Chronic tonsillitis - signs, symptoms, causes, diagnosis and methods of treating the disease

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NOT TONSOLS, BUT PALATINAL TONSIS

— Sergei Valentinovich, people far from medicine often say: “My tonsils are inflamed!” But there is no such term in medicine?

— Tonsils is really a common term; it doesn’t exist in medicine. There is a term "tonsils". Doctors abroad would say that this is tonsillopharyngitis. We separate two concepts: pharyngitis is a disease of the back wall of the pharynx, mucous membrane, and tonsillitis is a disease of the tonsils. There is inflammation - bacterial or viral. 70 percent of all inflammations in the pharynx are viral inflammations. Classic inflammation has five signs: redness, swelling, pain, fever, dysfunction. But a sore throat does not always indicate that a person has a viral or bacterial infection. It can be caused, for example, by a temperature reaction: a person drank ice water and his throat hurt; I drank too hot tea and my throat hurt. Some chemicals - for example, pepper or alcoholic drinks, environmentally harmful substances - can also create discomfort in the throat.

Exacerbation of chronic tonsillitis: symptoms

Often, for a long time, chronic tonsillitis occurs without symptoms or has scanty symptoms (in a simple form). There may be discomfort when swallowing food and liquids, a sensation of a foreign body in the throat, dry mouth, halitosis (bad odor) and tingling. Externally, the tonsils increase in size and there are signs of inflammation. The disease is characterized by exacerbations of sore throats up to three times a year, long periods of recovery, with general symptoms of asthenia and prolonged low-grade fever.

For the toxic-allergic form, more frequent exacerbations are typical, often with complications in the area of neighboring tissues (pharyngitis, peritonsillar abscesses), and the almost constant presence of asthenia and prolonged fever are typical.

The clinical picture of chronic tonsillitis during an exacerbation is as follows:

sore throat that gets worse when swallowing;
redness of the throat and tonsils;
characteristic plaque;
purulent discharge from the tonsils;
bad breath;
swelling of the nasopharynx;
temperature increase;
weakness;
headache;
fast fatiguability;
arrhythmia;
enlarged lymph nodes;
dyspnea.

Contraindications for sore throat

Sore throat is a disease that cannot be carried on your feet. Even in cases where it occurs in a mild form. This can trigger the infection to become chronic or severe, and also contributes to complications.

If you feel better, you should not stop taking antibiotics. It is also not recommended to smoke or drink alcohol, as smoke and alcohol can irritate a sore throat. It is necessary to exclude fatty, spicy, sour and solid foods from the diet for the same reason - so as not to irritate the throat.

It is extremely important to completely cure the disease so that it does not become chronic. Otherwise, you will face the fact that the infection will torment you regularly.

Causes, main risk factors

Up to 30 different colonies of pathogenic microbes can be sown on the surface of the tonsils of patients suffering from chronic tonsillitis. But in crypts and lacunae staphylo- or streptococcus is usually determined. A key role in the pathogenesis of chronic tonsillitis is played by beta-hemolytic strains of streptococcus (type A). Other flora - gram-negative coccal, fungal, viral - have an impact on local immunity, they support inflammation.

There are a number of factors contributing to the occurrence of the disease:

hypothermia;
decreased immunity;
microtrauma of the tonsils;
foci of inflammation in the mouth and in the head area (caries, sinusitis, adenoids, etc.);
smoking;
poor nutrition;
allergy.

Viruses and bacteria that cause tonsillitis can come from the external environment.

Classification

Doctors distinguish various clinical forms of chronic tonsillitis, differing in clinical manifestations, severity of the condition and prognosis, risk of complications, as well as treatment tactics.

The simple form of chronic tonsillitis is characterized by a predominance of local symptoms. If general manifestations and lymphadenitis occur, this is referred to as a toxic-allergic form of tonsillitis. It comes in two versions:

Toxic-allergic chronic tonsillitis 1st degree . Sore throats are typical for him, which can worsen after ARVI, combined with general symptoms.

Toxic-allergic chronic tonsillitis of the 2nd degree - the symptoms are more pronounced, associated with diseases that have common factors of etiology and pathogenesis.

According to the degree of compensation of the process, the disease is divided into two options:

chronic tonsillitis, compensated form - the source of infection is in a dormant state, there are no reactions from the body, repeated sore throats do not occur; The function of the tonsils and general reactivity are not impaired.
chronic tonsillitis is a decompensated form - relapses of sore throat occur, complications of the heart, damage to the paranasal sinuses, middle ear, and renal complications are possible.

