Chronic tonsillitis is a disease of the palatine tonsils, which is characterized by exacerbations and periods of remission, the duration of which largely depends on the state of the patient’s immune system, as well as on the adequacy of therapy. The symptoms of chronic tonsillitis are vague, and therefore patients cannot independently diagnose the presence of this disease. If you feel even the slightest discomfort in your throat, this is a reason to immediately consult a doctor for advice. Timely conservative treatment will help avoid surgery and numerous systemic complications.
Description and symptoms of chronic tonsillitis
Chronic tonsillitis occupies a leading place among inflammatory diseases of the throat. Throat diseases reduce the quality of life and lead to complications. Chronic inflammation of the tonsils is often observed in children starting from 3 years of age and in young people.
Types of tonsillitis
- Acute tonsillitis (tonsillitis) is an infectious disease with local manifestations of acute inflammation of the components of the lymphatic pharyngeal ring, most often the palatine tonsils, which is caused by streptococci or staphylococci, less often by other microorganisms.
- Chronic tonsillitis is a long-term inflammation of the pharyngeal and palatine tonsils. 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.
There are two stages. Compensated and decompensated stages:
- The compensated stage is a dormant focus of infection. There is no visible reaction from the whole body, no repeated sore throats. The barrier function of the tonsils and the reactivity of the body are not impaired. The edges of the palatine arches thicken, cicatricial adhesions appear between the tonsils, plugs form in the lacunae of the tonsils, liquid purulent discharge forms, and the submandibular and cervical lymph nodes enlarge. One of the problems of the compensated form of tonsillitis is bad breath, which occurs as a result of the formation of plugs in the lacunae.
- During decompensation, frequent sore throats are a concern; complications of tonsillitis in the form of abscesses, inflammatory diseases of the ear and sinuses, as well as damage to other organs (heart, kidneys) are often observed. Exacerbation of chronic tonsillitis is also called tonsillitis.
Symptoms of chronic tonsillitis
- discomfort and pain when swallowing, especially in the morning;
- dryness, sore throat; sensation of a foreign body in the throat
- cough;
- bad breath;
- increased fatigue, weakness and sweating;
- decreased performance;
- low-grade fever 37.2-37.5°C
- deterioration of sleep;
- decreased appetite;
- pain in the cervical lymph nodes.
Causes that can lead to chronic tonsillitis
The following factors have a particularly strong influence on the chronicity of the process:
- Frequent sore throats, especially in the absence of adequate treatment;
- Impaired nasal breathing, which can be a consequence of both a deviated nasal septum and chronic rhinitis and sinusitis. If rhinitis is of an allergic nature, then it is advisable to do an allergen test and undergo appropriate treatment;
- Low body immunity.
Chronic tonsillitis develops due to a number of factors
- Intoxication - due to the absorption of bacterial toxins and products of chronic inflammation in the tonsils. Intoxication explains symptoms of chronic tonsillitis such as fatigue, weakness, headache, low-grade body temperature, etc.
- The formation of plugs in the tonsils irritates the nerve endings and causes moderate pain in the throat and heart area, cough, and bad breath. Nerve endings undergo degenerative changes, which can cause neurosis and other disorders of the nervous system.
- The body develops sensitivity to bacterial and tissue antigens - an allergy develops. Therefore, chronic tonsillitis is also of an autoimmune nature.
Chronic tonsillitis with complications can lead to functional disorders of cardiac activity, acquired heart defects. Chronic tonsillitis is associated with pathologies such as rheumatism, infectious arthritis, diseases of the urinary system, prostate gland, meninges, etc.
Features of the disease in children
Intensive development of the lymphoid ring begins in infancy - in the second year of life. Immediately after birth, the tonsils are underdeveloped and do not yet function fully. A feature of the tonsils in children 1-3 years old is deep lacunae, as well as narrow, densely branching orifices, which can extend to the capsule. Sometimes the lacunae turn sharply and extend under the integumentary epithelium instead of going deep into the tonsils. At the end of narrow passages there are characteristic expansions that contribute to the development of the inflammatory process.
A feature of younger age is hypertrophy of lymphoid tissue, which, along with an increase in the number of lymphoid follicles, leads to the growth of tonsils. The latter reach their largest size by 5-7 years. At this age, children are most susceptible to infectious diseases and most need protection from infections. Representatives of this age category are recommended to receive preventive vaccinations aimed at mobilizing lymphoid tissue to develop immunity.
