Tonsils are the areas of the body that are used to help fight off infection. They are pads of lymphoid tissue, a type of immune tissue. They make up part of our immune system. 

Lymphoid tissue contains a form of white blood cells called lymphocytes, which are used to fight off infection. When viruses, bacteria or other pathogens enter into the body through the nose or the mouth it is the role of the tonsils to immediately detect this threat. They alert the immune system to start mounting an immune response against it. 

There are four tonsils that are found at the back of the throat and mouth.

 

These are known as

  • the adenoids (behind the nose)
  • two palatine tonsils (can be seen in the back of the throat)
  • the lingual (at the base of the tongue)

The two palatine tonsils are the ones most often talked about when we suffer from red, swollen, or inflamed tonsils. These are seen on the right and left side in the back of the throat. This is the reason why the doctor pushes down your tongue with the tongue depressor when doing a health check-up.

 

What is tonsillitis?

Tonsillitis is an inflammation of the tonsils, which is caused by a viral or bacterial infection. A tonsil infection is most common in young children. 

When germs invade the mouth or nose, the immune cells in this area are immediately activated. The body sends more blood and immune cells to the area to help them fight off the pathogen. This results in swelling of the normal tonsils as they accommodate these extra immune cells.

When they become infected and inflamed, they swell and may put pressure on the base of the throat. This causes pain and swallowing difficulties. In some severe cases, it can even obstruct the airway.

What does tonsillitis look like? Other than inflammation or swelling, tonsillitis symptoms often include:

  • A sore throat,
  • Scratchy throat
  • White spots on the throat
  • Hoarseness
  • Bad breath
  • Tonsil stones (Tonsilloliths)
  • An accompanying ear infection

 

Tonsillitis can be bilateral, if both sides are inflamed, or unilateral if only one is. It can either be acute or chronic, depending on the course of the disease. 

Severe or chronic cases can require a surgery to remove the tonsils. This is only done if necessary, because of the important function they play in the body’s immune defence.

 

What are the signs of tonsillitis?

Characteristic symptoms include:

  • Pain and difficulties in swallowing
  • Muffled speech
  • Palpable and tender lymph nodes
  • Headache
  • Fatigue
  • Feeling unwell and fever

 

In more severe cases, this condition can also be accompanied by an ear infection or an abscess. A peritonsillar abscess is an infection with pus-filled tissue near one of the tonsils. Healthcare providers can help with this complication.

What causes tonsil stones?

People who had a lot of infections in their life and those with lots of folds and gaps in their tonsils are more prone to develop tonsil stones. Tonsil stones form from hardened bits of bacteria and debris and look like yellowish tiny pebbles. 

One of the main symptoms of tonsil stones is bad breath, sometimes they can also cause a sore throat or difficulty swallowing. Gargling with salt water can soothe the throat and help remove tonsil stones at home.   

Is tonsillitis contagious? 

Even though it is not contagious itself, the infections that cause it are. This includes the common cold, the flu, or bacteria. Washing your hands thoroughly helps to stop the spread. 

 

Strep throat, scarlet fever or tonsillitis?

Scarlet fever and strep throat are two other conditions that can present similarly to tonsillitis.

They both will cause:

 

However, tonsillitis vs strep throat vs scarlet fever can be differentiated by the type of pathogen that causes them. Tonsillitis can be caused by various viruses or bacteria.

Both scarlet fever and strep throat are caused by a bacterium known as group A beta-hemolytic streptococcus (GABHS). This is the only pathogen that can cause strep throat. 

What is unique for scarlet fever is the distinct red rash that sometimes accompanies these general symptoms. It can also cause a white coat on the tongue. When the coating is removed, it reveals a red tongue, often called a strawberry tongue. 

An easy way to differentiate between tonsillitis and strep throat is to use a rapid strep test. It is a type of swab that can be done at a family doctor's office. This will let you know if your sore throat is a streptococcal infection or not. 

Streptococcal infections leading to strep throat can cause complications if not properly treated. These include a condition known as rheumatic fever and glomerulonephritis. For the right treatment it is always important to identify the cause, including whether it is from a bacterial or viral infection.

 

What is causing the sore throat?

Sore throats commonly occur during a cold. Most of the time they resolve quickly on their own after a few days. In many cases, a tonsillitis treatment with over-the-counter medications such as lozenges, self-care and home remedies is enough.

However, there are some causes of sore throats, such as strep throat or scarlet fever, that are less likely to resolve on their own.

Some forms of sore throat might need medications to help them resolve. With purulent or bacterial tonsillitis, you may have to take antibiotics. A swab can be used to help identify the pathogen.

 

Some further causes of sore throat include

  • Pharyngitis, laryngitis, or epiglottitis
  • Sleep apnea (obstructive sleep apnea)
  • Infectious diseases: Glandular fever, scarlet fever, diphtheria, mumps, measles, and strep throat
  • Irritated respiratory tract due to smoking, dusty air, toxic fumes
  • Thyroid diseases
  • Mononucleosis (Epstein Barr virus) or infectious mononucleosis
  • Adenoid infection
  • Peritonsillar abscess or abscesses in general

 

Natural and home remedies for a sore throat

There are many home remedies for swollen tonsils and a sore throat. They can help with inflammation, reduce swelling and decrease pain.

It is very important to drink plenty so that the mucous membranes in the throat remain moist. Drinking warm teas that are not hot is best, this includes sage, thyme and chamomile tea. 

These herbs have a soothing effect on the throat but also act against the germs and the inflammation in the area. Honey is a powerful soothing food with antimicrobial effects that can also be added.

 

Gargling can also be helpful. Saltwater and strong sage or chamomile tea are suitable for this. For the salt water, add a quarter teaspoon of salt to 0.2 litres lukewarm water.

Throat packs with either a chilled tea towel or warm compresses and a wool scarf are a rewarding measure for relief. The cold or warm throat pack should be left in place for around 20 to 30 minutes. To stimulate the immune system in the area, warm and cold compresses can also be alternated. 

As swallowing is commonly difficult, lukewarm foods that are not too dry are good. Soups provide the body with fluid. They can be prepared with plenty of fresh vegetables and lean meat to boost the immune system and prevent the body from being overloaded.

There are also some homeopathic remedies that can help support the immune response, ease inflammation, swelling and pain and shorten the duration of symptoms.