64 December 2014 www.womanthismonth.com If there was one recurring ailment that plagued your childhood, tonsillitis would probably be it. Dr Jinan Harith Darwish goes to the core of the problematic illness. A Throaty Problem LIFESTYLE | parenting Tonsils are like hotel porters. They alert the body to ‘what's coming in’. They say: “Please take a seat over there” to the bacteria and virus, while they contact the body’s police squad. The tonsils form lymphocytes, which are white blood cells that produce antibodies to combat harmful organisms trapped in the mucous membrane lining the throat. Sometimes, however, the ‘porter’ becomes lazy, plump and criminal – at which point they get the sack! Tonsillitis refers to the inflammation of the pharyngeal tonsils – those glands at the back of your throat. The inflammation may involve other regions in the back of the throat, including the adenoids and the lingual tonsils (the tonsil tissue at the back of the tongue). There are numerous variations of tonsillitis: acute, recurrent, and chronic tonsillitis, and a quinsy. Viral or bacterial infections and immunologic factors lead to tonsillitis and its complications. Virtually all children in Bahrain have experienced at least one episode of tonsillitis. Due to advances in medical and surgical treatments, complications associated with tonsillitis, including mortality, are exceptional. Tonsillitis mostly occurs in children, but rarely in those younger than two years old. Tonsillitis caused by the streptococcus bacteria classically occurs in children aged five to 15 years, while viral tonsillitis is more common in younger children. A peritonsillar abscess is usually found in young adults but can occur occasionally in children. The patient's history often helps identify the type of tonsillitis present (i.e., acute, recurrent, chronic). Here are the symptoms for the different branches of tonsillitis: Acute tonsillitis: Your child will have a fever, sore throat, foul breath, difficulty swallowing, painful swallowing, and tender cervical lymph nodes. Airway obstruction due to swollen tonsils may cause mouth breathing, snoring, night-time breathing pauses, or sleep apnea. Fatigue and malaise are common. These symptoms usually resolve in three to four days, but may last up to two weeks despite therapy. Recurrent tonsillitis: This diagnosis is made when an individual has multiple episodes of acute tonsillitis in a year. Chronic tonsillitis: Individuals often have chronic sore throat, bad breath, tonsillitis, and persistently tender cervical nodes. Quinsy: Individuals often have severe throat pain, fever, drooling, foul breath, difficulty opening the mouth, and muffled voice quality, as if talking with hot potatoes in their mouth. Tonsillitis is customarily treated with a regime of antibiotics. Viral tonsillitis is not treated with antibiotic medications because antibiotics are ineffective at conquering viral infections. Fluid replacement and pain control are essential. Hospitalisation may be mandatory in severe cases, particularly when there is airway obstruction. When the ailment is chronic or recurrent (more than five to seven times during a 12-month period), a surgical procedure to remove the tonsils is often recommended. A Tonsillectomy removes only the palatine tonsils and sometimes adenoids. Lingual tonsils are anatomically big and remain intact over a lifetime. A quinsy may need more urgent treatment to drain the abscess. g Virtually all children in Bahrain have experienced at least one episode of tonsillitis.
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