Tonsillitis. Causes, symptoms, signs, diagnosis and treatment of pathology What is the name of the throat disease tonsillitis

Tonsillitis affects the tonsils, thereby causing inflammation in them. Belongs to the group of infectious diseases, the causative agent of which is a viral or bacterial infection.

Treatment of tonsillitis

As a rule, tonsillitis is treated at home with bed rest.

Considering that sore throat in the vast majority of cases is caused by streptococci, to treat tonsillitis the doctor prescribes a course of antibiotics and, if necessary, antiviral therapy. In parallel with taking antibiotics, it is necessary to use local antiseptics that relieve pain (Hexoral, Bioparox, Stop-Angin).

In addition, conservative treatment includes washing the tonsils (to remove purulent plugs) and lubrication with Lugol's solution, and physiotherapeutic procedures. To eliminate pain and fever, the following medications are prescribed: Paracetamol, Analgin, Ibuprofen and others.

A gentle diet rich in vitamins C and B, and drinking plenty of fluids are necessary. Do not forget about gargling with special preparations, including those based on natural ingredients. If outpatient treatment does not lead to success, then surgical intervention is considered. Most often, the tonsils are simply removed as the main source of the threat.

It must be remembered that if acute tonsillitis is not treated correctly or is not treated, it becomes chronic. And at the moment, doctors’ opinions differ on how to treat chronic tonsillitis. The choice of treatment regimen in each specific case depends on the form of chronic tonsillitis, the general condition of the patient, the presence of concomitant diseases, etc.

Antibiotics for tonsillitis

Prescribing antibiotics is justified only in severe cases of the disease. It must be remembered that antibiotics are drugs against bacteria, so they are prescribed only when bacterial flora is the causative agent of the disease.

Most likely, you will be prescribed antibacterial drugs from the penicillin group:

• penicillin;
• oxacillin.

If you are allergic to this component, antibiotics from the macrolide group are prescribed:

• erythromycin;
• azithromycin.

The spectrum is very wide. The final decision on the advisability of using a particular drug should be made by the doctor. In addition, even an obvious improvement in well-being does not give reason to break the regimen, diet, or stop taking antibiotics. Treatment must be completed to completely destroy the bacteria.

How to treat tonsillitis at home

For the greatest effectiveness, treatment at home should simultaneously eliminate unpleasant symptoms, the causes of the disease and fight infection.

Basic principles of treatment at home:

• strict bed rest;
• drinking plenty of water;
• special diet;
• inhalation and gargling with antiseptic solutions and decoctions of medicinal herbs;
• irrigation of the tonsils with antiseptic drugs;
• taking non-steroidal anti-inflammatory drugs to reduce fever and pain;
• taking immunomodulators and vitamins;
• taking appropriate antibiotics as prescribed by your doctor.

If there is a prolonged absence of a positive therapeutic effect or if complications develop, the person is sent to a hospital.

Treatment with folk remedies

The use of folk remedies can be used as an addition to traditional medicine; it is not recommended to prescribe such treatment yourself, without the advice of a doctor. Among the folk remedies for treating tonsillitis, gargling with decoctions and pharmaceutical preparations is widely used.

1. Medicinal herbs - chamomile, marshmallow, sage, coltsfoot, calendula, oak bark decoction, St. John's wort;
2. Pharmacy products – Miramistin, Furacilin, Malavit;
3. A simple method using salt, soda and iodine;
4. They also do inhalations with decoctions of medicinal herbs (eucalyptus, sage, chamomile, etc.).

Basically, traditional methods of treatment are aimed at reducing inflammation in the pharynx, strengthening the immune system, and speeding recovery after illness. Traditional recipes are not suitable as the only method of treatment.

Damage to the palatine tonsils, and in advanced cases, other soft tissues of the throat, accompanied by sore throat, is called tonsillitis. The disease can occur in an acute form, much more often the name angina is applied to it, or it can progress to a chronic form. The disease is infectious in origin and is dangerous due to its complications.

Tonsillitis: what is it?

The palatine tonsils are the body’s defense, protecting it from attacks by infections that penetrate through the respiratory system. They take an active part in the processes of blood formation, metabolic processes, and are responsible for the development of immunity.

Important! If the infection has captured the tonsils, then it quickly spreads throughout the body.

The immune system is not always able to cope with attacks from viruses and bacteria from the environment, and then the tonsils become inflamed. Acute and chronic course of the disease is possible.

Answer to the question: “Is tonsillitis contagious?” Yes. Tonsillitis is a disease with an increased level of contagiousness.

Infection can occur when a pathogen enters from the external environment from a sick person or with food. You can also become infected through self-infection: sinusitis, ethmoiditis, untreated carious teeth are also a source of infection, etc.

Reasons for the development of the acute stage:

• bacteria (streptococcus, staphylococcus, or all together);
• virus (herpesvirus, adenoviruses, Coxsackie enterovirus);
• Vincent's spirochete in combination with a spindle-shaped rod;
• fungus of the genus Candida.

The penetration of the pathogen into the body is due to disruptions in the immune system, hypothermia, damage to the tonsils, disruption of the central nervous system and autonomic system, chronic diseases of the nose and oral cavity.

Reasons for the transition to the chronic stage:

• frequent cases of sore throat;
• ARVI;
• caries, periodontitis;
• crooked nasal septum, nasal polyps, enlarged inferior turbinates;
• other foci of infection;
• inappropriate or completely absent treatment of the acute stage.

A major role in the development of the chronic form is played by the immune status of the human body and the tendency to allergies.

Remember! Allergies can be both the cause of the disease and its consequence.

The disease is associated with increased activity of foreign microorganisms that cause inflammation. The disease is called acute or purulent tonsillitis.

Characteristic symptoms of the acute form:

• sore throat;
• the temperature rises sharply and remains at high levels;
• tonsils have a changed appearance: red, enlarged, with plaque;
• difficult to swallow;
• lymph nodes enlarge.

A blood test confirms the presence of an inflammatory process in the body.

Note! A sore throat differs from a common cold in the absence of a runny nose, reluctance to eat due to a severe sore throat, sudden changes in mood, pallor or cyanosis of the skin.