The cause of hypertrophy of lymphoid tissue is the intensive formation of active immunity, which is accompanied by local production of antibodies in response to the penetration of an infectious agent. With age, by the age of 9-10, antibodies accumulate in the body, the immune system improves, which leads to age-related involution of lymphoid tissue. Part of it degenerates and is replaced by connective or fibrous.
The causes of childhood respiratory diseases are fungi, bacteria and viruses. If a child gets sick too often, the tonsils are regularly attacked, so the body does not have time to fully defend itself. This becomes the main reason for the development of chronic tonsillitis, along with incorrectly prescribed antibiotic treatment.
Chronic tonsillitis in a child turns into a constant source of infection, depleting the immune system. Quite often, the disease leads to serious complications, especially if timely help is not sought.
Symptoms
Unlike adults, in children the disease develops quickly, occurs in an acute form and is quite obvious. An obvious indication of chronic tonsillitis may be the following local reactions:
- redness of the tonsils;
- their increase, looseness;
- purulent discharge;
- enlarged cervical lymph nodes.
Frequent sore throats, bad breath, and discomfort during swallowing may also indicate the chronic nature of tonsillitis. Some patients experience sleep problems, headaches, and a subfertile temperature (37-37.5 °C).
Chronic tonsillitis in a pregnant woman
Symptoms of the disease in a pregnant woman are fever, general weakness, dry cough, sore throat, which is accompanied by a sensation of a foreign body. This is due to the fact that the tonsils withstand the attack of tonsillitis and respond to it with pain.
Not everyone knows that even a mild sore throat can harm the unborn child, as well as the woman herself. Sometimes the disease causes early miscarriage, and sometimes causes the development of late toxicosis, which negatively affects the development of the fetus. Since the presence of a chronic infection in the body weakens the immune system, a pregnant woman is at risk of developing other diseases.
Clinical studies have confirmed that chronic tonsillitis has repeatedly caused poor labor and premature birth, so women with this diagnosis are often recommended to have a cesarean section. Sometimes a disease that is not treated during pregnancy leads to the development of a heart defect in the child.
Causes of chronic tonsillitis in pregnant women
- sore throat, which has become a latent chronic form;
- hypothermia;
- deficiency of vitamins and nutrients;
- weakened immunity;
- problems with nasal breathing caused, for example, by a deviated nasal septum, polyps or adenoids;
- untreated caries;
- sinusitis.
To avoid undesirable developments, pregnant women are advised to eat well, avoid hypothermia, visit the dentist and generally monitor their health.
Why is chronic tonsillitis dangerous?
Regardless of the form of its occurrence, chronic tonsillitis can cause allergization and infection of the body. In the absence of medical control, the disease can lead to serious complications - frequent exacerbations in the form of a sore throat, recurring up to 6 times a year.
Another serious complication is phlegmon of the neck, which occurs against the background of severe forms of peritonsillar abscess. In addition, weakening of the tonsils leads to the penetration of infection into the underlying respiratory tract and the development of pharyngitis and bronchitis. In general, chronic tonsillitis either itself becomes a source of concomitant diseases or complicates their course.
An infection that has entered the body finds “weak” spots and can cause diseases of any of the systems - bronchopulmonary, urinary, cardiovascular. A chronic focus of infection has a negative effect on the blood coagulation system, metabolic and endocrine processes, the adrenal cortex, and the course of allergic conditions. Inflammation of the palatine tonsils causes epileptic attacks and aggravates the course of encephalitis and cerebral rheumatic vasculitis. The most dangerous is the decompensated form, which provokes changes in internal organs.
Consequences of chronic tonsillitis
- The disease in a certain way affects the course of collagen diseases - rheumatism, systemic lupus erythematosus, scleroderma, polyarthritis, dermatomyositis, periarthritis nodosa.
- The cause of frequent sore throats is heart disease - arrhythmias, endocarditis, myocarditis, acquired defects. Since there is a close connection between the lymphatic system of the heart and the ducts of the tonsils, even people under the age of 30 are diagnosed with cardialgia.
- Chronic intoxication has an adverse effect on blood vessels, especially capillaries. Patients complain of increased fatigue, weather sensitivity, headaches including migraines, and dizziness (Meniere's syndrome).
- The consequence of the chronic form of tonsillitis can also be diseases of the gastrointestinal tract - gastritis, colitis, duodenitis, stomach and duodenal ulcers.
