Normal Tonsils

Tonsils are groups of lymphoid tissue occurring in the respiratory-digestive tract. The collection consists of 2 palatine tonsils, adenoid tonsil, lingual tonsil, and 2 tubal tonsils. Out of all the components, when people commonly refer to tonsils, then they mean the 2 palatine tonsils which are located at the back of the mouth or throat, on either side. They are almost circular lumps or masses of soft tissue of lymphatic matter and are a component of the immune system.

The size of healthy normal tonsils varies from one person to another. The tonsils are the immune system’s first line of defense. They trap viruses, bacteria, and other pathogens that enter the body via the nose or mouth and kill them, thus preventing lung and throat infections. They are however prone to infections which can result in a variety of health problems like breathing problems, etc.

Conditions that adversely affect normal tonsils are usually treated with medications. Doctors may advise surgical removal of tonsils in case of severe and frequent episodes of tonsillitis or other tonsil problems that cause the daily routine to be in disarray.

Normal tonsils – Health Conditions that affect them

Healthy normal tonsils are usually affected by two main conditions, i.e., repeated throat and nose infections, and severe tonsils enlargement marked by breathing and/or nasal blockages, sleep disturbances, and swallowing difficulties.

1. Tonsillitis

• Infection of normal tonsils is known as tonsillitis. It is of two types:
  • Acute tonsillitis, which occurs due to bacterial or viral infection of normal tonsils along with sore throat, swelling, and white/gray coating on tonsils
  • Chronic tonsillitis marked by prolonged and recurrent tonsil infection, which may occasionally occur due to persistent bouts of acute tonsillitis.
• Symptoms of infection of normal tonsils usually worsen for 2 to 3 three days and the slowly disappear in about 7 days. The infection is often caused by viruses, but some cases of tonsillitis may also be caused by bacteria. The most common symptom of tonsillitis is a sore throat; other symptoms are as follows:
  • Sore throat may sometimes occur with pain in ear
  • Fever or high body temperature
  • Nausea
  • Feeling of being unwell or malaise
  • Pain and discomfort when swallowing
  • Yellow or whitish coating on normal tonsils
  • Lethargy
  • The tonsils may be swollen
  • Headache
  • Increased redness of tonsils as compared to normal tonsils
  • Coughing
  • Swollen tonsils may cause minor voice changes
  • Halitosis or bad breath
  • Swelling of lymph glands in neck
  • Appearance of pus as whitish spots on swollen tonsils

2. Enlargement of normal tonsils

• The two most common effects of enlarged tonsils are disturbed breathing when sleeping and difficulties in breathing through nose. Other symptoms are as follows:
  • Breathing via mouth instead of nasal breathing, almost all through the day
  • Breathing during day is noisy
  • Chronic and persistent running nose
  • Nasal blockage
  • Nasal noises when speaking
  • Restlessness when sleeping; breathing may pause for some seconds when sleeping at night which may be indicative of sleep apnea
  • Snoring when sleeping at night
  • Repeated episodes of ear infections
  • Breathing obstructions caused by sleep disturbances and snoring may result in sleepiness during the day, thereby adversely affection performance at work or school

Other conditions that affect normal tonsils are mentioned below.

• Glandular fever/acute infectious mononucleosis: It is caused due to infection by Epstein-Barr virus. Patients may experience symptoms like extreme swelling of normal tonsils, rash, fever, fatigue, and sore throat.
• Peritonsillar abscess: Also called quinsy, a peritonsillar abscess is a pocket or deposit of pus which forms next to normal tonsils, often because of an underlying bacterial infection. The pus deposit typically forms on one side. The condition may occur on its own or may develop after a bout of tonsillitis. Initially, the tonsil on the side with the pus pocket may appear normal or swollen. However, as the pus and abscess grows in size, it pushes the tonsil towards the other side. Patients may suffer from severe pain and elevated sense of being increasingly unwell.
• Strep throat: It is an infection of throat and tonsils by strep virus. Along with sore throat, patients may experience pain in neck and fever.
• Tonsil stones/tonsilloliths: Debris of food, bacteria, dead cells, etc. gets trapped in crevices in normal tonsils and then calcifies or hardens to become tonsil stones.
• Tonsil cancer: It is a rare condition and often affects alcoholics and smokers. Cancer of the tonsils needs to be detected and diagnosed early for better treatment.

Treatment of conditions affecting normal tonsils

• Most conditions that affect normal tonsils are treated with medications. Antibiotics are usually prescribed for bacterial infections like strep throat.
• Steroids or other painkillers may help alleviate pain
• It is important to puncture and drain a peritonsillar abscess to cure the infection and promote healing
• Severe enlargement of tonsils, chronic infections, cancer, and repeated ear infections associated with tonsillitis may be treated with surgical removal of the tonsils.