According to pathomorphological criteria, the process is divided into the following options:

lacunar tonsillitis with predominant damage to the area of the lacunae;
parenchymal-lacunar, involving in addition to the lacunae also the area of the lymphoid tissue of the tonsils themselves;
phlegmonous - inflammation is predominantly localized in the area of lymphoid tissue;
sclerotic with abundant growth of connective tissue fibers in the area of the tonsils and surrounding tissue.

Types of sore throat

Sore throat differs in the degree of damage to the tonsils:

catarrhal - the easiest option, in this case the inflammatory process affects only the mucous membrane, the tonsils are swollen and bright red
lacunar – damage to the canals of the tonsils (lacuna), the tonsils are covered with a characteristic white coating;
follicular - follicles are formed in the tonsils, which are filled with pus;
combined - a severe form of tonsillitis, when both lacunae and follicles are affected on the tonsils.

Complications of chronic tonsillitis

Against the background of a chronic inflammatory process in the tonsil area, various complications are possible. Therefore, it is important to know why chronic tonsillitis is dangerous. Thus, the tonsils themselves, losing their function as a barrier to infection, become its breeding ground. Inside them are pathogens with the products of their metabolism. The infection can spread throughout organs and tissues, affecting the renal parenchyma, joint and heart tissue, and liver. In addition, tonsillitis adversely affects the functioning of the immune system and can be a provocateur of collagen diseases - lupus, scleroderma, dermatomyositis, periarteritis. The skin and peripheral nerve fibers may also be affected. With prolonged intoxication against the background of the disease, damage to blood vessels (vasculitis) and platelets (purpura) is possible.

Diagnostics

Diagnosis of chronic tonsillitis occurs on the basis of complaints, examination of the patient, and questioning of the patient. Objective signs, manifestations of chronic tonsillitis, and the general condition of the tonsils are important; the doctor determines the stages of the process and the form.

The following diagnostic procedures are also carried out:

throat swab for flora;
general blood and urine tests;
blood test for antibodies to streptococcus.

This helps determine treatments for chronic tonsillitis.

Treatment methods in adults

In most cases, they resort to conservative treatment of chronic tonsillitis. Source: Modern methods of treating chronic tonsillitis. Ryazantsev S.V., Eremina N.V., Shcherban K.Yu. Medical Council, 2021. p. 68-72:

therapy for inflammation in the head and oral cavity;
procedures that increase immunity (hardening, taking vitamins, physical education, etc.);
hyposensitizing drugs (to suppress allergic reactions);
immunomodulators (normalize the immune system);
means of reflex action (acupuncture, manual therapy);
washing the tonsils with antiseptics;
administration of drugs to the tonsils.

The treatment plan is complemented by physical therapy for chronic tonsillitis.

A radical method of treating chronic tonsillitis is surgical removal of the tonsils (tonsillectomy). The operation is performed in cases where inflammation occurs more than five times a year and does not respond to complex conservative treatment of chronic tonsillitis. Source: Choosing an antibiotic for exacerbation of tonsillitis. Karpishchenko S.A., Kolesnikova O.M. Medical Council, 2015. p. 40-43.

Features of the disease

The peripharyngeal ring is a collection of lymphoid tissue, which is an important peripheral organ of the body's immune system. Pathogenic microorganisms that enter the body with food and water are retained in the oral or nasal cavity precisely by the tonsils of the peripharyngeal ring. As a result of the struggle between the body and the infectious agent, a local reaction of the tonsils occurs, which is expressed in increased production of lymphocytes and can lead to tissue inflammation.

Inflammation of the tonsils can also be caused by an internal infection of the body, namely diseases of the oral cavity or ENT organs: caries, sinusitis, rhinitis, otitis media, etc. When the body's immune defense is weakened due to illness or hypothermia, opportunistic microflora found in the growth or nasal cavity can provoke acute inflammation of the tonsils. Factors that provoke pathology are bad habits (smoking and alcohol abuse), diseases of the gastrointestinal tract, working in hazardous working conditions, and unhealthy diet.

The risk group for the disease includes pregnant women, the elderly and children, as well as people with chronic damage to the immune system.

Prevention of chronic tonsillitis in adults

Preventive measures to prevent chronic tonsillitis include:

proper hygiene;
hardening;
balanced diet;
maintaining cleanliness in the home and workplace, eliminating dust;
timely treatment of inflammationSource: Treatment and prevention of chronic tonsillitis. Atagulova G. Zh. Medicine and ecology, 2012.