- Against the background of chronic tonsillitis, skin pathologies and diseases of the subcutaneous fatty tissue often develop - psoriasis, neurodermatitis, acne, microbial eczema, atopic dermatitis, polymorphic exudative erythema. It makes no sense to treat them until the source of infection is eliminated.
- Chronic tonsillitis often causes lung diseases - bronchial asthma and chronic bronchitis, and also contributes to the exacerbation of chronic pneumonia. According to pulmonologists, the number of complications with such diagnoses can be reduced by 2-3 times if the source of infection is carried out in a timely manner.
- The disease also has a negative effect on the accommodative apparatus of the eye. Early sanitation can, according to ophthalmologists, prevent the development of myopia, as well as prevent relapses of conjunctivitis and blepharitis.
- The liver and the biliary system are also targeted by infection: cholecystitis, cholangitis and cholangiocholecystitis develop against the background of tonsillitis.
- Weakening of the functions of the pancreas due to focal infection in the tonsils contributes to the formation of diabetes mellitus. The thyroid gland also suffers, and its hormone-forming function is disrupted (thyrotoxicosis).
- Against the background of tonsillitis, there are disorders in the reproductive sphere: potency in men decreases, and in women of childbearing age, uterine bleeding, endometriosis, uterine fibroids, hypomenstrual syndrome and infertility are observed. Cases of pathological pregnancy - threats of miscarriage and premature birth - are not uncommon.
- Another serious consequence is kidney damage (pyelonephritis, glomerulonephritis, nephritis, etc.).
The concept of “loose tonsils”
The tonsils or tonsils are located behind the palatine arches and create a protective barrier against bacteria and germs. In normal condition they are almost invisible. If the inflammatory process develops, they begin to increase in size and become swollen and convex.
This occurs due to inflammation of the lymphoid tissue, which is the first to encounter the harmful effects of pathogenic microorganisms.
Loose tonsils can occur in the following cases:
- the beginning of the acute phase of the disease (ARVI, tonsillitis, pharyngitis and other diseases);
- chronic form of throat diseases;
- as a residual phenomenon after severe infectious diseases (angina, scarlet fever and others).
Loose tonsils require some care, as food debris gets stuck in them, which is an excellent flora for the proliferation of bacteria and the development of inflammatory processes.
Diagnosis of chronic tonsillitis
Diagnostic measures begin with an examination of the patient by a doctor who is interested in the appearance of the tonsils, as well as the presence of purulent or other contents in the lacunae. If this is detected, then it is necessary to conduct a bacteriological analysis of the discharge, followed by testing for sensitivity to antibiotics. A similar procedure is performed even if surgical removal of the tonsils is indicated to prevent postoperative infectious complications.
Often diagnostic measures include consultation with a cardiologist, nephrologist and so-called rheumatic tests. This allows you to determine how far the process has gone and whether there is systemic autoimmune damage to the target organs, such as the heart, kidneys and joints.
If there are indications for surgical removal of the tonsils, the patient must undergo additional examination, which includes:
- Blood test for hepatitis and HIV infection;
- Blood sugar test, since diabetes mellitus is a contraindication to such an operation;
- Cardiogram;
- Consultation with a therapist.
Possible complications
As a rule, the viral form of tonsillitis, if a sore throat is treated correctly and in a timely manner, does not pose a danger and goes away without complications.
ARVI can be complicated by the addition of a bacterial infection of the nasal cavity: a characteristic sign is green discharge from the nose. The prognosis for this development is favorable, just the duration of treatment will increase by several days.
Influenza viruses cause complications more often than other viruses. This can be pneumonia, lung abscess, hepatitis, diseases of the heart muscle, neuritis. Adenoviruses can cause sinusitis and pneumonia.
A common consequence of viral tonsillitis is infection of the oral cavity and pharynx by fungus. Bacterial tonsillitis often develops. Exacerbations of chronic diseases are possible.
Treatment of chronic tonsillitis
Treatment of chronic tonsillitis is traditionally carried out in two directions.
Conservative treatment
This therapy is relevant if pathological changes in the tonsils are compensated. This treatment effectively combines pharmacotherapy with physiotherapeutic methods and pursues the following goals:
- Physical elimination of infection from the surface of the tonsils;
- Relieving swelling and reducing the size of the tonsils;
- Elimination of symptoms of an allergic nature;
- Increasing local immunity, including through the inclusion of the tonsils themselves in the work.
