I have a swollen tonsil with painless bump in mouth. Please advise.

Question

Hello doctor,

I have had a swollen tonsil for a couple of months now with a whitish patch at the top. I was advised before that it may be silent reflux causing it or could be something to do with my nose. I followed instructions on the Omeprazole and nose spray but does not seem to fix the issue. I take an allergy pill daily as well. It seems to go up and down in size but white patch and general enlargement never really subsides. I do not usually have pain unless my mouth is dry or when my allergies seem to flare really bad. I also have a small bump (painless) on the lining of my mouth behind back teeth that is odd to me as well. I am just wondering if this is an issue I should go see an ENT in person over just because I fear it could be something much worse.

Answer 1

Hi,

Welcome to icliniq.com.

I had a detailed look at the picture you have sent (attachment removed to protect patient identity) and I am certain that there is absolutely nothing that you need to be worried about. Your tonsils belong to what we call as a part of the Waldeyers ring and comprises of several components of lymphoid aggregates. These aggregates chiefly participate in defense of the body and fight infections. If you closely observe your posterior pharyngeal wall (back of your throat), you will see small bumps between the leash of blood vessels. These are again lymphoid follicles and perform the same function as mentioned above.

In a situation, where you end up having multiple episodes of sore throats the defense mechanisms in the body get more stronger and you will see that the tonsils and these aggregates often increase in size. (These episodes might have happened in your child hood as well). Enlarged tonsils do not require to be surgically removed unless and until they are constantly getting infected and creating trouble. In a nutshell, there is absolutely nothing that you need to worry about this small structure as it does not look malignant or cancerous. Make sure you maintain a good oral hygiene to prevent recurrent throat infections.

This has nothing to do with the GERD or LPR and anti reflux medications will not be of any trouble. There is a very less chance that this patch is going to disappear as it is a part of the lymphoid aggregates which constitute the immune defense in the oral cavity. If this has been the only issue, there is no requirement to meet an ENT now.