Chronic tonsillitis is a very common disease that causes a lot of inconvenience to the patient. But is it possible to cure chronic tonsillitis? If your tonsils often become inflamed, then do not self-medicate, but consult a doctor who will select the optimal treatment regimen for you and determine how to get rid of chronic tonsillitis. You can make an appointment with a medical specialist in St. Petersburg by calling the phone number listed on the website.

Article sources:

Treatment and prevention of chronic tonsillitis. Atagulova G. Zh. Medicine and ecology, 2012
Chronic tonsillitis in the practice of an otolaryngologist and cardiologist. Yalymova D.L., Kostyuk V.N., Vishnyakov V.V., Yalymov A.A., Shekhyan G.G., Zadionchenko V.S. Cardio Somatics, 2014. p. 60-65
Choice of antibiotic for exacerbation of tonsillitis. Karpishchenko S.A., Kolesnikova O.M. Medical Council, 2015. p. 40-43
Modern methods of treating chronic tonsillitis. Ryazantsev S.V., Eremina N.V., Shcherban K.Yu. Medical Council, 2021. p. 68-72

Comments

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13.10.2020, 12:31

Since childhood, my daughter’s throat has been her weakest point. Sore throats are also quite common in our country. I don’t want to constantly stuff my child with antibiotics, but Tonsilotren helps the throat very well.

—Mati0xxx

24.04.2019, 01:00

Gargling with salt, soda and iodine is very effective; there is even a ready-made drug called iodangin, which will clear up your neck in a couple of days.

—Sergo34

01.02.2017, 05:20

If you choose an antibiotic to quickly cure tonsillitis, then I recommend Azitral to everyone. It's inexpensive. I took one capsule a day for three days, 2 hours after lunch. After the third I felt fine. Azitral really helps.

— Marie (guest)

01.02.2017, 02:52

If you are afraid to take antibiotics, then it is in vain. You can safely take Azitral. The eldest son fell ill, and then received a complication - an earache. The doctor said it was otitis media. Prescribed Azitral. I was afraid that there would be all sorts of side effects. But it helped my son. Drink Azitral once a day before meals. If you need a proven antibiotic, then take Azitral.

— Nastya Sharova (guest)

31.01.2017, 21:36

If you are afraid to take antibiotics, then it is in vain. You can safely take Azitral. The eldest son fell ill, and then suffered a complication - tonsillitis. Prescribed Azitral. I was afraid that there would be all sorts of side effects. But it helped my son. Drink Azitral once a day before meals. If you need a proven antibiotic, then take Azitral.

— Kira (guest)

22.12.2016, 02:13

I agree with your opinion, Daria. I generally have a weak throat, just a few times I caught a cold like laryngitis, pharyngitis, tonsillitis...... I’m already used to it, on the one hand, but it also often happens in this habit to trigger the situation. Then I turn to antibiotics and Azitral became the best for me. It really gives a quick effect in recovery and without side effects. I recommend!

— Stas (guest)

17.12.2016, 01:49

Julia, I agree with you. I am very skeptical about antibiotics. But due to the fact that I have chronic tonsillitis since childhood, I have tried a lot of things... Doctors prescribe antibiotics, and sometimes they have to be used too. I noticed the greatest and best effect from Azitral capsules. And it helped quickly and didn’t notice any negative effects. Combined with rinses. So I recommend it!

— Darsha (guest)

11.12.2016, 00:19

I have had chronic tonsillitis since childhood. If I have ARVI or the flu, then every once in a while I get a sore throat. I have a weak throat. Rinsing helps, but not always. The doctor prescribes antibiotics. I don't really like antibiotics because they are harmful to the stomach. But there is nowhere to go. This year the doctor prescribed Azitral. It helped quickly and there were no side effects. I took two capsules a day two hours after lunch. A good and inexpensive antibiotic, I recommend it to everyone.

— Yulia Tarasenko (guest)

07.04.2016, 16:23

The disease is insidious and fraught with consequences. At the first sign of a sore throat, Tonsilotren helps. He treated my throat more than once. I love these tablets for their natural origin and the absence of dyes. I also give it to my child without fear.

- Dina

11.02.2016, 04:22

A sore throat is a common problem. I am being treated with Tonsilotren. Take 1 tablet every 2 hours. Relief comes quickly. I usually try to take it at the first discomfort, then tonsillitis goes away quickly and without complications.

- Dina

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