Conservative treatment includes:
- Sanitation of the tonsils using ultrasound, which ensures a deep degree of cleaning of the lymphoid tissue;
- Anti-inflammatory laser therapy;
- Irrigation of the oral cavity with special medicinal solutions that increase local immunity and have bactericidal properties;
- Pharmacotherapy.
Surgical treatment involves complete or partial removal of lymphoid tissue, which can be carried out either traditionally or using a laser. Tonsillectomy has a significant list of contraindications, so the attitude of doctors towards it in recent years has been more wary than in previous decades.
Treatment of chronic tonsillitis in a child
Proper treatment of sore throat in most cases leads to a successful cure, while ignoring symptoms or incorrect actions can lead to the disease becoming chronic. In this case, exacerbations are possible almost once a month.
The treatment regimen for chronic tonsillitis in a child depends on the course of the disease and can be completely different, especially for periods of exacerbations and remission. In a state of remission, it is important to extend this period as long as possible, for which purpose anti-relapse therapy is prescribed at least twice a year, taking into account the individual characteristics of the patient.
General treatment includes non-sedating antihistamines, immunomodulators, vitamin therapy and homeopathy. Local methods include massaging the tonsils, washing the lacunae with medications, rinsing with antiseptics and treating the tonsils with agents that have antiseptic, anti-inflammatory and regenerating properties.
Physiotherapeutic methods are aimed at improving microcirculation in the tissues of the tonsils. These include:
- microwave therapy;
- ultrasound;
- laser therapy;
- Microwave and UHF;
- inductothermy;
- magnetic therapy;
- electrophoresis;
- inhalation;
- ultraviolet irradiation of the tonsils;
- mud therapy, etc.
If the disease has entered a protracted form, the approach to treatment changes radically - bacteriophages are used. We are talking about viruses that destroy streptococci and staphylococci as the main causative agents of the disease. This method has shown excellent results in the treatment of infections of the oral cavity and nasopharynx, which are accompanied by frequent relapses.
Home methods for treating chronic tonsillitis are allowed only under the supervision of a doctor. These include:
- ingestion of herbal tea from medicinal plants - St. John's wort, peony, calendula, chamomile, dill, coltsfoot, thyme, sage, eucalyptus, etc.;
- gargling with the above herbs;
- ingestion of propolis with honey.
Only regular treatment for two years can achieve positive dynamics. If exacerbations have not been observed for five years in a row, they speak of improvement. Compliance with all instructions often leads to a decrease in the number of relapses, however, if this result cannot be obtained, extreme measures are resorted to - tonsillectomy, or complete removal of the tonsils. Surgery has a number of contraindications.
Prevention of chronic tonsillitis
In order to prevent exacerbations, the tonsils need not only protection from adverse factors, but also hardening. To do this, doctors recommend periodically eating ice cream and drinking cold drinks in small portions - only during the period when the person is completely healthy.
It is important to eliminate all factors that can cause a sore throat, that is, take care in advance of the treatment of the nose and oral cavity, as well as the free breathing of the child. Rinsing with antiseptic agents helps clear the tonsils of bacteria. It is useful to gargle twice a day after meals with a solution of furatsilin, a decoction of sage, chamomile or calendula. The course is carried out for a month, then take a break.
Another effective remedy is tonsil massage. Perform it before going outside and before eating cold food. The procedure consists of light stroking in the area under the chin in the direction from the jaw to the chest. If the disease has become protracted, treatment should be more intensive.
Tonsillitis is a rather dangerous disease that can haunt a person throughout his life from early childhood and cause the most unexpected complications. Therefore, it is so important not to let the disease take its course, but to seek help in time.
Types of cleaning loose tonsils
To prevent the occurrence of inflammatory processes in loose tonsils, they should be cleaned regularly. Deeper cleansing is performed in a medical facility.
In the case of small children, such manipulation at home is unacceptable. The child undergoes ultrasound treatment. And then, using a special syringe, the entire larynx is irrigated. This allows you to remove food debris, plaque and pathogenic microorganisms from the tonsils. The procedure is carried out at least 10 times both as treatment and prevention of diseases.
For older children, you can use the following methods to clean the tonsils:
- We ask the child to open his mouth wide. Use the convex side of a teaspoon to press on one of the tonsils.
- The exposure is carried out until whitish discharge appears in their lacunae.
- The child should gargle thoroughly with a solution of sea salt.
- We perform the same action with the second amygdala.
Such cleaning can be carried out not only during illness, but also for its prevention.
