Tonsillitis - BMJ Best Practice

Patient information from the BMJ Group
Tonsillitis
Tonsillitis is a type of sore throat. It can make you very ill and keep you in bed for
a few days.
We've brought together the best and most up-to-date research about tonsillitis to
see what treatments work. You can use our information to talk to your doctor and
decide which treatments are best for you.
What is tonsillitis?
Tonsillitis is an infection in your tonsils. Your tonsils are two small mounds on either side
of the back of your throat.They can get infected with a virus or bacteria.The most common
bacteria to cause tonsillitis are called Streptococcus. You may hear a sore throat or
tonsillitis called strep throat.
What are the symptoms?
Tonsillitis causes a bad sore throat that lasts for several days. It may hurt when you
swallow. You'll probably have a fever and a headache, and not feel like eating. You may
be able to feel lumps under your jaw and in your neck (these are swollen glands). You
may need a few days off school or work.
Children under 5 years don't often say they have a sore throat, because they don't know
where the pain is coming from. They may say they have a tummy ache.
If your symptoms are very bad or go on longer than two days, see your doctor.
What treatments work?
You won't usually need any treatment for tonsillitis. Your body will fight off the infection.
Resting and drinking plenty of fluids may help you feel better while this happens. Taking
painkillers such as acetaminophen (Tylenol), aspirin, or ibuprofen (Advil) should help
you feel better. But don't give aspirin to children or teenagers.
If your doctor thinks your tonsillitis is caused by bacteria, he or she may prescribe
antibiotics. Antibiotics will work only if your tonsillitis is caused by bacteria, not a virus.
But it can be hard for your doctor to tell what's caused your tonsillitis.
Studies of people with a sore throat have found that antibiotics can reduce how long you
have symptoms for, but only by about a day. There haven't been any studies that looked
only at people with tonsillitis. Antibiotics can have side effects, although these are usually
mild. You may get an upset stomach, diarrhea, or a rash.
Do I need surgery to remove my tonsils?
If you or your child gets tonsillitis a lot, you may want to think about surgery. Doctors
don't tend to recommend it unless someone gets at least seven attacks of tonsillitis a
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Tonsillitis
year, or five attacks a year for two years, or three attacks a year for three years. It will
be up to you to decide whether to have surgery. Some people choose it if tonsillitis has
been interfering with their life by making them feel sick a lot.
If your child has his or her tonsils out, he or she may get fewer throat infections in the
short term. One study has found that, in the first two years after surgery, most children
had two or three fewer throat infections.
But after a few months or years, there's no real difference in the number of throat infections
between children who've had their tonsils out and children who take antibiotics instead.
This may be because children who don't have surgery tend to grow out of throat infections.
There hasn't been much research about whether surgery can help adults who get tonsillitis
a lot.
Surgery has some risks. You should discuss these with your doctor. There's a chance
you could bleed heavily during your operation or afterward, and need another operation.
There's also a chance your teeth could get damaged, or you could get a chest infection.
What will happen to me?
Tonsillitis usually clears up on its own. You won't need any treatment unless your
symptoms are very bad.
Occasionally, people get more serious problems after having tonsillitis. Some people get
an abscess in their throat. This can make your throat very sore, and you may have
difficulty opening your mouth. If you get these symptoms, you should see your doctor.
If your tonsillitis is caused by infection with a particular type of bacteria, you can get
rheumatic fever. This causes pain and swelling in your joints, a fever, and pain in your
abdomen. This disease used to be quite common. But it doesn't happen much now.
This information is aimed at a US patient audience. This information however does not replace medical advice.
If you have a medical problem please see your doctor. Please see our full Conditions of Use for this content. These
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© BMJ Publishing Group Limited 2015. All rights reserved.
Last published: Sep 16, 2015
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