development of the decompensated form, the following symptoms appear:

• increased fatigue;
• general malaise;
• headache;
• prolonged low-grade fever (temperature stays around 37 degrees).

In addition, signs of complications may appear. The most common complication in the decompensated form of chronic tonsillitis is a peritonsillar abscess.

It begins as a sore throat, but later the patient cannot swallow or open his mouth at all. There is pronounced swelling of the pharyngeal tissue. The patient requires urgent medical care and hospitalization. Exacerbation of chronic tonsillitis can be triggered by hypothermia, an acute respiratory viral infection, or drinking cold drinks or food.

Under what conditions can tonsils be enlarged without fever?

Without an increase in temperature, the tonsils can become inflamed due to:

• Allergies. Enlarged tonsils often occur in people prone to allergies. Allergens include various substances - animal hair, dust, pollen, food, insects, household chemicals.
• Fungal infection. The following symptoms are observed: sore throat, dry mouth, visible cheesy coating on the mucous membrane.
• Dry air. Due to constant inhalation of dry air, the mucous membrane of the larynx dries out, causing the tonsils to swell. Working in polluted conditions also leads to this.
• Smoking. Tobacco smoke burns the mucous membrane, which can result in swelling of the tonsils.
• Some forms of sore throat (tonsillitis). The biological meaning of an increase in temperature during infectious diseases is to accelerate the death of pathogenic carriers in an environment with high temperatures. Consequently, if the body temperature has not increased, it means that the number of infectious carriers that have entered the body is small. Usually, if the infection was minor, then the person easily and quickly suffers from this illness. But with enlarged tonsils and no temperature, we can talk about an untreated acute inflammatory process in the tissues of the tonsils and its transition to chronic. In this case, the recovery process will take longer, and in addition, there is a possibility of complications developing. Both variants of pathologies require examination and prescription of correct treatment by an otolaryngologist.

Diagnostics

During the examination, the doctor palpates the lymph nodes and examines the tonsils directly. But experts do not limit themselves to this, given how many complications can be caused by this disease. The contents of the lacunae are also sampled and sent for analysis. Taking material for laboratory testing is carried out by pressing on the tonsil, from which pus is released. If the pus has a mucous structure and an unpleasant odor, then most likely there is a chronic form of tonsillitis. But even this analysis cannot show the complete clinical picture and accurately determine the diagnosis.

To make an accurate diagnosis, doctors pay attention to the general condition of the body and the presence of deviations from the norm. Such deviations are primarily considered to be thickened edges of the palatine arches and hyperthermia. Experts also determine cicatricial adhesions between the palatine arches and tonsils.

Tonsils, in the chronic form of tonsillitis, have a loose appearance and a scar-altered surface. In the lacunae of the tonsils there are purulent plugs or purulent discharge.

Chronic form of tonsillitis, why the tonsils become inflamed

Infection is the main cause of inflammation of the tonsils. The acute form of the disease in 70% of cases is caused by viruses, the remaining 30% is caused by bacterial and fungal flora. Therefore, sore throats most often accompany acute respiratory infections and are seasonal.

Damage to the tonsils in chronic tonsillitis in 80% of cases is of a bacterial nature. The main causative agents of the disease:

• β-hemolytic streptococcus.
• Group A streptococcus.
• Staphylococcus aureus.
• Haemophilus influenzae.
• Rarely encountered bacteria: mycoplasma, chlamydia, etc.

Viruses in the chronic form of the disease have a predominantly provocative, destabilizing effect. Acute and chronic recurrent viral infections weaken the immune defense, which creates conditions for the activation of bacterial flora. Hypothermia, acute intoxication, and ingestion of cold or irritating food lead to the same result.

Consequences

When tonsillitis becomes chronic, the body's immune response decreases, which can affect the functioning of internal organs. In severe cases, when symptoms of intoxication appear, some complications develop.

Prolonged infections lead to complications associated with cardiac dysfunction and kidney disease. Often, advanced tonsillitis is accompanied by rheumatism and tonsillocardial syndrome. Serious damage to health is caused by toxins that are released during sore throats.

Treatment of chronic tonsillitis

When treating a compensated form and in the absence of complications, chronic tonsillitis is treated conservatively at home using effective drugs. If the patient has signs of decompensation of chronic tonsillitis and complications develop, then surgical intervention may be required.

First of all, measures are taken to strengthen the body's defenses - proper nutrition, reduction of bad habits. If there are concomitant diseases, which are also sources of constant infection, they need to be cured:

• mandatory sanitation of the oral cavity - treatment of inflammatory diseases (caries, stomatitis);
• treatment of sinusitis, pharyngitis, rhinitis.