There are several forms of sore throat:

1. Catarrhal is the mildest and goes away quickly with the necessary treatment.
2. Follicular - small cavities are formed filled with pus.
3. Lacunar - the mucosa is covered with pus-filled depressions that can cover the entire surface of the tonsils.
4. Fibrinous - the tonsils are covered with a yellowish film, which can spread beyond the tonsils.
5. Phlegmonous - the affected tonsil is red and enlarged in size, a purulent plaque forms, under which the tissue of the tonsils can melt, forming phlegmon.
6. Ulcerative-necrotic - the tonsils are covered with ulcers under which the tissues die, if they are torn off they will bleed. Gray or greenish plaque, putrid odor from the mouth.
7. Herpetic - blisters form, which gradually fester, dry out, and become crusty. Accompanied by abdominal pain, vomiting, fever, diarrhea.

Paying attention to the causes of the disease, several types can be distinguished: bacterial, viral, fungal, herpes.

It is caused by staphylococcus or streptococcus bacteria that penetrate the organs of the nasopharynx, mainly the tonsils. This form occurs frequently. The penetration of a large number of microbes with a general weakening of the immune system allows the disease to develop.

Pathogens are transmitted from the carrier through the air and settle in the body. It is more often observed in adults and adolescents; in childhood, this type is less common. Dormant pathogens in the body, which are normally present in every person, can also awaken.

How to express it:

• sore throat;
• grayish plaque or yellowish pustules on the tonsils;
• sore throat;
• muscle and joint pain;
• nauseated, lack of appetite;
• fever, headache;
• lymph nodes are inflamed, general poor health.

Characteristic signs are refusal to eat, excessive salivation, plaque on enlarged and reddened tonsils, inflammation of the lymph nodes.

Remember! The manifestation of the first signs of poor health is a reason to seek help from a doctor. It is easiest to cure the disease at an early stage.

Bacteria that have settled in the body produce toxins that spread throughout the body, causing new diseases. Constant fatigue develops into problems with internal organs.

Before starting treatment, a throat culture is taken to identify the pathogen.

The manifestations of viral and bacterial forms are similar, however, they have different origins. The development of the viral form often occurs against the background of poor therapy for influenza or ARVI, and can develop into a bacterial form.

The pathology is caused by:

• herpes virus;
• adenovirus;
• Epstein-Barr virus;
• cytomegalovirus, etc.

Diagnosis is carried out to determine the nature of the origin of the disease. Viral tonsillitis is characterized by gradual development and less acute symptoms.

Important! Antibiotics are not used to treat the viral form.

The attending physician may prescribe Arbidol, Tamiflu, Amiksin, and antiseptic solutions for gargling.

Fungal tonsillitis

The causative agent is a fungus of the genus Candida. In a healthy body, this type of fungus can safely exist as part of the normal microflora. The disease often develops due to improper use of antibiotics or disruption of the immune system. Children are highly susceptible to the disease, adults less so.

For what reasons can a fungal form develop:

• diets, changes in food quality;
• bad habits (alcohol, smoking);
• the presence of inflammation in the body;
• weakened immunity;
• lack or excess of vitamins;
• excessive use of medications;
• oncology, diabetes mellitus, metabolic disorders, immunodeficiency conditions, chronic diseases of the tonsils, pharynx, mouth.

Newborn children can also become infected through contact with pathogenic microflora.

How it manifests itself:

• bad breath;
• weakness, headache, fever (not always);
• the throat does not hurt very much, it is scratchy;
• a curd-like coating of yellow or white color, under which bleeding wounds are found on the mucous membrane;
• lymph nodes are slightly enlarged.

At the initial stage, the disease may occur without symptoms.

Children and people with weakened immune systems are most susceptible to the disease. The streptococcal form is a bacterial infection of the throat and is contagious. It can only be detected after certain tests are carried out.

What are the symptoms:

• constant and very severe pain in the throat, worsening when swallowing;
• bad breath;
• enlarged lymph nodes;
• the tongue is covered with red dots, which can also be seen on the palate;
• the tonsils are red and enlarged, they have a white or yellowish coating on them, white purulent stripes can be seen;
• nausea, loss of appetite, sometimes vomiting and stomach pain.

Important! If a sore throat lasts more than 2 days, consult a doctor.

Chronic tonsillitis

The inflammatory process has become permanent. Exacerbation of chronic tonsillitis is replaced by a decline and subsidence of symptoms. Inflammation can spread to other tissues and systems, causing complications.

How it manifests itself:

• frequent colds;
• morning sore throat when swallowing;
• the throat is sore and raw;
• constant fatigue, weakness;
• tonsils are almost always enlarged, their surface may be loose;
• slight increases in temperature for no apparent reason.

There are 2 forms:

1. Compensated tonsillitis, in which general signs of a chronic inflammatory process of the tonsils are found.
2. Decompensated tonsillitis is manifested by general symptoms, and paratonsillitis, paratonsillar abscesses, and diseases of other organs and systems also differ.

Acute chronic tonsillitis occurs when the body's protective functions are weak, hypothermia, the presence of foci of infection in other organs, and the absence of adequate treatment for the disease.

Attention! An exacerbation is accompanied by fever, chills, sore throat, difficulty swallowing, weakness, and headache. The joints and lower back also hurt, and the lymph nodes become inflamed. Proper treatment allows you to recover within a week.

Tonsillitis during pregnancy

During pregnancy, the organs and tissues of a new person are formed inside the expectant mother. Therefore, it is so important for a woman to monitor her health during this period, because any disease and taking medications can provoke the development of pathologies in the fetus. The most common causes of tonsillitis in pregnant women are bacteria, viruses and fungi - less often.

Why is tonsillitis dangerous in pregnant women?

• glomerulonephritis (kidney damage);
• myocarditis;
• toxins produced by microorganisms can cause miscarriages, premature birth, weak labor, toxicosis;
• the child is at risk of intrauterine infection.

The woman’s temperature rises sharply, she feels unwell, experiences pain when swallowing, cannot open her mouth wide, the tonsils swell, turn red, and a purulent coating forms on them.

