When you wake with a sore throat, you might gargle with mouthwash, hoping it will disappear. When you look in a mirror, you see that the back of your throat is red and swollen. A sore throat is a common symptom of tonsillitis, an infection that causes inflammation of the tonsils. Viruses or bacteria can cause tonsillitis. Since the treatment for each type is different, this article will help to understand those differences.
What is tonsillitis?
Tonsillitis is a common condition that affects children and adults. It’s an infection that causes inflammation (redness and swelling) of the tonsils and can be caused by viruses or bacteria. According to the National Library of Medicine, common causes of viral infections resulting in tonsillitis include adenovirus (one of the causes of the common cold), influenza (flu), and Epstein-Barr virus. Tonsillitis of bacterial origin can be caused by bacteria such as Group A beta-hemolytic streptococcus (strep throat), Staphylococcus aureus, Streptococcus pneumonia, and Haemophilus influenza.
Symptoms of tonsillitis
Now that you know the common pathogens leading to bacterial and viral tonsillitis, let's discuss some common symptoms. They often occur suddenly, and you may experience some or all of these symptoms:
- Sore throat
- Red, swollen tonsils
- Fever
- White or yellow patches on the tonsils
- Difficulty or painful swallowing
- Swollen lymph nodes in the neck (lymph nodes are small lumps of tissue that contain white blood cells that help the body fight off an infection)
Why does tonsillitis happen?
Tonsils are two small lumps of tissue on each side of the throat. Their purpose is to trap germs from your mouth and nose and serve as a barrier against infection. When a virus or bacteria infect your tonsils, they may become inflamed (red and swollen), resulting in tonsillitis.
Risk factors
According to the National Library of Medicine, tonsillitis is common in children over two and teenagers. Children aged 5–15 years are more likely to get bacterial tonsillitis. Children who attend school or daycare are at a higher risk for tonsillitis because they are frequently exposed to germs. People with weakened immune systems, such as those with immunodeficiencies or anyone taking immunosuppressant drugs, are generally more prone to infection, including pathogens causing tonsillitis.
At-home remedies for tonsillitis
Now that you know what causes tonsillitis, let’s discuss some home remedies that can help ease the discomfort.
Rest and hydration
It’s important to rest when you are fighting off an infection. It helps the body recover faster. To stay hydrated, drink lots of fluids such as water and avoid acidic drinks like orange juice and lemonade because they may irritate the already inflamed and sensitive throat.
Saltwater gargle
A sore throat occurs when there is inflammation of the tissues of your throat. According to one study, saline solution gargle may reduce symptoms, such as pain in swallowing, urge to cough, and hoarseness in individuals with viral pharyngitis (inflammation of the tissues at the back of your throat).
Here are the steps to making a saltwater solution:
- Boil one cup of water. Allow the water to cool to a warm temperature.
- Add one teaspoon of salt to eight ounces of warm water.
- Stir the water solution until the salt completely dissolves.
Make sure the water is warm and not too hot before you gargle. Gargle the salt water solution at the back of your throat for 15–30 seconds and spit it out. You can repeat this process every few hours whenever you feel throat pain.
Pain relief
To ease the pain and reduce inflammation from a sore throat, you can take over-the-counter (OTC) pain relievers such as Tylenol (generic: acetaminophen) or Motrin (generic: ibuprofen). You’ll want to consult your doctor for the recommended frequency and dose of these medications. Avoid giving aspirin to children and teenagers due to the risk of Reye’s syndrome.
Humidifiers
Humidifiers moisten the room air and may help keep your throat from drying out. In traditional medicine, this is thought to help with some symptoms of tonsillitis, such as throat dryness and pain. However, the beneficial effects of air humidifiers are mainly self-reported and highly vary on an individual basis. Depending on the climate, you may choose to use an air humidifier if you have tonsillitis.
Throat lozenges
Medicated lozenges may reduce specific symptoms of a sore throat, such as pain and difficulty swallowing. These lozenges usually contain small doses of various analgesics that act directly on the inflamed tissues of the throat and reduce pain.
Even though they seem like a quick and easy way to alleviate throat pain, throat lozenges are not generally recommended for small children because there is a risk of choking.
When to see a doctor for tonsillitis
Most cases of mild tonsillitis can be treated with home remedies. However, if your sore throat lasts longer than four days and has more severe symptoms, you should see your doctor.
Signs of severe infection
You should see a healthcare provider if you experience any of the following symptoms:
- Persistent fever over 101ºF
- Difficulty breathing and swallowing
- Pus around the tonsils or severe swelling of the tonsils
Potential complications
According to the National Library of Medicine, one potential complication of tonsillitis is a peritonsillar abscess. This occurs when pus collects near one of your tonsils. The swelling is so severe that the uvula (the small tissue that dangles at the back of your throat) is pushed to one side of your throat.
Another complication of tonsillitis is recurrent tonsillitis. According to the National Library of Medicine, recurrent tonsillitis is having five or more episodes of tonsillitis in one year. When this occurs, you may need surgery to remove your tonsils (a tonsillectomy). You'll need to talk with your doctor about whether surgery is the right option for you.
