What is tonsillitis?

Tonsillitis is an inflammation of the tonsils. The tonsils are glands at both sides of the back of the throat that help protect the body against infection.

Tonsillitis makes the tonsils swollen and sore. It is most common in children but anyone can have it.

What are the symptoms of tonsillitis?

People with tonsillitis often feel unwell and they may have:

• a sore throat
• red, swollen and painful tonsils, sometimes with white patches or pus
• fever
• difficulty or pain on swallowing
• headache
• swollen lymph nodes in the neck
• feeling unwell, loss of appetite
• hoarse or muffled voice
• bad breath
• stiff neck
• pain in the ears

What causes tonsillitis?

Tonsillitis is usually caused by a virus, or occasionally by bacteria, and often follows a cold.

You cannot be immunised against tonsillitis so you cannot prevent it, although good hygiene can help. You can have it more than once.

There may be other cold symptoms, such as a runny nose, cough or sore eyes. Younger children may have nausea, vomiting or stomach pain. They may be unusually fussy and drool a lot because they can’t swallow.

Not every sore throat is due to tonsillitis.

How is tonsillitis treated?

If the tonsillitis is caused by a virus, antibiotics will not help. But if it is caused by bacteria, the person will need antibiotics. If it is not treated, it can lead to complications like scarlet fever, middle ear infections or rheumatic fever.

Children under 3 years usually do not get bacterial tonsillitis. But see your doctor if your child has a sore throat and a fever, or if you or your child have:

• a sore throat that does not improve in a few days
• difficulty breathing or swallowing
• a persistent fever
• severe pain, particularly if it is mainly on one side of your throat.

Paracetamol can reduce discomfort, and any fever or headache.

People with tonsillitis should rest, drink plenty of fluids to prevent dehydration and avoid cigarette smoke. You can gargle with saltwater and use throat lozenges to reduce discomfort.

Ice cream, jelly and other soft, cool foods can soothe a sore throat. Ice blocks and ice chips, or gargling salty water, may help.

Surgery

Some people who have recurring bouts of tonsillitis will be offered surgery to remove their tonsils. The operation is known as a tonsillectomy.

People who have a tonsillectomy need a general anaesthetic, and often stay in hospital overnight. There is a risk of heavy bleeding after the operation. It doesn't prevent sore throats coming back. Some people have a lot of pain afterwards, and it can take up to 2 weeks to recover.

You should talk to your doctor or ear, nose and throat specialist about whether a tonsillectomy is likely to help you.