Recurrent Tonsillitis Treatment
Tonsillitis is inflammation of the tonsils, the two pads of tissue at the back of the throat. It is usually caused by a viral or bacterial infection and brings on a sore throat, pain on swallowing, fever and swollen glands in the neck. Most single episodes settle within a week or so. When attacks keep coming back, however, the condition is described as recurrent tonsillitis, and it can have a real impact on work, school and quality of life.
If you find yourself needing repeated courses of antibiotics, taking time off work several times a year, or simply never feeling that your throat is fully well, it is worth having a specialist assessment to understand what is happening and what can be done about it.
Symptoms of recurrent tonsillitis
Each episode tends to involve some combination of the following:
- A painful sore throat, often worse on one side
- Pain or difficulty swallowing food and drink
- Fever, chills and a general feeling of being unwell
- Tender, swollen glands in the neck
- Red or swollen tonsils, sometimes with white or yellow patches of pus
- Bad breath and a muffled voice
Between attacks you may feel completely well, or you may have a lingering sore throat, persistent bad breath and tiredness.
Chronic laryngitis can arise from various factors, including persistent infections, allergies, or irritation caused by acid reflux or frequent coughing, among others.
A consultation is essential to confirm the diagnosis and rule out serious conditions, such as cancer, as a cause of prolonged hoarseness. This is achieved thorough a review of symptoms and performing a detailed examination of the larynx.
When should tonsillitis be treated as recurrent?
Surgery to remove the tonsils (tonsillectomy) is usually considered when sore throats are both frequent and disabling. As a guide, national criteria suggest that removing the tonsils may be worthwhile when episodes of sore throat are due to tonsillitis and you have had:
- Seven or more well-documented, clinically significant episodes in the preceding year, or
- Five or more such episodes in each of the preceding two years, or
- Three or more such episodes in each of the preceding three years.
These numbers are a guide rather than a strict rule. I take into account how severe your episodes are, how much time you are losing, and how the infections affect your daily life when we discuss whether surgery is right for you.
How I assess recurrent tonsillitis
During your consultation I will take a careful history of how often the infections occur, how long they last and how they are treated. I will examine your throat, tonsils and neck, and where helpful I use a thin flexible camera (nasendoscope) passed gently through the nose to look at the whole of the throat and voice box. This allows me to rule out other causes of a persistent sore throat and to check for related problems which in some cases, can be serious.
Treatment options
Not everyone with recurrent tonsillitis needs surgery. Treatment is tailored to you and may include:
- Conservative measures and self-care – good hydration, pain relief, and treating contributing factors such as reflux or nasal allergy.
- Targeted use of antibiotics – for confirmed bacterial episodes, while avoiding unnecessary repeated courses. A six-week course of a low dose of antibiotic (doxcycline) can also be useful in chronic tonsillitis.
- Tonsillectomy – removal of the tonsils for frequent, disabling infections. I offer modern techniques including the coblation intracapsular method, which can mean less pain and a quicker recovery than traditional surgery.
If surgery is the right choice, I will explain exactly what it involves, the benefits and risks, and what to expect during recovery, so that you can make a fully informed decision.
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FAQs
Is recurrent tonsillitis treatment available privately and on the NHS?
Assessment and treatment of recurrent tonsillitis, including tonsillectomy, are available both on the NHS and privately. Private care offers faster access to a specialist appointment and surgery at a time that suits you. I will discuss the most appropriate pathway for your circumstances during your consultation.
Will I definitely need my tonsils removed?
No. Many people with recurrent sore throats are managed successfully without surgery. Tonsillectomy is generally reserved for those with frequent, well-documented and disabling episodes.
How long does recovery from tonsillectomy take?
Most adults need around two weeks off work to recover, with the throat feeling progressively better over that time. I provide detailed aftercare advice and follow up to make sure healing is on track.
Can adults get recurrent tonsillitis, or is it only children?
Both children and adults can suffer from recurrent tonsillitis. While it is common in childhood, plenty of adults experience repeated episodes, and the assessment and treatment options are very similar.