Treatment options
If you test positive for bacterial tonsillitis, your doctor will prescribe antibiotics. For viral tonsillitis, there is no need to be on antibiotics because they do not help treat viral infections. In this case, your body will fight off the viral infection, and you need appropriate rest, hydration, and other at-home treatments. In both cases of tonsillitis, you can try some of the home remedies to ease the symptoms.
Preventing tonsillitis
Here are some ways to prevent tonsillitis if you are healthy:
- Wash your hands frequently, especially before eating and after you touch your nose or mouth.
- Good oral hygiene.
- Avoid people who are sick.
- Receive the flu vaccine every year to protect against viruses that can cause tonsillitis.
Here are some ways to prevent spreading tonsillitis if you are sick:
- Use tissues and cover your mouth when coughing or sneezing.
- Avoid sharing personal items (e.g., food, cups, utensils).
- Stay home when you are sick.
Tonsillitis in children vs. adults
Although tonsillitis affects children and adults, it tends to be more common among children. This may be due to poor hand hygiene and exposure to other children who may be sick or carriers of viral and bacterial pathogens that may cause tonsillitis.
Children also tend to present with other tonsillitis symptoms that are uncommon in adults.
Differences in symptoms
Both children and adults present with similar symptoms of tonsillitis. Symptoms include sore throat, fever, red and swollen tonsils, difficulty or painful swallowing, and white or yellow patches on the back of the throat. However, young children may present with uncommon symptoms, such as stomachache, nausea, or vomiting. So when your child complains of stomachache, nausea, or vomiting, as well as the other symptoms mentioned, you should consult with a healthcare provider.
Care tips for children with tonsillitis
Here are some things you can do to help your child feel better:
- Keep them hydrated by giving them lots of fluids.
- To relieve pain, give them OTC pain relievers such as Tylenol (generic: acetaminophen) or Motrin (generic: ibuprofen). Children and teenagers should not be given aspirin.
- Have them gargle with saltwater (saltwater gargle should be discussed with your healthcare provider as it may not be suitable for younger children and/or certain individuals).
- Offer them warm liquids (warm water or soup) or cold foods like popsicles or frozen yogurt to help soothe their throat.
Consult with your child’s pediatrician if your child develops any of the following symptoms:
- Sore throat that lasts for a few days.
- Sore throat that accompanies a fever.
- Difficulty breathing or swallowing.
- Pus around the tonsils or severe swelling of the tonsils.
- Stomachache, nausea, or vomiting.
Tonsillitis, if caused by a viral infection, usually resolves independently because the body will fight off the infection. The symptoms you experience may be relieved with some home remedies. However, when your sore throat lasts more than four days and is accompanied by fever, difficulty swallowing, pus around the tonsils, or severe swelling, you should seek professional medical help. You must be on antibiotics if you test positive for a bacterial infection.
FAQ
How long does tonsillitis last?
The symptoms of viral tonsillitis usually last three to four days and gradually improve with the help of some at-home remedies. However, if your symptoms last more than four days, it may be time to see your healthcare provider. The symptoms of bacterial tonsillitis can last one to two weeks.
Is tonsillitis contagious?
Tonsillitis itself is not contagious, but the bacteria and viruses that cause tonsillitis can be. Bacteria and viruses can be spread from person to person by sharing personal items (e.g., food, cups, or utensils), touching your mouth and nose after touching a surface that's been contaminated, or being around someone who is coughing or sneezing.
Can tonsillitis cause bad breath?
Yes. Tonsillitis may cause bad breath due to the accumulation of pus and bacteria on the back of your throat. In addition, the infection of the mucous membranes around the tonsils may also cause bad breath.
What foods should be avoided when you have tonsillitis?
Certain foods should be avoided when you have tonsillitis. These include hard and crunchy foods, acidic fruits, and spicy foods. Hard and crunchy foods are challenging to swallow and may further irritate the throat. Acidic fruits such as orange, lemon, and lime are harsh on the throat and may irritate the inflamed tissues.
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Viral tonsillitis resolves independently because the body fights off the infection, while bacterial tonsillitis usually requires antibiotic treatment.
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Seek medical care when your sore throat lasts more than four days and is accompanied by fever, difficulty or painful swallowing, pus around the tonsils, and severe swelling on the tonsils.
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While it may cause unwanted symptoms, mild tonsillitis easily resolves on its own with enough rest, fluids, and pain relievers if needed.
7 resources
- National Library of Medicine. Tonsillitis.
- NHS Inform. Tonsillitis.
- ENT Health. Tonsillitis.
- European Archives of Oto-Rhino-Laryngology. Ectoine lozenges in the treatment of acute viral pharyngitis: a prospective, active-controlled clinical study.
- International Journal of Clinical Practice. Efficacy and safety of a triple active sore throat lozenge in the treatment of patients with acute pharyngitis: Results of a multi‐centre, randomised, placebo‐controlled, double‐blind, parallel‐group trial (DoriPha).
- National Library of Medicine. Peritonsillar abscess.
- European Archives of Oto-Rhino-Laryngology. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management.
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