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Suggest Treatment For Tonsillitis

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Posted on Tue, 20 Sep 2016
Question: I have had tonsillitis more commonly since exposure to mold 2 years ago and have been working with a specialist for all my mold related symptoms but since a sore throat with tonsillitis in mid-May 2016, my tonsils have been swollen and one in particular is lumpy and irregular. Although they don't hurt anymore (infection is gone - likely viral) and have gone down a little bit, they are still huge (about ping pong size). I have been avoiding allergies and reducing inflammation using diet/lifestyle/supplements but they won'd get any smaller. They don't give me any noticeable symptoms but I don't want them this big.

I want to know more about possible causes before continuing with a tonsillectomy. I know other blood markers like liver enzymes (AST and ALT) have been unexplainably high and no chronic or latent virus infections have been found.
doctor
Answered by Dr. Abubakar Siddiqh (8 hours later)
Brief Answer:
Tonsillar hypertrophy

Detailed Answer:

Hi,

I had gone through your question and understand your concerns that you are having tonsillar enlargment.

Based on your clinical details and As per picture, it appears to be tonsillar hypertrophy.

It usually occurs due to recurrent episodes of tonsillitis or secondary to allergy ( inhalational and consumed) or due to acid peptic disease.

If it's bothering with pain, respiratory obstruction, sleep apnea or with recurrent infections tonsillectomy is the choice. Very often, boold markers ( liver n kidney) will not give any clue towards tonsillar hypertrophy.

Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Abubakar Siddiqh (4 hours later)
Thank you. I have not heard of hypertrophy of the tonsils yet but after some reading it seems to fit my signs/symptoms much better than anything else: reoccurring tonsillitis, throat infections, and oral+respiratory allergen exposure, chronic enlargement, no pain or known infection (currently).

My ENT and ND suggested I get my tonsils removed but I need more information before I go through with my scheduled tonsillectomy this December.

Is it easier for the throat to get infections (like strep, thrush, etc.) with tonsillar hypertrophy than it is with regular/common sized tonsils?

If the cause of tonsillar hypertrophy was recurrent episodes of tonsillitis, can the tonsils ever reduce or do the tonsils ever shrink?

If allergen exposure is the cause - or part of the cause - and the allergens are strictly avoided (my major ones are foods and household molds) can the tonsils shrink?

I may try a sleep apnea take home test to see if these tonsils affect my sleep/breathing. Do you have any clinical opinions about this? How else can I tell if there is any respiratory obstruction?

It seems like studies show no noticeable impact on immune functions after tonsillectomy but I worry about my lymph functions and immune activity particularly since I lost my spleen in a traffic accident 3.5 years ago. Theoretically, could there be any immune dysfunctions - however minor - post tonsillectomy in a person without a spleen? (This will not affect my decision on tonsillectomy but how I take care of my body afterwards)

Thank you so much for your time. I really appreciate it.
XXXXXXX
doctor
Answered by Dr. Abubakar Siddiqh (2 hours later)
Brief Answer:
tonsillectomy.

Detailed Answer:

Hello again,

Thanks for considering my answer and for your follow up.

Answers for your queries.

1. Yes. Tonsillar hypertrophy is more prone for infections, when compared to normal sized ones.

2. Yes. Control of repeated infections can bring back the original size but not the allergic one.

3. Yes. Partially, you can reduce the size, if you know the exact allergen (there are several thousands of allergens in environment, which are very difficult to control them).

4. Sleep studies. This study gives information of number of episodes of respiratory obstruction per hour and constricted area causing the obstruction. This apnoea ( respiratory obstruction during sleep) episodes will decide the decision of surgery.

5. Tonsills are important organs of immunity in case of children but not in adults. They become atrophic and vestigial in adults. Post spelnectomy, pneumococcal infections are common, where pneumococcal vaccine given (it also gives protection to streptoccci, which is commonest one causing tonsillitis). Therefore, you can go ahead for tonsillectomy.

All the best. Take care.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Abubakar Siddiqh

ENT Specialist

Practicing since :1994

Answered : 2038 Questions

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Suggest Treatment For Tonsillitis

Brief Answer: Tonsillar hypertrophy Detailed Answer: Hi, I had gone through your question and understand your concerns that you are having tonsillar enlargment. Based on your clinical details and As per picture, it appears to be tonsillar hypertrophy. It usually occurs due to recurrent episodes of tonsillitis or secondary to allergy ( inhalational and consumed) or due to acid peptic disease. If it's bothering with pain, respiratory obstruction, sleep apnea or with recurrent infections tonsillectomy is the choice. Very often, boold markers ( liver n kidney) will not give any clue towards tonsillar hypertrophy. Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.