How to treat chronic tonsillitis: list of drugs

For the conservative treatment of chronic tonsillitis in adults, the following drugs are used:

1. Antibiotics for tonsillitis. This group of drugs is prescribed only in the presence of an exacerbation of chronic tonsillitis; antibiotic therapy is recommended based on tank data. sowing. It is not worth prescribing drugs blindly, as this can cause a lack of effect and loss of time, not to mention side effects and worsening of the condition. Depending on the severity of the inflammatory process in sore throat, the doctor may prescribe a short course of the safest and easiest remedies, since with long courses of strong drugs it is necessary to supplement the treatment with a course of probiotics. In the latent course of chronic tonsillitis, treatment with antimicrobial drugs is not indicated, since this additionally disrupts the microflora of the oral cavity and gastrointestinal tract, and also provokes immune suppression.
2. Painkillers. For severe pain, the most optimal is Ibuprofen or Nurofen; they are used as symptomatic therapy and for minor pain their use is not advisable (see the full list and prices of non-steroidal anti-inflammatory drugs in the article Injections for back pain).
3. Probiotics. When prescribing aggressive forms of broad-spectrum antibiotics and in the presence of concomitant gastrointestinal pathologies (reflux, colitis, gastritis), before taking antibiotics, it is necessary to take probiotics that are resistant to the action of the former - “Normoflorin”, “Gastrofarm”, “Primadofilus”, “Narine”, "Rela Life", "Acipol".
4. Antihistamines. To reduce swelling of the mucous membrane, tonsils, and swelling of the posterior pharyngeal wall, you need to take desensitizing medications; they will also contribute to better absorption of other medications. From this group of drugs, it is better to use the latest generation of drugs, since they have a prolonged effect and do not have a sedative effect, they are safer and stronger. Among the antihistamines, the best are Fexofast, Fexadin, Telfast, Zodak, Letizen, Zirtec, Parlazin, Cetrin.
5. Antiseptic local treatment. An important condition for effective treatment is gargling; for this you can use various solutions, either ready-made sprays or dilute special solutions yourself. It is most convenient to use Miramistin (250 rubles), which is sold with a 0.01% solution spray, Octenisept (230-370 rubles), which is diluted with water 1/5, as well as Dioxidin (1% solution 200 rubles 10 ampoules), 1 amp. diluted in 100 ml of warm water (see list of all throat sprays). Aromatherapy can also have a positive effect if you gargle or inhale with essential oils - lavender, tea tree, eucalyptus, cedar.
6. Antiseptic local treatment. An important condition for effective therapy is gargling. For these purposes, you can use both ready-made sprays and self-prepared solutions. It is most convenient to use Miramistin 0.01% solution, Octenisept, Dioxylin, which are diluted with warm water. Aromatherapy also has a positive effect if you gargle and inhale with essential oils - cedar, eucalyptus, tea tree, lavender.
7. Immunostimulating therapy. Among the drugs that can be used to stimulate local immunity in the oral cavity, perhaps only Imudon is indicated for use, the course of therapy is 10 days (absorbable tablets 4 times a day). Among the products of natural origin, you can use Propolis, Pantocrine, ginseng, and chamomile to boost immunity.
8. Emollients. Inflammation in the throat and taking certain medications may cause dry mouth, sore throat, and sore throat; in such cases, it is effective to use sea buckthorn, peach, and apricot oils, provided there is no individual intolerance to them. In order to soften the nasopharynx well, you can instill one of the oils into the nose in the morning and evening, a few drops at a time, during the procedure you should throw your head back. Another method of softening the throat is 3% hydrogen peroxide, which is used to gargle for as long as possible, after which the mouth is rinsed with warm water.

Purulent plugs in chronic tonsillitis

We care about your health

Tonsillitis is one of the most common diseases. Infections of a viral or bacterial nature enter the respiratory tract (often one of them is joined by another), causing an inflammatory process. A surge in tonsillitis is most often observed in the spring and winter, when many people have a weakened immune system. Also, this disease can develop against the background of existing foci of infections in the body, for example, with dental caries, periodontal disease, sinusitis and others.

Tonsillitis is transmitted mainly by airborne droplets, pathogens: staphylococci, streptococci, fungi, bacilli.

Tonsillitis can have both acute (called sore throat) and chronic forms. Acute tonsillitis most often occurs as a result of an exacerbation of the chronic form, when a person with reduced immunity could, for example, become hypothermic.

