Tonsillectomy is a common surgical procedure to remove tonsils, often for recurrent infections or breathing issues. Some bleeding after a tonsillectomy is a normal part of healing. Knowing the difference between typical and excessive bleeding is important for patient safety and peace of mind during recovery.
Normal Bleeding Patterns
After a tonsillectomy, minimal bleeding is expected, often appearing as streaks or specks in saliva or mucus. Small, dark brown or black clots may also be present, indicating older blood. This bleeding is not a steady flow and should gradually decrease as the throat heals.
Blood-tinged saliva is common, especially during the first few days post-surgery. Scabs form where the tonsils were removed; these thick, yellow-white patches are a normal part of healing. Around 5 to 10 days after surgery, these scabs usually begin to detach in small pieces, which can lead to a small amount of fresh bleeding.
Recognizing Excessive Bleeding
While some bleeding is normal, certain signs indicate excessive bleeding requiring immediate medical attention. Bright red blood that is more than just streaks, such as actively dripping, pooling in the mouth, or requiring frequent swallowing, is a concern. Large blood clots or vomiting fresh, bright red blood also signal a complication.
Any sudden increase in bleeding after an initial decrease, or bleeding that does not stop after a few minutes of rest and applying ice, warrants urgent evaluation. In young children, excessive or frequent swallowing can be a subtle but important indicator of ongoing bleeding, as they may swallow blood rather than spitting it out. If these signs are observed, contact the surgeon or seek emergency medical care promptly.
Post-Tonsillectomy Care and Bleeding Prevention
Following post-operative instructions is important to minimize bleeding risk and support healing. Limiting physical activity is a primary preventative measure; strenuous activities, heavy lifting, and bending over should be avoided for 7 to 10 days. Quiet activities are recommended during initial recovery.
Dietary modifications also prevent irritation and bleeding. Patients should consume soft, bland foods and cool liquids, avoiding sharp, crunchy items like chips or toast, and hot or acidic foods such as citrus juices. Adequate hydration with clear or pale liquids is important for healing and can help prevent scabs from detaching prematurely. Avoiding red or dark-colored liquids can also help differentiate normal fluids from any potential bleeding.
Pain management should follow medical advice, usually involving acetaminophen. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are avoided due to their potential to increase bleeding risk. Rest is also important for recovery, allowing the body to focus on healing. Avoiding irritants such as smoking, forceful coughing, sneezing, nose blowing, and harsh gargling can help protect the surgical site from trauma.