The fact is that tonsillitis affects more than just children — and surgery is not (!) always the best course of treatment - Dr. Axe


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The tonsils are considered “guardians” since they’re a part of the immune system, specifically the lymphatic system, and are made up of tissue that acts as a natural germ filter. The tonsils are one of our first lines of defense, since they normally trap germs (bacteria, fungi, viruses, etc.) that make their way into the mouth or nose and threaten the immune system.

They’re responsible for tackling threatening pathogens soon after they enter the body, stopping them from potentially traveling further into the body and causing infections. The production of germ-fighting antibodies is one of the most important roles for the tonsils, since these white blood cells attack bacteria that are deemed dangerous.

There are actually several kinds of different tonsils found in the inner throat at a location where mucous membrane meet (called the “arch’s fold”). Only a portion of the tonsils can be seen when someone opens her mouth, but other parts are situated above the roof of the throat and as far back at the base of the tongue. Together, the different parts of the tonsils form a ring where the mouth and nasal cavity meet the throat (the tonsillar ring), which is located at the perfect spot to interject viruses or bacteria. Because they always come into contact with outside particles, the tonsils are often inflamed and enlarged, but this doesn’t always signify a problem.

However, when there’s an influx of bacteria or other germs, the tonsils can’t handle the job and become overworked, very inflamed and infected themselves. This is what causes tonsillitis, which is accompanied by swelling, pain, tenderness and other symptoms common with infections.

Surgery/Antibiotics: Safe or Even Necessary for Tonsillitis?

For years, the first line of defense against tonsillitis (and many other infections, for that matter, such as ear infections like “swimmer’s ear”) was to prescribe antibiotics. However, today we know that frequent use of antibiotics, especially over long periods, increases the risk for antibiotic resistance as well as allergies and other problems.

It’s alarming how many children receive multiple courses of antibiotics before making it to their teenage years, which can unfortunately change the bacterial environment within the gut. Every time you take antibiotics, you essentially kill off “good,” sensitive bacteria in the body in addition to bad bacteria causing infections.

Good bacteria have the important role of reducing and balancing all types of harmfulpathogens in the body, so we suffer when populations of these “good bugs” are greatly reduced. If even a small percentage of bad bacteria remain, they can multiply and spread without enough good bacteria present to combat them.

Some experts feel that antibiotics for tonsillitis aren’t appropriate and are overprescribed. According to the Department of Head and Neck Surgery at the University of Munich, “microbiological screening tests in children without symptoms are senseless and do not justify an antibiotic treatment.” Many doctors now encourage patients to think twice about asking for prescription antibiotics since sore throats and other infections are commonly viral in nature (not bacterial infections), which aren’t helped by antibiotics.

Before starting any antibiotic treatment, you want confirmation from your physician that bacterial tonsillitis is definitely the cause of your condition, which can be determined pretty effectively using swabs. Be careful that if a swab test comes back negative, you don’t immediately begin taking antibiotics anyway. In some cases, doctors automatically prescribe antibiotics based on physical symptoms alone and no presence of bacteria, but there’s no guarantee that this even works.

And even when antibiotics are needed to treat acute tonsillitis after trying short-term steroid treatments or over-the-counter painkillers first, antibiotic therapy should only last for as little time as possible, which is just as effective as traditional 10-day therapies. Antibiotics can be given in a single shot or taken for up to 10–20 days by mouth (split into two treatments to kill off the infection), so always take the minimum dose needed.

When it comes to surgery, experts warn that a tonsillectomy (to remove either a part of the tonsils or the whole thing) should be a last-resort treatment option. This is especially true for young children under 6 years old, who should only have a tonsillectomy if they experience reoccurring bacterial tonsillitis that doesn’t respond to other natural or prescription treatments.

Removal of the tonsils — usually done with a scalpel but now also commonly performed with targeted lasers, radio waves, ultrasonic energy or electrocautery to cut, burn or evaporate away parts of the tonsils — can be painful and risky, since it removes lymphatic tissue that is normally protective. Tonsillectomy is a surgery (usually taking about 45 minutes and performed in an outpatient setting) and therefore involves anesthesia, risk for infection, scar-tissue formation or fever, and at least seven to 10 days to rest and recover.

New guidelines are being developed that diagnose recurrent tonsillitis only if seven or more clinical episodes of throat infection occur in the preceding year or 10 or more occur in the two preceding years. In all other cases, it’s best to try to solve the problem as naturally as possible before considering even partial removal of the tonsils (called partial tonsillectomy), which has lower risks for side effects and requires less recovery time than full removal.

Because the tonsils are one critical part of the immune system, removing them can be dangerous and lead to poor immunity in the future. Removal of any part of the tonsils poses side effects like bleeding, swelling, pain and future infections, so always consider alternatives to this traditional method.

Source: Excerpt from 4 Ways to Get Rid of Tonsillitis,

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Last Updated : Thursday, January 30, 2020