Understanding Tonsillitis

Frequent tonsil infections, also known as recurrent tonsillitis, occur when the tonsils — the two lymph nodes located on each side of the back of your throat experience repeated episodes of infection. These infections can cause significant discomfort, pain, and other symptoms that impact daily life. Recognising the causes, symptoms, diagnosis, and treatment options for frequent tonsil infections is essential for managing the condition and improving quality of life.

At Aglow ENT Centre, our team is ready to support you in overcoming and recovering from various ear, nose and throat conditions, including tonsillitis. Do not let recurring tonsillitis negatively impact your life and seek the medical help you need as soon as possible.

What is Tonsillitis?

Tonsillitis refers to a condition where your tonsils become infected. Tonsils are two small glands located at the back of the throat, one on each side. They are visible in a mirror when you open your mouth and stick your tongue out.

Under normal circumstances, the tonsils are part of your immune system, trapping germs that enter the body via the mouth or nose. This makes them vulnerable to infections as it is considered one of the first lines of defence of the body.

When the tonsils become infected, they swell and become sore, which may interfere with daily activities such as swallowing or talking. Sometimes, people mistake tonsillitis for a simple sore throat. Although tonsillitis can affect anyone at any time, it is most common among children. As an individual grows, the function of tonsils as part of the immune system tends to decline. Hence, it may be the reason why tonsillitis is less common in adults.

Symptoms of Tonsillitis

The symptoms of tonsil infections can vary in severity and may include:

Sore Throat: Often severe and lasting longer than 48 hours.
Red and Swollen Tonsils: Sometimes with white or yellow patches or streaks.
Difficulty Swallowing: Due to pain or swelling.
Fever: High temperature is common during active infections.
Swollen Lymph Nodes: Located in the neck or jaw area.
Bad Breath: From infection in the tonsils.
Voice Changes: Hoarseness or loss of voice can occur.

You may notice increased fussiness in young children who cannot clearly express their symptoms. Some children may also experience headaches and a loss of appetite during an episode of tonsillitis.

Without proper treatment, frequent or chronic tonsillitis may result in further complications such as:

The development of obstructive sleep apnea is a condition in which your breathing is disrupted during sleep.
An infection that extends deep into the surrounding tissues is known as tonsillar cellulitis.
An infection leading to a pus-filled collection behind a tonsil, referred to as a peritonsillar abscess.
Spread of infection to other areas, such as the middle ear or sinuses.

If you see that your child is struggling with pain, consult an ear, nose, and throat (ENT) specialist as soon as possible to alleviate symptoms and help your child recover and return to good health.

Causes of Tonsillitis

The two most common causes of tonsil infections are viral and bacterial infections. Viral infections resemble those responsible for the common cold. However, tonsillitis can also result from common bacterial infections such as streptococcus pyogenes.

Usually patients who contracted tonsillitis due a viral infection may experience milder symptoms than those who become infected by a bacteria.

For those who experience frequent tonsillitis, risk factors include:

Close Contact: Tonsillitis is contagious, and close contact with others who have viral or bacterial infections can increase the risk.
Weakened Immune System: Individuals with weakened immune systems are more susceptible to frequent infections.
Age: Tonsillitis is most common in children, but it can affect adults as well.

If your child is experiencing recurrent tonsillitis and is not responding well to conventional treatment, your ENT specialist may suggest tonsil removal surgery called tonsillectomy – a safe and commonly done procedure in children and teens.

How does a Throat Specialist in Singapore Diagnose Tonsillitis?

Many ear, nose, and throat conditions can have overlapping symptoms. If you experience symptoms of recurrent tonsillitis, visit a throat specialist in Singapore to obtain an accurate diagnosis and appropriate treatment.

Diagnosis of frequent tonsil infections typically involves:

Medical History: The doctor will ask about the frequency and severity of the episodes, along with the symptoms that are present.
Physical Examination: A visual inspection of the throat and tonsils for signs of inflammation or pus. Your doctor may also check the ears and nose for other signs of infection.
Throat Swab: Your doctor will collect sample fluids from the back of the throat using a sterile swab. This will then be tested for presence of bacteria, such as Streptococcus pyogenes.
Blood Tests: Your doctor may draw some blood for testing which can be used to differentiate between a bacterial and viral infection.

What are the Treatment Options Available for Tonsillitis?

Treatment for frequent tonsil infections depends on the cause and severity of the symptoms:

Home Care measures to help manage milder symptoms include:
- Get plenty of rest
- Drink plenty of fluids, like water, warm tea, or broth, to prevent dehydration
- Gargle with warm salt water or a commercially available antiseptic solution to relieve a sore throat
- Eat soft and non-irritating food to relieve sore throat
- Take a lozenge to help soothe an irritated throat
- Introduce moisture into the air can soothe a sore throat and ease breathing using a humidifier
- Avoid irritants like smoke that can exacerbate symptoms and should be avoided.

Pain Relief Medication: When pain is unbearable or hinders daily activities, over-the-counter pain relief medication can be helpful.

