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What Causes Swollen Tonsils?
Question: Hi. My tonsils are a bit enlarged and back of my throat red. I do not have trouble swallowing nor do I experience any pain. I can't sing like I used to and excessive yelling and talking over loud music may make my voice sound hoarse but that's about it. Any Ideas as to why tonsils are enlarged?
Brief Answer:
Information
Detailed Answer:
Hello and welcome,
Sometimes tonsils become enlarged (over time) and there is some redness of the throat due to chronic drainage from the sinuses down the throat. This drainage can be from a low grade sinus infection, but is more likely due to either allergies or irritant rhinitis (upper airway reactivity from common things such as laundry fragrances, dryer sheets, smoke, etc. in the inhaled air).
Another possibility is that acid reflux can come up into the back of the throat (with "silent reflux", people may not be aware of this happening) and this can also cause some inflammation (redness, enlargement).
Do either of these things (drainage going down, or acid coming up) seem like possibilities for your situation?
Information
Detailed Answer:
Hello and welcome,
Sometimes tonsils become enlarged (over time) and there is some redness of the throat due to chronic drainage from the sinuses down the throat. This drainage can be from a low grade sinus infection, but is more likely due to either allergies or irritant rhinitis (upper airway reactivity from common things such as laundry fragrances, dryer sheets, smoke, etc. in the inhaled air).
Another possibility is that acid reflux can come up into the back of the throat (with "silent reflux", people may not be aware of this happening) and this can also cause some inflammation (redness, enlargement).
Do either of these things (drainage going down, or acid coming up) seem like possibilities for your situation?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the quick response. As a matter of fact I did neglect to mention that I've had some sort of acid reflux for the past two decades, I do take Nexium and it seems to keep that at Bay, Works rather well actually.
Brief Answer:
Thoughts on this
Detailed Answer:
Yes, the redness may be due to acid then.
Sometimes, although proton pump inhibitors like Nexium do greatly decrease acid production, they can in some people actually increase the likelihood of reflux. H2 blockers such as Zantac don't usually cause this, but if you have been on a ppi for a long time, especially if continuously, you may not be too happy switching because when a ppi that has been used on a continuous basis is discontinued, there can be a rebound hyperacidity.
Without being able to see the degree of redness in the throat I am hesitant to tell you to make any changes.
Thoughts on this
Detailed Answer:
Yes, the redness may be due to acid then.
Sometimes, although proton pump inhibitors like Nexium do greatly decrease acid production, they can in some people actually increase the likelihood of reflux. H2 blockers such as Zantac don't usually cause this, but if you have been on a ppi for a long time, especially if continuously, you may not be too happy switching because when a ppi that has been used on a continuous basis is discontinued, there can be a rebound hyperacidity.
Without being able to see the degree of redness in the throat I am hesitant to tell you to make any changes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I thought it might be from the acid. Was at the dentist getting pictures and an exam for crowns and they noticed it and wanted me to just check it out before they proceeded. I don't suppose there would be any way to get some sort of certification that it's most likely caused bu my reflux?
Brief Answer:
Information
Detailed Answer:
There are tests to diagnose GERD. Usually we diagnose based on symptoms, so these aren't used that often.
One way to document and diagnose it is visually with an endoscope of the upper digestive tract. A thin fiberoptic tube is passed down the esophagus into the stomach. The tract can be seen along the way.
Another way is via 24 hour pH (acid/base) testing either by putting a monitor in the lower esophagus, or placing a wire through the nose and testing the pH in the pharynx (throat).
These tests involve a gastroenterologist (GI doctor).
You may want to see this type of doctor anyway. Likely they will give you a trial of a prescription strength proton pump inhibitor such as pantoprazole, for a short duration (a couple of months) to see if it will clear up the problem.
Lifestyle modifications can help too. Here are the usual recommendations:
1. Put blocks under the posts of the head of your bed to raise it up. You might find blocks made for this purpose at a drug or hardware store. (GERD is a common problem!)
2. Avoid eating for 2 to 3 hours before lying down or going to bed.
3. Avoid alcohol, limit caffeine, and get help for quitting smoking if you smoke.
4. Avoid mint such as peppermint. Mint can relax the lower esophageal sphincter, making it easier for food to come up.
5. Keep track to see what foods make it worse (if you can tell). Common foods that make GERD worse are citrus/sour and acidic foods such as tomatoes. For some (not all) people, spicy and greasy food increases the problem.
6. Avoid big meals as this causes problems in 2 ways. It increases the pressure differential between the stomach and esophagus and increases the chance food and stomach acid will come up. The other reason is because when the stomach is distended/stretched, it increases it's acid production. So eating smaller amounts more frequently can help.
7. If overweight, try to lose weight (easier said than done of course). Even losing a few pounds can make a difference.
Information
Detailed Answer:
There are tests to diagnose GERD. Usually we diagnose based on symptoms, so these aren't used that often.
One way to document and diagnose it is visually with an endoscope of the upper digestive tract. A thin fiberoptic tube is passed down the esophagus into the stomach. The tract can be seen along the way.
Another way is via 24 hour pH (acid/base) testing either by putting a monitor in the lower esophagus, or placing a wire through the nose and testing the pH in the pharynx (throat).
These tests involve a gastroenterologist (GI doctor).
You may want to see this type of doctor anyway. Likely they will give you a trial of a prescription strength proton pump inhibitor such as pantoprazole, for a short duration (a couple of months) to see if it will clear up the problem.
Lifestyle modifications can help too. Here are the usual recommendations:
1. Put blocks under the posts of the head of your bed to raise it up. You might find blocks made for this purpose at a drug or hardware store. (GERD is a common problem!)
2. Avoid eating for 2 to 3 hours before lying down or going to bed.
3. Avoid alcohol, limit caffeine, and get help for quitting smoking if you smoke.
4. Avoid mint such as peppermint. Mint can relax the lower esophageal sphincter, making it easier for food to come up.
5. Keep track to see what foods make it worse (if you can tell). Common foods that make GERD worse are citrus/sour and acidic foods such as tomatoes. For some (not all) people, spicy and greasy food increases the problem.
6. Avoid big meals as this causes problems in 2 ways. It increases the pressure differential between the stomach and esophagus and increases the chance food and stomach acid will come up. The other reason is because when the stomach is distended/stretched, it increases it's acid production. So eating smaller amounts more frequently can help.
7. If overweight, try to lose weight (easier said than done of course). Even losing a few pounds can make a difference.
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. Chakravarthy Mazumdar
Answered by
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