Treatment for pregnant women is complicated by their position, so preference is given to bed rest, rinsing with saline solution or decoctions of chamomile, calendula, and eucalyptus. Temperatures above 38 degrees can be brought down with Paracetamol. The purulent plaque is removed with a cotton swab soaked in Chlorophyllipt or hydrogen peroxide. You can use throat sprays based on vegetable oils.

Drugs used in the treatment of tonsillitis

To treat the acute form, antiseptics are used: Hexoral, Stopangin, Tantum Verde. Depending on the type, antibiotics are prescribed for tonsillitis: Bioparox, Amoxiclav.

Remember! You cannot refuse the drug chosen by your doctor or shorten the course of using antibiotics on your own. This can lead to a transition from the acute to the chronic phase.

To treat the chronic form, conservative treatment methods are also used; physiotherapeutic procedures, washing the tonsils, and lubricating them with antiseptic solutions may be prescribed.

When is tonsil removal indicated for chronic tonsillitis:

• at least 2 cases of tonsillitis per year, with fever and complications;
• as a consequence of the development of exacerbations of the heart or joints after a sore throat;
• chronic tonsillitis manifests itself against the background of diseases of the heart, joints, etc.

Increasing immunity, avoiding possible situations with hypothermia, refusing to eat excessively cold foods, and being attentive to your health will reduce the risk of developing a sore throat. There is no need to delay contacting a doctor to avoid complications.

Bacterial tonsillitis is a lesion of the tonsils caused by bacteria. This type of disease occurs quite often in both adults and children. A feature of bacterial tonsillitis is...

Chronic tonsillitis is a disease in which inflammation of the tonsils occurs. It has a long-term, sluggish nature with periodic exacerbations. It can appear in both children and adults....

Almost everyone has encountered such a problem as a sore throat during a cold. The tonsils enlarge, become swollen and red - this is quite normal in this condition, but there are cases when their inflammation develops against the background of complete health. In this case, doctors make a diagnosis: What kind of disease is this? Let's try to figure it out in our article. Some underestimate the seriousness of the problem, but in vain.

Essence of the disease

Everyone has tonsils in their throats, which can be affected by the inflammatory process. If the inflammation is almost constant, then it is said that chronic tonsillitis occurs. ICD 10 includes it, as well as the acute form of the disease, into independent forms that have their own code:

• Code J03.
• J35.0.

Assigning your own codes to diseases makes it easier to maintain statistics and dispensary records of patients.

The development of chronic inflammation occurs under the influence of many forms of microorganisms, which a healthy person almost always has. But a number of factors provoke their mass reproduction, which leads to an exacerbation of the disease.

In a person’s throat there is a lymphopharyngeal ring, which includes 7 tonsils, but it is the palatine tonsils that most often become inflamed.

The tonsils are a lymphoid organ that actively provides immunobiological protection to the body. Periodic inflammatory processes lead to the formation of immunity; this function is especially active in children.

Quite often, a sore throat is a companion to colds, in which case they say that acute tonsillitis occurs. It proceeds a little more mildly, does not have such pronounced symptoms, but most often develops due to poorly treated sore throat.

Mild symptoms are not a reason to delay treatment. Chronic tonsillitis and inflammation of the pharyngeal mucosa) can lead to serious complications, which will be discussed below.

For what reason does the disease develop?

Otolaryngologists often claim that almost the entire population suffers from chronic tonsillitis. In a sense, we can agree with this, because every person’s tonsils contain a huge number of bacteria, but if the body is completely healthy, then it does not allow pathogenic microorganisms to multiply and quickly suppresses their growth, but in the presence of an inflammatory process or a weakened immune system, this can be done does not work.

The disease chronic tonsillitis does not form immediately, it all starts with the acute phase, it can become chronic for the following reasons:

1. Poorly treated tonsillitis is one of the main reasons for the development of chronic tonsillitis. Most of us, as soon as the sore throat subsides and the temperature subsides, we stop taking medications and antibiotics, and this is a big mistake. Chronic tonsillitis and pharyngitis recede, but do not give up their positions completely, so they will soon return again.
2. Persistent pharyngitis, which many simply do not pay attention to and believe that no special treatment is required, will certainly lead to the development of a chronic form of the disease.
3. Failure to maintain oral hygiene and the disgusting condition of teeth will certainly cause the development of chronic tonsillitis. The constant presence of pathogenic microflora in the oral cavity will lead to this.
4. A chronic form of rhinitis or periodically worsening allergic rhinitis can result in tonsillitis.
5. Prolonged disruption of nasal breathing can lead to the development of chronic tonsillitis. Many people have no idea that this is connected, for example, with adenoids. A deviated nasal septum and polyps can also cause this.

As can be seen from the above, many reasons can provoke the development of a disease that must be treated.

Types of chronic tonsillitis

To answer the question of how to cure chronic tonsillitis once and for all, it is necessary to understand that it can manifest itself in different ways. Doctors note two scenarios:

1. After treatment, tonsillitis subsides a little and it seems that we managed to get rid of it, but as soon as you get a little cold or get your feet wet, it’s right there.
2. In the second option, the inflammatory process does not stop, it may subside a little, the patient even feels quite tolerable, goes to work, but the doctor notes that not everything is in order.

Both options require medical intervention to select effective measures to combat this disease.

In medical circles, there are two forms of chronic tonsillitis:

• Compensated. It manifests itself as a slight inflammation of the tonsils, sore throat, the general condition of the patient is normal. Doctors say in such cases that the tonsils compensate for the state of inflammation and generally cope with their function.
• The decompensated form of chronic tonsillitis usually manifests itself not only as pain in the throat, sore throat develops, and other organs are also involved in the process.

Any form of tonsillitis can lead to infection of the entire body, so do not delay a visit to an ENT doctor.

Symptoms of chronic tonsillitis

If there is chronic tonsillitis, then such patients may often complain of an unreasonable sore throat, which occurs not only when swallowing, but also during yawning. Painful sensations may appear after eating ice cream or drinking a cold drink, which is not uncommon in the summer; it turns out that this is how a person himself provokes an exacerbation of tonsillitis.

If chronic tonsillitis occurs, the following symptoms usually appear:

When all of the listed signs appear, patients try to get rid of them as quickly as possible, but it is more important to find out the reason that provoked the inflammatory process. This can only be done by a competent specialist who recognizes chronic tonsillitis. How to get rid of this disease forever and without complications is a question that should be asked specifically to the doctor.

