Tonsillitis is simply inflammation of the tonsils . (Tonsils/itis, where itis means inflammation)
Major cause is the infection. Certain bacteria (Most common being streptococcal group), viruses, and allergens are known to produce Tonsillitis. Tonsillitis may also occur as a result of certain allergy to food-preservatives, artificial colors, etc.
Tonsils may be considered as two guards standing at the entrance (throat) and protecting the human system against a wide range of intruders such as bacteria, virus, allergens and the like. Tonsils are natural protectors and vital organs of self-defense mechanism of the body. They are like the soldiers fighting on the border who get injured (inflamed) protecting the country.
When the internal immune system is low or weak, one tends to get infections. Tonsils work towards protecting us against the infections. Inflamed tonsils or recurrent tonsillitis is the result of low immunity and not the cause of it. The treatment should be targeted towards enhancing the immunity and not by removing the tonsils!
The commonest cause of tonsillitis is infection of the tonsils by micro-organisms. Certain bacteria (most common being the streptococcal group of bacteria), viruses, and allergens are known to produce tonsillitis. Allergens are usually in the form of certain food articles. Common food articles that can trigger tonsillitis are artificially colored sweets, sour fruits, bananas, preservatives added to certain drinks, cold food or drinks, ice-creams, etc. Environmental factors that may trigger an attack of tonsillitis are exposure to excessive cold weather, damp climate or change of weather. It must be borne in mind that bacteria and viruses tend to flourish in crowded areas and hence patients who are prone to tonsillitis can easily catch the infection in schools, parks, theatres, etc. All these factors contribute to lowering the immunity of the body and thus the tonsils fall prey to infection by the micro-organisms.
Another causative factor that can be of importance in the diagnosis of recurrent tonsillitis or chronic tonsillitis is genetic tendency. Recurrent tonsillitis is frequent in patients whose parents have also suffered from the same condition during childhood or adolescence.
Thus it is not just one, but multiple factors that combine together to lower the immunity of the body and this in turn causes recurrent and chronic tonsillitis in patients.
Sore throat : Pain in the throat is the most common presentation. However, young babies may not present with the pain but may present with an inability to eat.
Dysphagia : That is difficult swallowing. This may either be due to pain or due to huge increase in the size of the tonsils due to frequent inflammation.
Fever : Acute infection of the tonsils may present with moderate to high rise in body temperature. In case of septic foci on the tonsils, there may be fever with chills.
Sleep apnea, a disturbed sleep disorder may occur due to an obstruction to the air passage due to heavily enlarged tonsils or adenoids.
However, it is interesting to note that most children with sleep apnea do not recover of this disorder after the removal of the tonsils. (This is because, in many cases, there are associated causes for apnea, such as obesity, adenoids, small jaw, bony skull deformity (congenital), neuromuscular disorder, etc.)
Snoring : Due to obstructed air passage caused by the enlarged tonsils, snoring may be one of the symptoms in many children suffering from recurrent tonsillitis. Again, it may be noted here that snoring may be due to reasons other than the enlarged tonsils.
General symptoms : Tonsillitis may be associated with general fatigue, tired feeling, bodyache, loss of appetite, low energy level, headache, etc.
On examination : The attending doctor may have a look at the throat with a torch to find inflamed, red, congested tonsils. There may be visible septic foci (small pus pockets). Externally, one may palpate enlarged and mildly painful neck glands, indicating some more lymph glands in the neighborhood.