Should I Stop Self-Checking My Tonsils? Expert Advice on Tonsil Health

May I ask the doctor?

Hello Doctor, about five or six years ago, I had tonsil stones and would often use my fingers to poke at my tonsils.
I accidentally discovered that there seems to be a small hard spot in my left tonsil.
At the end of last year, I remembered this and went to a major hospital for an examination.
The doctor ordered a CT scan, and the results showed no abnormalities.
The doctor said it is unlikely to be a tumor or stones, but rather a result of tonsillitis that feels more like fibrosis.
He described it as scar-like tissue and advised me not to worry since I have health anxiety.
For the past five or six years, I have almost daily checked my tonsils for any changes, and they have remained almost the same.
I have seen many ENT specialists who all said my tonsils are of normal size and advised me not to overthink it.
I find this very distressing.
I consulted a doctor on the Taiwan e-Hospital platform, and your response was very kind.
I would like to ask if I can feel at ease in my daily life.
Other doctors have told me not to constantly check my tonsils and to only see a doctor if I feel pain, perhaps due to a cold or something similar, and that I don't need to pay constant attention to it.
Is it true that I don't need to keep self-examining my condition? Thank you, Doctor.

Cai Er, 30~39 year old female. Ask Date: 2018/11/14

Dr. Ji Zhaoyun reply Otolaryngology

Hello, regarding the question you raised, to achieve a 100% diagnosis, a tonsillectomy is required under the following conditions: 1) Enlarged tonsils causing breathing difficulties or conditions such as obstructive sleep apnea; 2) Presence of malignant tumors; 3) Recurrent tonsillitis, which is internationally recognized as: a) More than 7 episodes of tonsillitis within one year; b) More than 5 episodes of tonsillitis per year for two consecutive years; c) More than 3 episodes of tonsillitis per year for three consecutive years.
These criteria indicate recurrent tonsillitis, suggesting the need for surgical removal.
After a tonsillectomy, future colds will not lead to tonsillitis.
The immune function of the tonsils (such as T-cell production) primarily occurs during childhood; therefore, if an adult has medical necessity (as mentioned above), the tonsils can be removed.
Tonsillectomy is covered by health insurance, and potential complications mainly include: 1) Postoperative bleeding; 2) Wound infection, although the likelihood is low.
Pain may occur for three days post-surgery, and a light, cool diet is recommended, avoiding hard and spicy foods.
If you are still undecided about whether to undergo a tonsillectomy, it is advisable to rinse your mouth after meals to help clear any tonsil stones (located in the tonsillar crypts) and to avoid colds as much as possible.
If you do catch a cold, seek medical attention promptly to reduce the chances of tonsillitis.
Wishing you safety and health.
Sincerely,
Dr.
Chi Chao-Yun,
Director of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/11/14

More Info

It's understandable to be concerned about your health, especially when it comes to something as sensitive as your tonsils. Based on your description, it seems that you have been experiencing anxiety related to your tonsil health for several years, particularly after discovering what you thought might be a hard mass in your left tonsil. However, after thorough examinations, including a CT scan, medical professionals have reassured you that there are no signs of tumors or significant abnormalities, and that what you are feeling may be related to inflammation or fibrous tissue, similar to scar tissue.

In general, self-examination can be a double-edged sword. On one hand, being aware of your body and noticing changes can be beneficial for your health. On the other hand, excessive self-checking can lead to increased anxiety and unnecessary worry, especially if you have a tendency to be health-anxious, as you mentioned. This is often referred to as "health anxiety" or "hypochondria," where individuals become preoccupied with the fear of having a serious illness, despite medical reassurance.

Given that multiple ENT specialists have evaluated your tonsils and found them to be normal, it is reasonable to take their advice and reduce the frequency of your self-checking. Constantly examining your tonsils can lead to a cycle of anxiety, where you may interpret normal variations in your tonsils as signs of a problem, thus perpetuating your worry. Instead, consider the following recommendations:
1. Limit Self-Examination: Instead of checking your tonsils daily, try to limit this to once a week or even less frequently. This can help reduce anxiety and allow you to focus on other aspects of your life.

2. Focus on Symptoms: Pay attention to any actual symptoms you may experience, such as pain, difficulty swallowing, or changes in your voice. If you notice any concerning symptoms, then it would be appropriate to consult a healthcare professional.

3. Mindfulness and Relaxation Techniques: Engaging in mindfulness practices, such as meditation or deep breathing exercises, can help manage anxiety. These techniques can help you become more aware of your thoughts and feelings without becoming overwhelmed by them.

4. Seek Support: If your anxiety about your health continues to be a significant issue, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) has been shown to be effective in treating health anxiety by helping individuals change their thought patterns and reduce compulsive checking behaviors.

5. Regular Check-ups: While you may not need to check your tonsils frequently, it is still important to have regular check-ups with your healthcare provider. This ensures that any potential issues can be addressed promptly without the need for constant self-monitoring.

In conclusion, based on the information provided and the reassurance from medical professionals, it seems that you can indeed relax and not feel the need to constantly check your tonsils. Focus on your overall well-being and engage in activities that bring you joy and relaxation. If you have any new concerns or symptoms, don't hesitate to reach out to your healthcare provider for guidance. Remember, taking care of your mental health is just as important as taking care of your physical health.

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