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Tonsillitis is an infection of the tonsils, which are the small glands found at the back of the throat. The tonsils are part of the immune system which helps protect against infection, particularly helping to fight off infection of the throat and upper respiratory tract.

Normally, the tonsils appear as two pale and flat circles of tissue on either side of the throat. If the tonsils are infected they become red, swollen and painful and this is what is referred to as tonsillitis.

Anybody can get tonsillitis, but children between 5 and 15 years of age are particularly susceptible to tonsillitis because they have a relatively narrow throat. If the tonsils become swollen, they can obstruct the throat making breathing and swallowing difficult. As the child grows older, the throat widens and the tonsils reduce in size, and the child gradually becomes less affected by tonsillitis.
Tonsillitis is mostly caused by a viral infection. The types of viruses involved are usually the same ones that cause colds and influenza, and sometimes glandular fever (Epstein-Barr virus). Occasionally, the infection is bacterial. In which case, it is usually a bacterium called Streptococcus.

The virus or bacteria responsible for tonsillitis can be spread from one person to another by being carried in the air in the fine water droplets released when the person infected coughs or sneezes.
The main symptoms of tonsillitis are a sore throat, difficulty in swallowing and speaking. The back of the throat will look red and swollen and, sometimes, white pus filled spots are visible on the tonsils. The glands in the neck can also become swollen and painful. As the virus or bacteria causing tonsillitis may also be responsible for other infections, symptoms such as cough, headache, raised temperature and feeling tired may also be present.
Tonsillitis normally gets better on its own within a few days without the need for treatment. During this time, symptoms can be eased by drinking plenty of fluids to help lubricate the throat and make swallowing and talking less painful. Particularly sore throats may be eased with the use of pain killers such as paracetamol or ibuprofen. Aspirin may also be used by adults, but it should not be used in children under 16 years of age. Preparations containing codeine and dihydrocodeine should not be used to treat tonsillitis as they are not considered appropriate and may cause addiction if taken for more than 3 days. Throat lozenges and throat sprays containing the local anaesthetics benzocaine or lidocaine can also help bring relief.

Antibiotics are not effective when the tonsillitis is caused by a virus, but a doctor may prescribe antibiotics if a bacterial infection is strongly suspected.

Removal of the tonsils by an operation called a tonsillectomy is not usually recommended unless tonsillitis occurs repeatedly (five or more episodes in a year), and is so troublesome as to interfere with everyday life. A tonsillectomy is one of the most common operations performed in children. It takes place under a general anaesthetic and the child normally makes a complete recovery within a couple of weeks.
When to see your pharmacist
There are a large number of sore throat pastilles and sprays available from your local pharmacy without the need for a prescription that will help ease the symptoms of tonsillitis. Choice is usually based on personal taste for the various flavours used, but all work in a basically similar way to help lubricate the throat. Certain preparations should not be used by children or those who are sensitive to aspirin-like products or local anaesthetics so it is important that you tell the pharmacist who the medicine is for and whether they have any allergies or other illnesses.
When to see your doctor
If your symptoms are not getting any better after about three days, you should visit your doctor. If your symptoms are severe or if you have a child with tonsillitis and are worried about any of the symptoms, you should seek medical advice.
Living with tonsillitis
Although troublesome, tonsillitis does not usually require treatment and will normally get better on its own within a few days. Drink plain water at frequent intervals to keep your throat moist and to help swallowing. Try to avoid talking, but if you must talk, speak quietly and gently to avoid straining your throat.

If you suck throat pastilles or lozenges, or drink fruit juice, carbonated drinks, tea and coffee to ease your throat, remember to brush your teeth regularly to reduce the chances of tooth decay.

As most forms of tonsillitis are caused by a virus, there is no point in going to see your doctor for antibiotics as they are not effective against viral infections. However, if your tonsillitis does not get better or gets worse, you may have a bacterial infection that may require a visit to your doctor.
Useful Tips
  • Drink plenty of fluids
  • Do not take pain killers regularly or for long periods. Never exceed the recommended dose
  • Gargling with soluble aspirin can ease a sore throat
  • Aspirin should not be given to children under 16 years of age
  • If you smoke, stop smoking