Antibiotics: For infections that are caused by bacteria, your doctor will prescribe you an antibiotic course, which needs to be completed in the specified duration. It may take 7 to 10 days for antibiotics to fully clear the bacterial infection from the system.

Tonsillectomy: Removing the tonsils via surgery may be required for those with recurrent or chronic tonsillitis. This is particularly relevant when infections start to interfere with daily life significantly.

While surgery in young children sounds scary, you can be assured that it is a generally safe procedure that takes less than an hour to complete. With the right preparation and support from your care team, you will be able to provide long-term relief for your child from frequent infections.

When in doubt or you find your child’s symptoms have persisted for more than four days (with or without medication), you are highly advised to consult an ENT specialist for a proper diagnosis and treatment. This is especially urgent if your child presents with a high fever (above 38 degrees Celsius) and shows signs of troubled breathing. In Singapore, you can visit Aglow ENT Centre which provides care for paediatric patients.

When should you see a Throat Specialist in Singapore for Tonsillitis?

As an adult, facing frequent infections like tonsillitis is challenging enough. Imagine your child having to experience recurrent episodes of such infections. It is undoubtedly challenging, especially for those with a weakened immune system.

While occasional tonsil infections are not unusual, those who experience them at an alarming frequency suggest they may need more comprehensive management of their condition. In such cases, a proper visit to an ENT specialist is warranted to help patients and parents understand the actual triggers, symptoms, and effective treatment solutions to manage recurrent tonsillitis and prevent its return.

For tonsillitis treatment in Singapore, schedule a consultation with Dr Ker Liang, at Aglow ENT Centre. Dr Ker Liang is an experienced ENT specialist in Singapore who sees patients of all ages, including young children. Skilled at putting patients’ needs and well-being at the forefront, she is known to quickly build a strong rapport with her paediatric patients, helping them recover confidently.

Frequently Asked Questions

How to avoid tonsillitis?

Tonsillitis caused by the spread of viruses and bacteria is highly contagious. While it’s not always possible to prevent tonsil infections, especially in children, there are measures you can adopt to protect yourself and your loved ones.

Avoid exposure to infections by:
- Staying away from individuals who are sick
- Avoid sharing food or drink with those who are sick. This includes separating utensils used by healthy and ill individuals.
- Practice good hygiene by frequently and thoroughly washing hands before and after certain activities like using the toilet and eating
- Replace your toothbrush every three months and every time you get sick.
Strengthen the immune system by:
- Eating a healthy diet
- Getting enough sleep
- Exercising regularly
- Managing stress can help keep the immune system robust
Reduce the risk of infections spreading back to you by:
- Covering the mouth when coughing or sneezing
- Staying at home when sick, especially avoiding going to school, work or places that you frequent

What food should I avoid if I have tonsillitis?

Food that can irritate the throat such as acidic and spicy food.

Do tonsil stones cause tonsillitis?

Yes, tonsil stones can cause tonsillitis.

How do you remove tonsil stones?

Gently dislodge them by gargling your mouth after meals. For effective relief, surgery removes them permanently

How to soothe tonsillitis in toddlers?

To soothe sore throats in toddlers with tonsillitis, provide pain relievers and plenty of hydration. If their condition does not improve, promptly visit an ENT specialist.

Can tonsillitis cause obstructive sleep apnoea?

Yes, untreated tonsillitis can lead to obstructive sleep apnoea.

Does mouth breathing cause tonsillitis?

Chronic mouth breathing has the potential to cause tonsillitis.

What are the common treatment options for tonsillitis?

The common treatment options for tonsillitis typically include rest, fluids, over-the-counter pain relievers, and sometimes antibiotics if the infection is bacterial.

When is a tonsillectomy recommended for recurrent tonsillitis?

A tonsillectomy is usually recommended for patients with multiple episodes of tonsillitis within a year. It is also recommended if the condition significantly affects their quality of life.

Can antibiotics effectively treat all cases of tonsillitis?

No, antibiotics only work for bacterial tonsillitis. Viral tonsillitis cannot be treated with antibiotics and must resolve on its own.

How long does it take to recover from a tonsillectomy?

Recovery from a tonsillectomy generally takes about one to two weeks, though some discomfort may last a little longer.

Are there any non-surgical ways to prevent recurrent tonsillitis?

Maintaining good hygiene, staying hydrated, and strengthening the immune system through a healthy lifestyle can help reduce the frequency of tonsillitis.

Medical Teaching

Assistant Professor Ker Liang has a passion for teaching and is an Assistant Professor with NUS Yong Loo Lin School of Medicine (YLLSOM). As the NUS-NUH Otolaryngology Department Undergraduate Medical Director, Dr Ker Liang supervises the training of medical students from YLLSOM, NUS. She is actively involved
in the training of postgraduate junior doctors and residents in the Head and Neck Surgery department. She was conferred with an Undergraduate Teaching Award by the National University Health System in 2016 for her outstanding efforts as an Otolaryngology educator.