Tonsils and adenoids

[Anonymous]

Why remove the tonsils and adenoids?

Although the tonsils and adenoids, when healthy, do help fight infections, sometimes they cause much more trouble than they are worth.

• Infected tonsils can be very painful, especially on swallowing.
• Sufferers go off their food, some children fail to grow.
• Time is lost from school or work.
• Very high temperatures cause fits in some children.
• An abscess (quinsy) can form which needs emergency hospital admission.
• Very large tonsils can obstruct breathing at night.
• Bad breath can be caused by decomposing food and bacteria trapped in the deep folds of the tonsils.
• If the adenoids get too big, they cause blockage of the nose and Eustachian tube, resulting in glue ear.
• Some tonsils are chronically infected, causing constant sore throat.

If the tonsils are frequently or chronically infected, they are no longer working properly. In fact, they have been "subverted" by the enemy bacteria, acting as reservoirs for infection.

• There is plenty of other lymphoid tissue in the throat which takes over the work of the tonsils and adenoids if they are removed.
• It is not true that removing the tonsils and adenoids makes you more likely to get chest or stomach infections.

What can be done apart from surgery?

Tonsillitis can get better on its own. Simple treatment with

• rest
• plenty of fluids
• painkillers
• such as paracetamol or aspirin (not aspirin for children under 12 years) may be sufficient.

More severe infections can be treated with antibiotics. To prevent attacks, ensure

• a healthy balanced diet
• regular exercise
• plenty of fresh air
• Do not smoke
• do not expose children to passive smoking.
• If your child is a fussy eater, give multivitamin supplements.
• Encourage oral hygiene restrict sweets, and brush teeth at least twice daily.
• Insist on sensible bed times – lack of sleep can depress the immune system.

Many children go through a phase of repeated attacks of tonsillitis, especially when they start school and become exposed to a greater variety of viruses and bacteria. I usually recommend waiting at least a year or two, to see if the attacks will stop. A further bout of repeated attacks of tonsillitis is common in the teenage years, often following glandular fever. Again, it is sensible to wait and see for at least a year, to see if they will settle down. On the other hand, this is an important time at school for study and examinations. If it seems likely that the attacks will continue and disrupt education, operation may be the best solution.