The tonsils are two oval-shaped pads of lymphatic tissue at the back of the throat. They are part of the immune system, defending against pathogens entering through the mouth or nose. When these protective tissues become infected, they can swell and become inflamed, a common condition known as tonsillitis.
What Causes Swollen Tonsils
Swollen tonsils are frequently caused by infections, with viruses being the most common culprits. Viruses such as those responsible for the common cold, influenza, and mononucleosis (Epstein-Barr virus) account for a significant majority, between 70% and 95%, of tonsillitis cases. These pathogens trigger an immune response, leading to inflammation and enlargement of the tonsils.
Bacterial infections are another cause, making up 5% to 30% of cases, particularly in children aged 5 to 15 years. Streptococcus pyogenes (Group A Strep) is a frequent bacterial cause, leading to strep throat. Less common causes for swollen tonsils can include allergies, exposure to irritants like smoke or pollution, or even fungal infections.
Recognizing Other Symptoms
Swollen tonsils often present with other noticeable symptoms. A sore throat is prominent, often accompanied by pain or difficulty swallowing. Individuals may also experience a fever, headache, and generalized body aches.
Other indicators include bad breath, a muffled voice, or white spots, streaks, or a coating on the tonsils. Swollen and tender lymph nodes, typically felt on the sides of the neck, are also associated with tonsil inflammation.
At-Home Relief for Swollen Tonsils
Managing swollen tonsils at home focuses on easing discomfort and supporting recovery. Rest is important, allowing the body to conserve energy and fight infection. Staying hydrated with plenty of fluids, such as warm tea or broth, or cold drinks and ice pops, can soothe a sore throat and prevent dehydration.
Gargling with warm salt water can help reduce swelling and discomfort. Dissolve half a teaspoon of salt in 8 ounces of warm water and gargle several times a day. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can also help manage pain and reduce fever. Using a cool-mist humidifier can add moisture to the air, which may help alleviate throat dryness and irritation.
When to See a Doctor
While many cases of swollen tonsils resolve with at-home care, certain symptoms warrant medical attention. Consult a doctor for severe throat pain, significant difficulty breathing or swallowing, or a high fever above 101°F (38.3°C). A stiff neck, a rash, or symptoms that worsen or don’t improve within a few days also require medical advice.
White spots or pus on the tonsils, or if one tonsil appears significantly larger, should prompt a doctor’s visit. If you or your child experiences recurrent episodes of swollen tonsils, a medical evaluation can help determine the underlying cause and appropriate management. Timely care is important to prevent complications, such as a peritonsillar abscess or, with untreated bacterial infections, rheumatic fever or kidney inflammation.
Professional Medical Interventions
When consulting a doctor for swollen tonsils, a physical examination of the throat, nose, and ears is performed. A rapid strep test or throat swab may be taken to check for bacterial infections like Group A Strep, guiding the treatment plan.
If a bacterial infection is identified, antibiotics, such as penicillin or amoxicillin, are prescribed for 10 days. Complete the entire course, even if symptoms improve, to ensure the infection is fully eradicated and prevent complications. For viral infections, antibiotics are ineffective; treatment focuses on supportive care, similar to at-home remedies, to manage symptoms while the body fights the virus.
In chronic or recurrent severe cases, or with complications like obstructive sleep apnea or recurrent peritonsillar abscesses, surgical removal of the tonsils (tonsillectomy) might be considered. This procedure is a last resort, indicated for specific criteria, such as seven or more tonsil infections in one year.