Establishing diagnosis

Making the correct diagnosis in the presence of chronic tonsillitis is not at all easy. The doctor first examines the patient and listens to his complaints. The patient's medical history is also studied. Next, the doctor palpates the lymph nodes and examines the tonsils.

This does not end there, as the symptoms may resemble other diseases. Therefore, the doctor will definitely take discharge from the lacunae for analysis. If the purulent discharge has an unpleasant odor and a mucous structure, then most likely the patient has chronic tonsillitis. That this is exactly this disease can be concluded based on a whole complex of symptoms and signs.

To clarify the diagnosis, the doctor will pay attention to the general condition of the patient’s body and any deviations from the norm. In the presence of a chronic form of tonsillitis, the edges of the palatine arches will be thickened, and scar adhesions between the tonsils and arches will be visible. The tonsils themselves have a loose appearance, with purulent plugs or discharge in the lacunae.

Additional blood tests for antibodies to streptococcus may be required. Only after the diagnosis of chronic tonsillitis is confirmed, the doctor can prescribe the necessary treatment.

Therapy for chronic tonsillitis

To get rid of the chronic form of the disease you will have to try hard. Doctors, as a rule, recommend comprehensive treatment; this is the only way to ease your chronic tonsillitis symptoms:

• Local treatment (the photo demonstrates this) is one of the first to be prescribed. To do this, rinse with medicinal solutions and herbal infusions.

• During this procedure, purulent plugs are washed out. To carry it out, antibacterial and disinfectant solutions are used, for example, Furacilin, Miramistin, Chlorhexidine.
• Antibacterial therapy, which consists of taking antibiotics that are selected taking into account the sensitivity of the microflora.
• Physiotherapeutic procedures.
• Removal of tonsils.

The greatest effect is achieved only by complex therapy, which is preferably carried out twice a year.

Physiotherapeutic treatment

Physiotherapy is most effective during the period of remission of the disease. The following methods show the best results:

1. Laser therapy. Due to its antibacterial and anti-inflammatory effects on the tonsils, this method gives excellent results.
2. Application of short-wave UV radiation to the throat and oral cavity.
3. Ultrasonic exposure, with which you can not only influence the source of infection, destroying the structure of the curdled mass that appears, but also irrigate the tonsils with antibacterial solutions.
4. Inhalation with wet steam, but it must be remembered that at high temperatures this procedure is contraindicated. For inhalation, you can use infusions of medicinal herbs.
5. Phonophoresis of vitamins also gives a good effect.

The combination of physiotherapeutic treatment methods with medications and local therapy gives good results. There is no other way to get rid of this insidious disease forever.

Surgical intervention

Sometimes, when asked how to cure chronic tonsillitis forever, some doctors recommend tonsillectomy, that is, removal of the tonsils. But it is worth remembering that there is no need to rush to get rid of them, this can lead to even more serious consequences. Although there are situations where tonsil removal is necessary, the usual indications for surgery are:

• If the disease worsens up to 4-5 times a year.
• If the inflammatory process spreads to neighboring tissues.
• There is a danger of blood poisoning.
• There are signs of damage to the kidneys or heart muscle.

As a result of the operation, the tonsils may be completely removed or only partially removed when the doctor excises the overgrown tissue.

It must be remembered that tonsillectomy has its own contraindications, these include:

• Leukemia.
• Hemophilia.
• Tuberculosis in open form.
• Heart defects.
• Nephritis and some other pathologies.

If surgery is necessary, but there are serious contraindications to its implementation, then the patient is recommended to use cryogenic therapy.

Features of the treatment of chronic tonsillitis in children

If chronic tonsillitis is detected in a child, treatment should begin immediately. Taking into account the characteristics of the child’s body, therapy should be selected carefully, especially with regard to antibacterial agents.

Conservative treatment of tonsillitis in children must begin with adherence to the correct daily routine and diet. An important factor is the implementation of hardening procedures.

Parents should, if possible, eliminate all factors that could provoke an exacerbation of the disease. The use of local remedies gives a good effect if done promptly and regularly.

Tonsils can be lubricated with Lugol, and colloidal silver can also be used. During therapy, doctors often prescribe antiallergic drugs, as an unexpected reaction of the body is possible. This is especially true for antibiotics, which must be prescribed to children carefully.

Physiotherapeutic procedures in children also give good results (laser therapy, electrophoresis, magnetic therapy).

For chronic tonsillitis in children, pediatricians often prescribe bacteriophages; therapy with their use is quite effective. But it must be borne in mind that in the acute form of the disease it is better to give preference to antibiotics.

Considering that the treatment of tonsillitis is a long process, you can think about therapy with homeopathic medicines. Many parents leave good reviews about Vokara. It should be taken 1 drop per year of the child’s life, first diluted in water. Frequency of administration up to 8 times a day during exacerbation, during remission three times is enough.

When treating chronic tonsillitis in children, as well as in adults, it is important to remember that only an integrated approach to therapy can give the desired effect.

Tonsillitis in pregnant women

It is advisable to treat all existing diseases before pregnancy, but if there are chronic pathologies that make themselves felt in an interesting situation, then therapy should not be postponed. requires treatment, but only under the strict supervision of a doctor.

Considering the interesting position of the woman, the doctor may prescribe procedures such as:

• Treatment of tonsils with antiseptic compounds.
• In a specialist’s office, a woman’s throat and tonsils are washed with special medications.
• At home, it is recommended to gargle with infusions of medicinal herbs.
• Sprays and lozenges are prescribed.

A pregnant woman is prohibited from taking many medications, so it is very important to follow a daily routine, proper nutrition, and more vitamin supplements. If an exacerbation of the disease occurs during pregnancy, it is recommended:

1. Often gargle with a solution of salt, soda and a few drops of iodine.
2. Do inhalations with medicinal herbs, for example, sage.
3. A warm drink with honey and lemon is recommended.
4. To wipe the tonsils, you can use Chlorophyllipt or propolis tincture.
5. At elevated temperatures, you can take a Paracetamol tablet.

During pregnancy, the most important thing when treating chronic tonsillitis is not to harm the baby, so all remedies should be selected only by the attending physician.

