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While tonsils may occasionally become swollen when you have an infection, swelling goes down for most people in a few weeks. But for some people, the swelling becomes a chronic condition that can lead to other health complications if not treated.
Causes
Swollen tonsils are commonly caused by an infection, bacteria, or viruses such as:
- Strep throat
- Mononucleosis
- Common cold
- Cytomegalovirus (CMV)
- Herpes simplex virus (HSV)
In some people, the swelling in their tonsils becomes a chronic condition that does not go away. Others may have recurrent tonsillitis, a condition in which frequent infections cause their tonsils to become swollen on a regular basis. The large size of the tonsils can lead to other health risks and complications.
While swollen tonsils alone can cause complications, each infection will also have other complications unrelated to the tonsils. For example, untreated strep throat can lead to kidney and heart problems.
This article will cover complications specifically related to the size of the tonsils due to swelling. Other than infections, swollen tonsils can also be caused by tonsil stones (cryptic tonsils) or, more rarely, cancer of the tonsils.
Symptoms and Complications
These are the typical symptoms and possible complications from swollen tonsils:
Sore Throat and Painful Swallowing
Your biggest complaint while having swollen tonsils is likely to be a sore throat. This may cause you to have a lack of desire to eat or drink due to the level of pain with swallowing (also referred to as odynophagia).
While painful, you must keep drinking to avoid dehydration. Eating is also important to maintain your health and avoid malnutrition.
With acute swelling of the tonsils, lack of eating is not likely to result in malnutrition, however, if you have chronic or recurrent swelling and pain, lack of adequate nutrition and weight loss can become an issue. Whether chronic or acute pain with a sore throat, you should always drink plenty of fluids to avoid getting dehydrated.
Sleep Apnea
Sleep apnea is a condition that causes a person to stop breathing for brief periods of time during sleep. Swollen tonsils are a common cause of obstructive sleep apnea. Sleep apnea is a serious condition that has been associated with other serious health risks and symptoms including:
- Fatigue
- High blood pressure
- Mood changes
- Depression
- Heart attack
- Congestive heart failure
- Abnormal heart rhythms
- Stroke
Sleep apnea occurs in approximately 1% to 4% of children. The recommended treatment is surgical removal of the tonsils and adenoids.
While swollen tonsils can cause sleep apnea in adults, it is less common and more often related to other factors, such as obesity. Sleep apnea caused by enlarged tonsils often leads to the surgical removal of the tonsils.
Other Complications
- Difficulty breathing: The tonsils can become so swollen that they block off the back of the throat and the airway.
- Ear pain
- Ear infections
- Bad breath
- Voice changes
- Peritonsillar abscess: This occurs when infection from the tonsils spreads into the head and neck tissues. It most commonly occurs in adults and is rare in children.
Treatment
For acute tonsillitis, you can treat the symptoms. For pain associated with swallowing, you can use lozenges with menthol or throat sprays (like Chloraseptic) and over-the-counter medications like Tylenol (acetaminophen) or ibuprofen. Treating pain will help you to be able to eat and drink.
The other symptoms will improve with treatment (antibiotics) if the cause is bacterial or with time if the cause is viral.
Chronic tonsillitis or recurrent tonsillitis is different than the occasional infections which cause a temporary episode of swollen tonsils. These conditions usually persist despite the use of antibiotics or adequate time and rest for your immune system to fight off an infection.
Steroid use in this situation would be indicated only on a case-by-case basis, depending on the severity of the swelling. Steroids may also have side effects that outweigh the benefits of their use. Even if these medications work initially, symptoms may recur.
When other treatments have failed to decrease the size of your tonsils, your healthcare provider may recommend surgical removal of your tonsils and adenoids, especially if you have complications such as sleep apnea.
