Enlarged tonsils: Causes, Symptoms, Treatment and Cost

Enlarged tonsils are a medical condition where the tonsils (the two soft, round tissue masses located at the back of the throat) become swollen and enlarged.

• Acute tonsillitis: This is the most common form of enlarged tonsils and occurs when the tonsils become infected
• Chronic tonsillitis: This is a condition where the tonsils are constantly enlarged due to recurrent infections which cause swelling and inflammation of the tissues.
• Adenoid hypertrophy: This occurs when the adenoid tissue situated at the back of your throat becomes enlarged, blocking airflow through your nose and throat.
• Tonsil stones: These are small hard lumps that can develop in your tonsils due to accumulated bacteria, food particles, and mucus which can cause pain and discomfort when swallowed.
• Obstructive sleep apnea: This is a disorder characterised by pauses in breathing while sleeping due to blocked airways caused by enlarged tonsils or adenoids pressing against them, reducing airflow through the nose or mouth during sleep.

Enlarged tonsils are typically caused by chronic infection or inflammation, such as from a virus or bacteria.

Other causes of enlarged tonsils include allergies, smoking, air pollution, and inherited genetics. In some cases, tonsillitis can be caused by a physical obstruction in the throat that causes the tissue to become inflamed and enlarged.

• Difficulty in breathing and/or swallowing
• Painful or frequent sore throats
• Bad breath (halitosis)
• Swollen lymph nodes in the neck
• Ear pain, especially when swallowing
• Snoring and/or pauses in breathing during sleep (sleep apnea).

• Practise good oral hygiene: Brush your teeth twice a day and floss daily to reduce bacteria and prevent tonsil stones.
• Avoid smoking and secondhand smoke: Smoking weakens the immune system, making you more prone to infection and enlargement of the tonsils.
• Drink plenty of fluids: Drinking plenty of fluids helps thin mucus, which can help reduce swelling in the tonsils and keep them from becoming enlarged.
• Eat a healthy diet: Eating a balanced diet that includes fruits, vegetables, lean proteins, whole grains, and low-fat dairy products can help boost immunity and reduce inflammation in the throat area.
• Avoid irritants: Stay away from air pollutants such as cigarette smoke or chemicals that can aggravate the throat area and lead to enlargement of the tonsils or other infections.

• Physical examination: The doctor will examine the tonsils to check for signs of inflammation or swelling. They may also check for any visible signs of infection, such as pus or abnormal colouring.
• Imaging tests: The doctor may order imaging tests such as an X-ray or CT scan to get a better look at the tonsils and the surrounding structures in the throat.
• Throat culture: A sample of the patient's throat may be taken to test for the presence of bacteria or viruses that could be causing the infection.
• Blood test: A blood test may be ordered to check for anaemia or other underlying health conditions that can cause enlarged tonsils.

• Sleep disordered breathing: Enlarged tonsils can lead to sleep apnea, snoring, and other breathing difficulties.
• Obstructed airways: Difficulty breathing due to the enlarged tonsils blocking the airway.
• Ear infections: Fluid can become trapped in the Eustachian tubes when enlarged tonsils block them, leading to ear infections.
• Recurrent throat infections: Enlarged tonsils are more prone to infection and can cause recurrent sore throats and other throat problems.
• Dehydration: Difficulty swallowing due to the obstruction of the throat caused by enlarged tonsils can lead to dehydration and malnutrition in some cases if left untreated.

• Gargle with warm salt water twice a day to reduce inflammation and discomfort.
• Sip on ginger tea or warm turmeric milk to reduce throat inflammation and soothe the throat.
• Drink plenty of fluids such as water, fruit juices and herbal teas to keep your throat hydrated and help flush out toxins from the body.
• Consume honey mixed with ginger juice or chew on a piece of fresh ginger root to reduce inflammation and improve immunity.
• Make a paste of fenugreek seeds in water and apply it directly on the tonsils for relief from pain and swelling.

• Soft fruits and vegetables: cooked or pureed fruits and vegetables such as applesauce, mashed bananas, and cooked spinach can be easier to swallow.
• Soft proteins: cooked fish, eggs, and tofu can be easier on the throat than harder proteins like meat.
• Soups and broths: warm liquids can help soothe a sore throat and provide hydration.
• Pudding and yoghourt: these are easy to swallow and provide nutrition.
• Smoothies and shakes: these can be an easy way to get in a variety of fruits and vegetables while also being easy to swallow.