If you do not take this pathology very seriously, then tonsillitis can even provoke congenital defects in the baby, and in serious cases, pregnancy failure and miscarriages.

Traditional medicine for the treatment of chronic tonsillitis

If there is chronic tonsillitis, treatment with traditional methods gives good results in combination with drug therapy. It is necessary to take into account that treatment should be carried out long-term and regularly. Traditional healers advise using the following recipes for rinsing:

1. Infuse 2 tbsp. l. dry yarrow in 200 ml of boiling water. Use the infusion warm several times a day.
2. Dissolve 3-4 drops of basil oil in a glass of boiled water and gargle with the mixture.
3. Prepare a mixture of 1 tbsp. spoons of linden flowers, 2 spoons of oak bark, 3 spoons of chamomile and pour it all with a liter of boiling water. After cooling, add a teaspoon of honey. Rinse three times a day after meals.

You can offer recipes for lubricating the tonsils:

• Mix aloe juice and honey in equal proportions and lubricate the tonsils every day for two weeks; in weeks 3 and 4, you can carry out the procedure every other day.
• To treat tonsils, you can use fir oil up to 5 times over 3 days, you can also instill 1 drop into the nose.
• For kids, a mixture of 1 part radish juice and 3 parts honey is perfect for lubricating the tonsils. At the same time, you can take a decoction of chamomile, mint, and calendula orally to generally strengthen the immune system.

There are a lot of folk recipes to alleviate the condition during an exacerbation of chronic tonsillitis, but we must remember that therapy is usually long-term.

Complications of chronic tonsillitis

If tonsillitis itself is an unpleasant disease, but generally not dangerous, then in the absence of treatment it can have quite serious undesirable consequences. Chronic causes the following:

1. Frequent sore throats become a constant companion for a person.
2. This disease negatively affects the cardiovascular system.
3. It also affects the digestive system, since the intestinal microflora suffers and the mucous membrane is in an inflamed state.
4. The development of pyelonephritis and other kidney pathologies is not uncommon.
5. Attacks of suffocation may develop.
6. With chronic tonsillitis, the joints begin to suffer, and the development of rheumatism and arthritis is not far off.
7. Due to this disease, depression develops.

From all that has been said, it is important to remember that a fairly serious diagnosis is “chronic tonsillitis.” That this disease definitely requires timely treatment should not raise any doubts.

Prevention

The development of the disease can be prevented by preventive measures. Among these are the following:

• Healthy lifestyle.
• Hardening procedures.

• Taking medications that strengthen the immune system, for example, drugs “Immunal”, “Imudon” and others.

If you don't allow it to escalate, it won't be scary.

The result of all that has been said can be summed up as follows: any disease needs timely treatment. Even a seemingly harmless disease can lead to serious consequences that require longer therapy. Take care of your health and treat it with a sense of responsibility.

Tonsillitis is a disease characterized by inflammation of one or more tonsils, usually the palatine tonsils, caused by a bacterial or viral infection. It is one of the most common infectious diseases of the upper respiratory tract.

The lymphoid tissue of the pharyngeal tonsils is designed to serve as a barrier to the entry of bacteria and viruses into the upper respiratory tract. However, if the infectious process occurs in them for a long time due to untimely or inadequate treatment, they themselves can become a source of problems associated with the spread of infection to other organs and systems of the body.

The disease can occur in acute or chronic form. Acute tonsillitis is known as tonsillitis. However, often it is not a consequence of contact with an infectious pathogen, but an exacerbation of chronic tonsillitis due to hypothermia, overwork or weakened immunity under the influence of other factors. At the same time, acute tonsillitis that is not fully cured often takes a chronic form.

Causes and symptoms of chronic tonsillitis

The development of chronic tonsillitis is caused not only by frequent sore throats and acute respiratory viral infections (ARVI), but also by the presence in the oral cavity of teeth with untreated caries and periodontal disease. The occurrence of the disease is also facilitated by persistent difficulty in nasal breathing due to the curvature of the nasal septum, hyperplasia of the nasal turbinates, etc.

Chronic tonsillitis can occur in the form of periodically recurring relapses of tonsillitis, not associated with contact with infection, or in the form of a long-term, sluggish inflammatory process in the tonsils without exacerbations, manifested clinically as tonsillitis (non-anginal chronic tonsillitis).

Recurrent chronic tonsillitis is characterized by recurring tonsillitis, relapses occur one or more times a year. In the interval between exacerbations, a person may feel practically healthy, and even with an objective examination by an ENT doctor, pathological changes in the tonsils themselves, the adjacent oral mucosa or in the lymph nodes are not always detected. However, regularly recurring tonsillitis is a reason to suspect the presence of chronic tonsillitis.

More often, in the period between exacerbations, symptoms of the disease are present: sore throat when swallowing, especially in the morning, sore or raw throat, coughing attacks, bad breath, sensation of a lump or foreign body in the throat. Neuralgic pain may occur, radiating to the ear or neck. Local symptoms often include general malaise, fatigue, irritability, increased sweating, headaches, a slight increase in temperature in the evening, as well as various types of discomfort in the heart area, including severe pain.

Chronic tonsillitis can occur in compensated and decompensated (with damage to the heart, kidneys, joints, chronic intoxication) form. The disease also causes changes in the body's immune system.

Treatment of chronic tonsillitis

The main method of treatment is conservative therapy (general and local). If it does not lead to success, then the issue of surgical intervention (removal of the tonsils - tonsillectomy) is considered.

General methods of conservative treatment are hardening procedures (physical exercise in the fresh air, rubbing with room and then cold water, systematic sports). They are of great importance, but they cannot be used during periods of exacerbation and in the presence of symptoms of chronic tonsillitis in between. Physiotherapeutic procedures (irradiation with short-wave ultraviolet light, laser therapy, diathermy, phonophoresis) can be carried out even if the patient experiences general or local symptoms of the disease during the period between its exacerbations.

