Q. How to prevent frequent episodes of tonsillitis?

Answered by
Dr. Shyam Kalyan N
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 21, 2018

Hi doctor,

I am suffering with tonsillitis for past three years. Nearly four months back, my tonsils got swollen. Followed by that the right tonsil remains the same and the left got subsided.

In these four months, I had few episodes of pain in my ear. Also the glands in my right side of neck got swollen. I had Azithromycin, Erythromycin, Penicillin and Clavamax but the swelling of the tonsil and the glands did not go down?

What should I do to prevent further episode? Does the cold temperature affect the tonsils?

#

Hi, Welcome to icliniq.com.

With the conversation we had, I understand that you are an 18 year old male suffering from tonsillitis and you have been having acute exacerbation of the tonsillitis now. Due to the infection, you suffer from ear pain and swollen neck glands.

You seem to be suffering from chronic tonsillitis. This resulted in episodes once a while leading to throat pain, difficulty in swallowing, ear ache, neck swelling, fever, etc.

Tonsils are lymphoid organs which act as portals to remove offending agents like bacteria. However, in some individuals they themselves become the cause of infection.

Infection from enlarged tonsils can spread to nose, ear or further down as throat infection which will cause great discomfort to the patients.

Also, because of the same patient suffers from loss of days at work place or school or college.

For your condition, I would suggest you to go ahead with tonsillectomy operation. This operation removes both the tonsils.

It is done under general anesthesia and is done through the mouth. There will not be any incision outside.

The reasons why I suggest you to go for the tonsillectomy operation are that,

  • You have been suffering from this problem since 3 years.
  • Last 3 or 4 months you have been having it continuously.
  • Multiple courses of various antibiotics you have taken without much relief.
  • You get frequent throat pain and ear aches which affects your work or studies.

Few episodes of tonsillitis in a year can be successfully managed using medicines. However, in your case tonsillectomy operation is ideal as I explained above.

In the meantime till we decide for surgery, please follow the instructions and suggestions I have given below.

  1. Do hot saline gargling thrice daily.
  2. Drink plenty of hot fluids (3 to 4 liters of hot water daily).
  3. Take plenty of green leafy vegetables.

Some precautions to be taken are,

  • Avoid dust, smoke and cold winds while travelling.
  • Avoid sleeping straight under fan or air conditioner.
  • Avoid cold drinks and oily spicy foods.

It is true that cold climate can result in increased susceptibility to tonsillitis. Cold winds accompanied by consumption of road side or outside food can increase the chance of infection.

Always use boiled water and desist from drinking water from local places.

When tonsils are enlarged, the infection can move through the eustachian tube into the ear, complicate the condition and cause decreased hearing or ear discharge.

Sometime the tonsils can cause referred pain to the ear though the infection may be restricted to throat.

Lymph fluid from tonsils drains into neck nodes, more particularly the jugulodigastric node below the angle of jaw.

Hence, the tonsillar infection will also infect the node and cause neck swelling. The swelling will resolve once the tonsillitis is cured.


Investigations to be done:

If the symptoms do not recede then please do the following tests.
1. Complete blood count including but not restricted to ESR (erythrocyte sedimentation rate), platelet and lymphocytes.
2. Absolute eosinophil count.
3. Throat swab for culture and sensitivity.

Differential diagnosis:

1. Tonsillolith.
2. Acute Follicular Tonsillitis.
3. Acute Parenchymatous Tonsillitis.

Probable diagnosis:

Acute exacerbation of chronic tonsillitis.

Treatment plan:

I suggest you the following medications; however a complete and thorough physical examination is required to make a definitive diagnosis and prescribe the apt medication.
1. Take a stronger antibiotic, like Cefixime 200 mg, twice a day for 5 days.
2. Take an antibiotic that against anaerobic organisms, like Tinidazole or Ornidazole for 3 days after consulting with your doctor.
3. Take anti-inflammatory enzymes like trypsin-chymotrypsin tablet before food daily thrice for 2 days (Chymoral forte).
4. Take pain killers if necessary (Paracetamol 650 mg twice a day).
5. Hot salt water gargling daily three to four times and steam inhalation.
6. Follow the general instructions and precautions explained above.
If the treatment does not help, you may need hospitalization and intravenous administration of medicines. Also a throat swab is necessary in such cases to ascertain if any dangerous strain of bacteria has caused the infection.

Regarding follow up:

For further information consult an ENT otolaryngologist online.---> https://www.icliniq.com/ask-a-doctor-online/ENT-Otolaryngologist


Was this answer helpful?

 | 

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!



Related Questions:
As I am suffering from tonsillitis for three years, I do not eat properly. How to gain weight?

.. that you have chronic tonsillitis, due to which you do not take food properly and lost weight. You can take protein supplements for weight gain, but have you evaluated for your tonsillitis issue? Have you done any blood investigations, consulted a...   Read full

I have tonsillitis, and it pains while swallowing and talking. How to ease the pain?

.. are having acute tonsillitis, you can take the following medications. You can take tablet Amoxiclav 625 mg (Amoxicillin with Clavulanic acid) three times a day for seven days. You can take tablet Paracetamol 500 mg with Ibuprofen 400 mg one tablet...   Read full

What causes ear pain with mild hearing loss and throat pain?

.. details, you have given I understand that you have a throat infection for the past two days and you also have left earache and ear block. Also mild hearing loss on that side. This is most probably a resultant of the throat infection. There is a tu...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


Alzheimer's Disease - an Overview
Alzheimer's is a neurodegenerative condition that can seriously hamper one's day to day activities and quality of life. ...  Read more»
My father is experiencing hospital delirium after ankle surgery. Please help.
Hi doctor, I am concerned about drug interaction for my father. He is experiencing hospital delirium after surgery. My ...  Read more»
Is there a chance for dengue reattack in the same season?
Hi doctor, I was diagnosed with dengue towards the end of last month. I was hospitalized for five days. I went through...  Read more»

Ask your health query to a doctor online?

Ask an ENT Otolaryngologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.