Tonsillitis is a common problem. Its main feature is a sore throat, which may be accompanied by fevers, chills and trouble eating. It may affect one side or both sides of the throat and can be a recurrent illness. Some people become dehydrated and even require hospitalisation for intravenous antibiotics and fluids.

What do the Tonsils do anyway? 

The tonsils are part of the immune system. They are a ‘first defence’ against infection. Due to their location, they receive tiny parts of bacteria, viruses and other substances encountered in the mouth. They process this material and help to form or generate an immune response and create ‘memory’ in the immune system for fighting future problems.

They are at their most active when you are a child, as this is the time in life where you are building your immune system most aggressively. Hence, when you are small, they are often quite big as they are working hard.

Interestingly, the tonsils form only part of the immune system in that region. There are actually multiple sites of similar tissue in the mouth and oral cavity, which combine to perform the same function.

What goes wrong? 

The tonsils can become overwhelmed and infected when exposed to some bacteria and viruses. Usually this is temporary and the tonsils recover fully while you develop an immune system ‘strategy’ to deal with that particular bacteria or virus should you become exposed again.

Unfortunately, in some cases, the infections become chronic. Symptoms usually improve with antibiotics, but return at regular intervals giving the person recurrent tonsillitis. Why the tonsils and immune system don’t clear this problem remains a bit of a mystery, however we do know that once you develop recurrent tonsillitis there comes a point where your health is likely to be better with removal of the tonsils rather than keeping them.

In some rare cases, infections of the tonsils can become overwhelming and lead to significant illness. People may develop an abscess of the tonsil called a “quinsy” or and abscess in other parts of the neck. In rare cases this can progress on to become a serious and even life threatening illness.

What are the solutions? 

Individual episodes of tonsillitis may be treated with a combination of pain relief, fluids and in some cases antibiotics. In most instances this will solve the problem and there will be no ongoing issues.

However, in some cases tonsillitis occurs over and over again. Once a person reaches a certain number of infections or experiences a serious complication, it will usually be recommended that the person have tonsil surgery. Dr Morrissey can discuss the pros and cons of this surgery with you should it be relevant to your situation.

How do you cope without your tonsils? 

But what happens if you remove part of the immune system? Surely this has negative effects? Logic would suggest so, but it doesn’t seem to be the case. Research indicates that there are few changes we can find in immune function after the tonsils are removed and no overall change in the effectiveness of the immune system. Research would also suggest that if you meet certain criteria regarding number and nature of infections that you will likely experience better health with removal of the tonsils compared with keeping them.

Perhaps this is due to the presence of other islands of tonsil-like tissue that can effectively ‘take-over’ the function of the tonsils. It is also quite likely that chronically infected tonsils aren’t really performing the functions they should anyway.

Again, should recurrent tonsillitis or the complications of tonsillitis be a problem for you or a family member, Dr Morrissey can discuss your personal circumstances and help you reach a satisfactory outcome.