Local treatment consists of lubricating the tonsils and their lacunae with various solutions (1-5% iodine tincture, Lugol's solution, iodine glycerin, etc.). The main effect of the solutions used for these purposes is not associated with the antibacterial effect (for its implementation they do not contact the tissues of the tonsils for long enough), but with their anti-inflammatory, soothing, astringent properties. Antibiotics are used to treat chronic tonsillitis. When choosing them, it should be taken into account that this disease is characterized by the presence of a wide range of microbial flora on the affected tonsils, and many strains have high β-lactamase activity (the ability to destroy penicillins, which belong to the group of β-lactam antibiotics). Therefore, preference is given to protected aminopenicillins (for example, amoxiclav). Successful antibiotic therapy is complicated by a decrease in the resorbing capacity of the palatine tonsils and sclerotic processes around their lacunae against the background of chronic inflammation.

The lack of effect of conservative therapy and the development of complications of chronic tonsillitis are indications for surgical treatment. First of all, we are talking about diseases such as rheumatism, endocarditis, nephritis, cholangiohepatitis. In most cases, tonsillectomy leads to an improvement in overall health and reduces the severity of pathological changes in the affected organs. Unfortunately, surgery does not always lead to a complete recovery. Firstly, surgical treatment does not always ensure complete elimination of the source of chronic infection, since it can spread not only to the tonsils themselves, but also to the surrounding tissue, lymph nodes, etc. In addition, as a result of long-term chronic tonsillitis, it can lead to development of a progressive infectious-allergic process.
A relatively new method of treating chronic tonsillitis is cryotherapy. Low temperatures are applied to the tonsils themselves and to the back wall of the pharynx. This leads to the destruction of pathologically altered surface layers of tissue and the elimination of pathogenic microflora. After cryotherapy, the normal mucous membrane is quickly restored, while the functions of the tonsils are completely preserved. The advantages of cryotherapy compared to traditional tonsillectomy are the absence of bleeding, pain and a good cosmetic effect.

Complications of tonsillitis

The most dangerous complication of tonsillitis is rheumatism, which affects the joints and valve apparatus of the heart, leading to the formation of heart defects and the development of heart failure. Incompletely cured tonsillitis can lead to kidney disease (pyelonephritis, glomerulonephritis). Local complications of tonsillitis are paratonsillitis and paratonsillar abscess.

How to prevent chronic tonsillitis

Prevention of tonsillitis is, first of all, general hardening of the body. Timely treatment of diseases of the teeth and gums, sinusitis, and otitis is also of great importance. You should also not forget about preventive examinations by an ENT doctor.

Tonsils- a collection of lymphoid tissue shaped like an almond. Their function is to recognize antigens coming from the environment and inform the immune system about them. The tonsils are part of the Waldeyer–Pirogov lymphadenoid ring surrounding the entrance to the pharynx, which consists of:

• two palatal...
• two pipe...
• pharyngeal...
• lingual tonsil.

Structure of the tonsils

Parenchyma of the tonsil consists of connective tissue, between which there are a large number of lymphocytes, plasma cells and macrophages are also present. The structural unit of the tonsils is follicle, a vesicle whose walls are lined with lymphocytes. The outer surface of the tonsil is covered with stratified squamous epithelium, like the rest of the finished cavity.

Up to 20 go deep into the palatine tonsils recesses (crypts), which branch, forming large cavities lined with epithelium. The crypts contain phagocytes, microorganisms, desquamated epithelial cells, and sometimes food particles. Normally, lacunae are cleared of contents during the act of swallowing, but sometimes this process fails and purulent plugs form in the lumen of the crypts.

In the folds of the tonsils, long-term contact of external stimuli, mainly microorganisms, with the cells of the organ is ensured. It is necessary so that the immune system has time to become familiar with the pathogen and begin to secrete antibodies and enzymes to destroy them. Thus, the tonsils take part in the formation of local and general immunity.

Oral mucosa

1. Epithelial layer represented by stratified squamous epithelium. It consists of basal, spinous, granular and stratum corneum. Between the epithelial cells there are separate leukocytes. Their function is to protect against foreign bacteria and viruses. They are able to move independently and migrate to areas where inflammation develops.

2. lamina propria of the mucous membrane- a layer of connective tissue consisting of collagen and reticular fibers. Among them are:

• Fibroblasts– connective tissue cells that produce collagen fiber precursor proteins.
• Mast cells- representatives of connective tissue responsible for the chemical stability of the oral mucosa and the production of class E immunoglobulins to ensure local immunity.
• Macrophages capture and digest bacteria and dead cells.
• Plasma cells belong to the immune system and secrete 5 types of immunoglobulins.
• Segmented neutrophils- a type of white blood cell responsible for protection against infections.

The oral mucosa is pierced by ducts major and minor salivary glands. They produce enzyme-rich saliva, which has a bactericidal effect, inhibits the growth and reproduction of bacteria.

Thus, the oral cavity contains many mechanisms that protect against viruses and bacteria. A healthy body, when microorganisms enter the tonsils, copes with them without developing tonsillitis. However, when general or local immunity decreases, natural protection is disrupted. Bacteria lingering in the tonsils begin to multiply. Their toxins and protein breakdown products cause allergization of the body, which leads to the development of tonsillitis.

Causes of tonsillitis

• Airborne. A sick or asymptomatic carrier, when coughing and talking, releases pathogens along with droplets of saliva, infecting surrounding people.
• Food. Develops when eating dishes in which pathogenic microorganisms have multiplied. In this regard, the following are particularly dangerous: products with protein cream, milk and dairy products, dishes containing eggs and egg powder.
• Contact. You can become infected with tonsillitis through kissing and through household items: toothbrushes, cutlery and other utensils.
• Endogenous. Bacteria are carried into the tonsils through the blood or lymph from other sites of infection. Most often, tonsillitis occurs against the background of sinusitis, sinusitis, frontal sinusitis, otitis media, periodontitis, and caries.

• local and general hypothermia;
• acute stress reactions;
• high dust and gas content in the air;
• monotonous food with a deficiency of vitamins C and B;
• injury to the tonsils from rough food;
• lymphatic diathesis is an anomaly characterized by persistent enlargement of the lymph nodes, tonsils and thymus;
• disturbances in the functioning of the central and autonomic nervous system;
• chronic inflammatory processes in the oral and nasal cavities;
• reduced adaptation to environmental changes.