Symptoms of tonsillitis

Compared to chronic tonsillitis, acute tonsillitis occurs in a more severe form: the body temperature can rise to 40 degrees, the patient feels a very strong pain in the throat, and it is difficult for him to swallow. The tonsils are swollen and enlarged, with the presence of purulent plugs. Patients feel headache, weakness, and their lymph nodes are enlarged.

Depending on the type of sore throat, which can be lacunar, herpetic, catarrhal, follicular, etc., ulcers, follicles, and a film called plaque form on the palatine tonsils.

With chronic tonsillitis, the temperature can rise to 38. The patient has a light coating on the palatine tonsils, and the tonsils themselves look enlarged and reddened. A person feels weakness, muscle pain, and aching joints.

Chronic tonsillitis is characterized by stages of remission and exacerbation. During the period of remission, the focus of infection is passive, and the person is not bothered by unpleasant symptoms. But as soon as one becomes hypothermic (especially with reduced immunity), he immediately begins to feel an unpleasant sore throat, pain when swallowing, cough, fatigue, poor general health and lack of appetite. The patient's lymph nodes may become inflamed.

Chronic tonsillitis is a long-term inflammation of the pharynx and palate. Its simple form has only a local symptom: sore throat. But if the picture is complemented by persistent lymphadenitis of the neck, changes in the functioning of the heart and high temperature, then this is already a toxic-allergic form.

Chronic tonsillitis has several stages: compensated, when the source of infection is not active, and decompensated, when exacerbation occurs due to repeated sore throats, inflammation of the ear and nose.

Tonsillitis (tonsillitis) - what inflammation looks like (photo of the disease)

Photograph of the throat with purulent sore throat

Photo - throat with follicular sore throat

Catarrhal sore throat - photo

Photo - lacunar tonsillitis

Possible complications of tonsillitis

Like many other diseases, tonsillitis is dangerous due to its complications . These include, first of all, rheumatism. After suffering from a sore throat, a person may feel severe aching in the joints and an increase in temperature.

In second place, as a rule, are cardiovascular diseases. Interruptions in heart function, shortness of breath, tachycardia are sure signs that a sore throat has caused complications.

Another unpleasant symptom after tonsillitis is swelling and tenderness of the lymph nodes, which have become infected from the tonsils. This is lymphadenitis.

The infection can also spread from the tonsils to the surrounding tissues of the upper respiratory tract, leading to pain when swallowing. And this disease is a complication of tonsillitis and is called paratonsillitis.

It should be noted that more than a hundred diseases are known that arise as a result of complications after acute tonsillitis. These include a variety of kidney, eye, skin and thyroid diseases.

Diagnosis of tonsillitis

It begins, of course, with an examination by a doctor, who determines whether the tonsils and adjacent tissues are swollen and red, and whether the ear and cervical lymph nodes are inflamed. The patient is sent for a general blood test.

Before prescribing treatment to the patient, the ENT doctor determines the nature of the inflammatory process: in what form does tonsillitis occur - chronic or acute, the type of inflammation (purulent, catarrhal), is the sore throat primary or secondary, what is the causative agent (this is determined in the laboratory - a culture is done from the throat ).

Treatment of tonsillitis - specifics of therapy

In the treatment of tonsillitis, both conservative methods and surgical intervention can be used. Treatment methods depend on the specifics of the disease.

For chronic tonsillitis, if necessary, antibiotics are prescribed in tablets, and for sore throat they are often administered intramuscularly. Local treatment is also carried out: purulent plaque on the tonsils is removed, the lacunae are washed with antibacterial solutions, physiotherapy and a course of vitamins with immunomodulators are prescribed.

In case of acute tonsillitis, it is recommended to irrigate the oral cavity with antiseptic solutions, rinse, treat the tonsils with iodine-containing preparations (if there are no allergic reactions to iodine), inhalations, and resorption of antibacterial tablets are useful. You should also drink a lot (weak teas, fruit drinks, juices, rosehip decoctions, etc.), take antipyretic and painkillers.

Acute tonsillitis is not recommended to be treated with antibiotics, because they reduce local immunity. But if the form of the disease is more severe, then the patient requires mandatory bed rest and antibiotic therapy. However, the prescription of antibiotics should be preceded by an analysis of the results of culture in the pharynx area, which will identify the causative agent of the infection. It is recommended to include in the course of treatment drugs that enhance immunity, as well as general strengthening and anti-inflammatory drugs. Physiotherapy will also be useful.