• Avoid red meat, processed meats, and fried foods as they can exacerbate the symptoms of enlarged tonsils.
• Limit dairy products such as milk, cheese, cream, and ice cream.
• Avoid acidic foods that can irritate the throat, such as citrus fruits, tomatoes, and pickles.
• Refrain from eating spicy foods such as chilli peppers and hot sauces that may aggravate the inflammation in your throat.
• Limit alcohol intake and avoid smoking or second-hand smoke exposure for best overall health outcomes for enlarged tonsils sufferers.

Treatment for enlarged tonsils typically includes:

• Tonsillectomy: The tonsils are removed surgically in this procedure. It is usually performed under general anaesthesia and can take several days to recover from.
• Tonsillotomy: This is a minimally-invasive procedure in which only part of the tonsils are removed to reduce their size and reduce symptoms. It requires less recovery time than a tonsillectomy but may not provide as much relief from symptoms.
• Laser ablation: This procedure uses laser energy to shrink or damage the tonsils without needing to remove them completely. Recovery time is usually minimal and there is less risk of complications compared to traditional surgery.
• Radiofrequency ablation: This procedure uses radiofrequency energy to shrink or damage the tonsils without needing to remove them completely, similar to laser ablation. Recovery time is usually minimal and there is less risk of complications compared to traditional surgery as well

If you have enlarged tonsils, you should see an ENT (ear, nose, and throat) specialist. An ENT specialist is trained to diagnose and treat any medical issues related to the ears, nose, and throat.

• Antibiotics: Antibiotics such as penicillin, amoxicillin and cephalosporin are commonly prescribed to fight bacterial infections that can cause tonsillitis.
• Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and acetaminophen can help relieve the pain and swelling caused by enlarged tonsils.
• Corticosteroids: Oral or injectable corticosteroids may be prescribed to reduce inflammation in severe cases of tonsillitis.
• Throat lozenges: Sucking on throat lozenges containing menthol or eucalyptus may help reduce throat pain caused by enlarged tonsils.

Enlarged tonsils can take several weeks to resolve. Most people recover with conservative management, such as drinking plenty of fluids, getting enough rest, and taking medications to reduce pain and discomfort.

In some cases, treatment can be permanent, while in others it may only provide temporary relief.

• Follow your doctor's instructions for post-surgical care and take all medications as directed.
• For at least one week after surgery, avoid strenuous activity and contact sports.
• Don't eat or drink anything until the anaesthesia has worn off completely.
• Drink plenty of fluids to stay hydrated, and eat soft foods such as soups or smoothies to reduce discomfort while your throat heals.
• Use a salt water gargle several times a day to help reduce swelling in your throat, but avoid mouthwashes with alcohol or peroxide that can irritate the throat.
• Schedule follow-up appointments with your doctor so that they can monitor your recovery and ensure that any infection that develops after surgery is treated as soon as possible.

Generally, medications and home remedies can cost between ₹1,000 and ₹5,000.

Surgery to remove the tonsils may cost from ₹15,000 to ₹30,000. Other treatments like laser therapy may cost up to ₹50,000.

• Pain and discomfort: Tonsil enlargement can result in pain, difficulty swallowing, and difficulty breathing.
• Ear infections: Treatments of enlarged tonsils can increase the risk of developing ear infections.
• Bleeding: Treatments of enlarged tonsils can lead to bleeding in the throat or mouth.
• Infections: Tonsils that are enlarged can become a breeding ground for bacteria, resulting in frequent infections such as strep throat or sinusitis.
• Sleep apnea: Treatments of enlarged tonsils can also lead to sleep apnea, a condition in which breathing stops during sleep due to blockage in the airways from enlarged tonsils or adenoids.

If you are suffering from any complications relating to enlarged tonsils then you should consult a doctor nearby as they can cause complications like ' Obstruction of the airway, infections, Difficulty swallowing speech difficulty' in which treatment course can range from a few months to years depending on the severity of the situation.