1. Infection. The disease begins with the entry of pathogenic microorganisms into the tonsils. When the body's defenses are reduced, bacteria receive favorable conditions for reproduction. This leads to inflammation of the mucous membrane of the tonsils, which is expressed in their enlargement, swelling, and redness.
Some bacteria enter the bloodstream. Typically, such bacteremia is short-lived. But in weakened patients, it can cause the development of purulent inflammation in other organs (abscess, otitis media).

2. Intoxication. The number of bacteria increases. Clinical manifestations at this stage are associated with the entry into the blood of bacterial enzymes that cause intoxication of the body. Signs of poisoning of the nervous system include fever, general weakness, and headache. Streptococcal enzymes streptolysin-0 (SL-O), streptokinase (SK) and hyaluronidase have a toxic effect on the heart, causing spasm of its blood vessels. Streptococcal streptolysin causes necrosis of tonsil tissue. Lymphatic cells die, and in their place voids filled with pus form.

3. Allergization. Bacterial products contribute to the formation of histamine and the development of an allergic reaction. This leads to accelerated absorption of toxins in the tonsils and increased swelling.

4. Neuroreflex lesions of internal organs. The tonsils contain many nerve receptors. They have a close reflex connection with other organs, especially with the cervical sympathetic and parasympathetic ganglia (nerve ganglia). With prolonged or chronic tonsillitis, blood circulation is disrupted and aseptic (without the participation of microorganisms) inflammation develops. Irritation of these important nerve nodes leads to disruptions in the functioning of various internal organs for the innervation of which they are responsible.

The end of tonsillitis can have two options:

1. Destruction of microorganisms that caused tonsillitis and complete recovery.
2. Transition of the disease into a chronic form. The immune system is not able to completely suppress the infection, and some of the bacteria remain in the folds or follicles. At the same time, there is always a focus with a “dormant” infection in the tonsils. This is facilitated by the fact that after tonsillitis, the exit from the lacunae can be narrowed by scar tissue and their self-cleaning worsens, which promotes the proliferation of bacteria. The constant presence of pathogenic microorganisms weakens the immune system and can cause autoimmune pathologies (rheumatism, rheumatoid arthritis).

Symptoms of tonsillitis

Symptom	Development mechanism	Its manifestations
Fever	The reaction of the nervous system to the presence of bacterial toxins in the blood.	Acute tonsillitis - the temperature rises sharply to 38-40 degrees. Lasts 5-7 days. Chronic tonsillitis is a prolonged low-grade fever up to 37.5 degrees.
Inflammation of the lymph nodes	Lymph nodes trap microorganisms and their metabolic products that enter the lymphatic system.	The regional anterior cervical (closest to the tonsils) lymph nodes become inflamed. They are enlarged, not fused to the skin, and may be painful when palpated.
Significant redness of the palatine arches	Bacterial toxins cause dilation of small vessels in the mucous membrane of the palatine arches.	The redness is noticeable. Edema, as a rule, is not observed.
Hyperemia and swelling of the tonsils Catarrhal sore throat	Under the influence of toxins, blood vessels dilate, their permeability increases, and tissues become saturated with fluid.	Swelling and redness of the tonsils is pronounced. They can increase significantly in size.
Festering follicles Follicular tonsillitis	An accumulation of pus forms in the follicles of the tonsils.	The festering follicles are visible through the epithelium. They look like yellow millet grains.
Accumulation of pus in lacunae Lacunar tonsillitis	Phagocytosis actively occurs in the lacunae. Pus is formed from a mixture of bacteria, immune and epithelial cells in the cavities.	Irregularly shaped purulent plugs resemble grains of cottage cheese. They are visible in the gaps of the gaps. They often emit an unpleasant odor. A purulent plaque forms around the plugs on the surface of the tonsils, which can merge and cover its entire area.
A sore throat	The tonsils are rich in nerve endings. Their irritation causes pain.	Dryness and sore throat, which sharply intensifies when swallowing. Patients have difficulty swallowing solid food.
General malaise	Bacterial enzymes have a toxic effect on the central and peripheral nervous system.	Pain and aches in muscles and joints, weakness, drowsiness, apathy and loss of strength.

Diagnosis of tonsillitis

Examination by an ENT doctor

• Redness of the anterior and posterior palatine arches. Their edges are hyperemic and swollen.
• Swelling in the corner area, formed by the upper edges of the anterior and posterior arches.
• Redness and swelling of the tonsils.
• Enlarged tonsils. They can cover 1/3 or 1/2 of the lumen. This may indicate swelling due to tonsillitis, hypertrophic chronic tonsillitis, or anatomical features. In the absence of signs of inflammation, the size of the tonsil does not matter. It is also necessary to take into account that inflamed tonsils, with lacunae filled with pus, can be atrophic (reduced) and completely hidden behind the palatine arches.
• Purulent discharge on the tonsils may look like:
  • suppurating follicles;
  • purulent plugs in the lumen of lacunae or liquid pus released from them when pressed with a spatula;
  • purulent plaque on the surface of the tonsils, which does not spread beyond its boundaries.
• Adhesion of the tonsils to the palatine arch speaks of a chronic inflammatory process. It is detected when a probe is inserted between the arch and the tonsil.
• Firm and enlarged lymph nodes.

Tonsil examination

Examination of lacunae is carried out with a slightly curved button probe. It can be used to take a sample of the contents for bacterial testing. A probe is inserted into the lumen of the canal to determine its depth and the presence of adhesions, which indicates chronic tonsillitis.

To identify concomitant diseases, the doctor examines the nasal cavity and auditory canals.

Biopsy for tonsillitis is rarely used, since lymphocytes are found in both healthy and inflamed tonsils. The method is used if the development of a malignant tumor is suspected.

Lab tests

Swabs from the surface of the tonsils or the back of the throat

Using a sterile swab, smears of mucus are taken from the surface of the tonsils and the back wall of the pharynx. The sample is sent to the laboratory for microscopy of the material, which reveals the microorganisms that caused the disease. In the vast majority of cases, these are hemolytic streptococcus and staphylococcus. However, there are more than 30 different combinations of pathogenic, opportunistic bacteria and viruses that can cause tonsillitis.

For frequently recurring sore throats, antibiotic sensitivity test, which allows you to choose effective treatment.