If a person suffers from tonsillitis more than twice a year, has complications from this disease, and conservative treatment does not bring the expected results, then removal of the tonsils may be recommended. There are many modern methods of performing this operation (infrared laser, ultrasound, biopolar, radiofrequency ablation and others), but many consider the cold plasma coblation method to be the most effective and gentle. However, it should be remembered that the tonsils are the first protective barrier that stops and disarms pathogenic bacteria . But in many cases (especially after frequent colds), the tonsils stop performing their functions and themselves become a source of infection, causing serious complications. In this case, it is better to remove them.

Treatment of tonsillitis (tonsillitis) at the Medkvadrat ENT center in Moscow, Kurkino and Khimki.

Physiotherapeutic methods

Physiotherapeutic treatment of chronic tonsillitis can be effective during remission - laser therapy is recognized as very effective due to its antibacterial and anti-inflammatory effect due to its direct effect on the tonsils. Short-wave UV radiation of the throat and oral cavity is also used.

There are methods of ultrasonic treatment of the tonsils, which act on the source of the disease itself, destroying the structure of the resulting cheesy mass. Using ultrasound, you can also irrigate the tonsils with antiseptic solutions.

An effective remedy is inhalation of wet steam. But there is one contraindication here - high temperature, so the temperature must first be lowered, and only then inhalation. Inhalations can be used using various medicinal herbs - chamomile, calendula, etc., chlorhexidine solution, or you can simply breathe over potatoes. You should not take deep breaths when inhaling, because in the case of tonsillitis, only the inflamed tonsils need to be affected.

Possible complications

Home treatment for tonsillitis is dangerous due to complications. If treated incorrectly, acute tonsillitis turns into chronic tonsillitis. There is also a risk of developing a peritonsillar abscess. This condition is very dangerous, since a large cavity filled with pus forms in the throat near the tonsils. If an abscess ruptures on its own, the purulent masses can infect the entire body. There is a high risk of infection of the blood, bronchi and lungs.

Advanced chronic tonsillitis is practically untreatable. To improve well-being and get rid of constant sore throat, a person will have to have his tonsils removed.

To avoid complications, it is recommended to consult a doctor promptly. It is better to coordinate home treatment with a specialist. If it was not possible to avoid the development of chronic tonsillitis, it is necessary to consult a doctor about the possibilities of effective treatment. There is no need to endure a sore throat, especially if the inflamed tonsils negatively affect the functioning of the entire body. There are many modern methods of effective treatment of chronic tonsillitis, for example, cryodestruction and laser removal of tonsils.

Treating tonsillitis at home

Let's look at some of the most interesting recipes for treating tonsillitis at home, which include honey and its derivatives:

• For oral administration, prepare half and half onion juice and honey. Mix thoroughly and drink 1 teaspoon 3 times a day;
• Mix chamomile flowers and oak bark in proportions 3:2. Pour four tablespoons of the mixture into 1 liter of hot water and boil over low heat for 10 minutes. Before turning off, add a tablespoon of linden flowers. Let cool, strain, add a teaspoon of honey to the solution. Mix thoroughly and gargle while warm.
• To lubricate the tonsils, prepare a mixture consisting of 1/3 freshly squeezed aloe leaf juice and 2/3 natural honey. The mixture is carefully mixed and stored in the refrigerator. Before use, the medicinal composition must be warmed to 38-40 degrees Celsius. Using a wooden or plastic spatula, the composition is carefully applied to the sore tonsils 1-2 times a day, at least 2 hours before meals. Repeat treatment daily for two weeks. Then the procedure is done every other day.

Surgical treatment

Such treatment is mainly carried out when decompensated chronic tonsillitis is detected and in the absence of a positive effect from repeated conservative treatment.

A tonsillectomy can be complete or partial. A total tonsillectomy involves total excision of the affected tonsils. Partial tonsillectomy can reduce the size of enlarged tonsils, but this operation is now rarely performed due to the high risk of relapse of the disease. Rare types of surgical treatment include galvanocaustics and diathermocoagulation.

New types of treatment for tonsillitis include laser lacunotomy, an operation to remove the tonsils is performed using a surgical laser. It is possible to carry out such treatment using surgical ultrasound.

Cryodestruction – freezing the tonsils with liquid nitrogen – is gaining popularity. Its use is justified with a slight increase in the size of the tonsils.

Tonsillectomy (removal of tonsils)

Prevention

Prevention of exacerbations of chronic tonsillitis:

1. Compliance with the rules of hygiene of home and work premises.
2. Elimination of dust and air pollution.
3. General hygiene measures.
4. Hardening.
5. Balanced diet.
6. Sanitation measures: identification and treatment of diseases of the gums and teeth, sinusitis, otitis media, nasal breathing disorders.

It should be noted that even the implementation of all of the above measures does not at all guarantee the exclusion of relapses.