However, most doctors are of the opinion that smears from the surface of the tonsils are not an informative study, since 10% of healthy people are diagnosed with streptococcus during examination, and 40% with staphylococcus.
A more informative method is counting the number of microbial cells in a smear. In acute tonsillitis, from 1.1 to 8.2 10 6 cells are detected. However, due to its labor-intensive nature, this study is rarely used.

Clinical blood test for tonsillitis:

• the ESR level increases to 18-20 mm/h;
• neutrophilic leukocytosis (increase in the number of neutrophils in the blood) up to 7-9x10 9 /l;
• band shift to the left - increase in the number of immature (band) neutrophils, the appearance of myelocytes and metamyelocytes (young).

Changes in blood tests indicate an infectious disease accompanied by an inflammatory process. In some patients, especially with chronic tonsillitis in remission, blood tests remain normal.

Determination of antibody titer to streptococcal products

Increased production of antibodies to streptolysin O over 200 IU/ml indicates the causative agent of the disease. This study is advisable to carry out only for chronic tonsillitis, since antibodies to streptolysin appear in the blood on the 7th day of illness.

Treatment of tonsillitis

Treatment of tonsillitis with medications

Physiotherapeutic procedures for tonsillitis:

• Vacuum hydrotherapy of palatine tonsils– vacuum lavage of lacunae, when purulent plugs are removed under pressure. The resulting cavities are filled with an antiseptic - 0.1% hydrogen peroxide solution or antibiotic solutions. After washing, the surface of the tonsil is lubricated with Lugol's solution. The course consists of 5 procedures.
• Local ultraviolet therapy of palatine tonsils. The tonsils are irradiated with a beam of ultraviolet light according to the scheme, starting from 30 seconds to 2 minutes. There are 10 procedures prescribed per course.
• UHF. The emitter is installed on the side surface of the neck at the angle of the lower jaw. Session duration is 7 minutes. The course of treatment is 10-12 procedures.

Nutrition and lifestyle for tonsillitis

For chronic tonsillitis in remission It is advisable for patients to move more and be in the fresh air for at least 2 hours a day. Physical inactivity worsens the immune system. It has been proven that with insufficient physical activity, the local protective properties of the oral mucosa and tonsils worsen by 5-8 times. Therefore, regular exercise significantly reduces the number of exacerbations of tonsillitis.

• Avoid dusty and smoky air.
• Stop smoking.
• Humidify the indoor air. Humidity should be at least 60%.
• Toughen up. Contrast showers, cold rubdowns, and dousing with cold water are recommended daily.
• Spa therapy on the sea coast. Swimming, sunbathing and rinsing with sea water increase general and local immunity. Duration of treatment is 14-24 days.
• Follow a daily routine and allocate enough time for rest. Don't overwork yourself and avoid stress.

Table No. 13 is recommended for patients with acute and exacerbation of chronic tonsillitis. This diet is aimed at strengthening the body's defenses and quickly eliminating toxins.

Culinary processing - boiling in water or steaming. This helps ensure that the dishes are as gentle as possible. The mucous membrane of the mouth and pharynx should not be injured mechanically, thermally or chemically, therefore all dishes should be liquid or semi-liquid, temperature 15-65 degrees. Hot, spicy and sour foods are excluded.

During illness, frequent meals in small portions 5 times a day are necessary. It is advisable to take food during those hours when the temperature drops and appetite appears.

It is necessary to increase fluid intake to 2.5 liters per day. This reduces the concentration of toxins in the body and promotes their elimination in the urine.

Recommended Products:

• Wheat bread baked yesterday.
• Meat or fish soups. Not rich, low-fat - for this, drain the first water when cooking meat. Vegetables, pasta and cereals are added to soups. Since it is difficult for patients to swallow, soups are pureed or crushed in a blender.
• Steamed lean meats, poultry and fish. Steam cutlets, meatballs, and meatballs are also recommended.
• Fermented milk products, fresh low-fat cottage cheese, mild cheese. Sour cream is used only for seasoning dishes.
• Semi-liquid, viscous porridge from cereals.
• Vegetable side dishes: mashed potatoes, stew, vegetable caviar.
• Fresh fruits and berries, not hard or sour. Jam, compotes, jelly, juices diluted with water 1:1.
• Honey, marmalade, jam.
• Drinks: weak tea and coffee, rose hip decoction.

• Baking, rye bread.
• Fatty fish and meats, broths made from them.
• Smoked meats, canned food, salted fish.
• Barley and pearl barley, millet.
• Cream, whole milk, sour cream, fatty cheeses.
• Products that increase gas formation: cabbage, legumes, radishes, radishes.
• Spices, hot seasonings.
• Strong tea, coffee.
• Alcohol.

When is it necessary to remove tonsils?

Prevention of tonsillitis

What does that require?

• Lead a healthy lifestyle. This concept includes proper nutrition, physical activity and proper rest. Food should be rich in easily digestible proteins, vitamins and microelements. In this case, it helps strengthen the body's natural defenses.
• Will be tempered. You need to start hardening by pouring water at room temperature or swimming in an open pond for 3-5 minutes. Gradually, the water temperature is reduced and the time spent in the reservoir is increased.
• Maintain good hygiene: do not use other people’s toothbrushes, do not drink from the same cup, wash dishes thoroughly. Provide separate equipment for the patient.
• Restore impaired nasal breathing. To do this, you need to contact an ENT specialist.
• Monitor the condition of the mouth and teeth. Visit the dentist at least once a year.
• Gargle 2 times a day with diluted colanchoe juice (1 tsp per glass of water), infusions of chamomile or calendula. This recommendation will help people who often experience a sore throat.
• Massage of the front of the neck performed with stroking movements from the chin to the earlobes, from the upper jaw to the collarbones. Massage improves blood circulation and lymph flow, helps increase local immunity. It is recommended to perform it before going outside or after hypothermia.

• Contact with patients with sore throat. If possible, isolate the patient from other family members.
• Crowded places, especially during periods of epidemics, when there is a high probability of becoming infected.
• Overheating and hypothermia, as this entails a decrease in immunity.
• Smoking, consumption of strong alcoholic drinks, burning the mucous membrane of the throat.