Chronic Tonsillitis and Throat Inflammation: Causes and Concerns

Tonsillitis and pharyngitis?

Hello Doctor, I have been experiencing recurrent inflammation of my tonsils, which sometimes improves but then flares up again.
Additionally, I have had persistent throat inflammation for a long time.
I previously consulted a traditional Chinese medicine doctor who mentioned that I have a lot of mucus in my throat.
I also have allergic rhinitis and mild gastroesophageal reflux disease, so the TCM doctor diagnosed me with chronic pharyngitis.
However, I still have some concerns, so I would like to ask you why my tonsillitis keeps recurring.
Could it be related to my allergies? Also, when I experience allergy flare-ups, I tend to lick the area on my tongue that resembles the respiratory tract; I wonder if that is related.
Lastly, I frequently take antibiotics, and I am concerned about any potential side effects or harm to my body.
Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2022/03/09

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the situation you described may be chronic pharyngitis.
It is recommended to seek medical attention for a laryngoscopy to rule out any masses and to consider pharmacological treatment.
In addition to medication, daily lifestyle precautions include: avoiding lying down for two hours after eating, and avoiding coffee, tea, cigarettes, alcohol, fried foods, and spicy foods, as these can help improve symptoms.

The criteria for tonsillectomy are generally as follows:
1) Enlarged tonsils causing respiratory issues or conditions such as obstructive sleep apnea.
2) Presence of malignant tumors.
3) Recurrent inflammation (as you mentioned).

Internationally recognized criteria for recurrent tonsillitis include:
a) More than 7 episodes of tonsillitis in one year.
b) More than 5 episodes per year for two consecutive years.
c) More than 3 episodes per year for three consecutive years.

If you meet these criteria, tonsillectomy may be recommended.
Wishing you safety and health.
P.S.
Q: "I have allergies and I tend to lick the area on my tongue that resembles the respiratory tract." A: I cannot understand the meaning.
Q: "I often take antibiotics and I'm not sure if it has side effects or negative impacts on my body." A: The frequency of "often" and the names of the medications should be discussed with your prescribing physician.

Reply Date: 2022/03/09

More Info

Chronic tonsillitis and throat inflammation can be quite complex and multifactorial in nature. Your experience of recurrent tonsillitis and throat inflammation, coupled with your history of allergic rhinitis and gastroesophageal reflux disease (GERD), suggests that there may be several contributing factors at play.

Understanding Chronic Tonsillitis:
Chronic tonsillitis is characterized by persistent inflammation of the tonsils, often due to repeated infections. The tonsils are part of the immune system and help to fight infections, but they can become overwhelmed by pathogens, leading to chronic inflammation. This condition can manifest as sore throat, difficulty swallowing, and swollen tonsils. In some cases, the tonsils may harbor bacteria or other pathogens, which can lead to recurrent infections.

Potential Causes:
1. Infections: Recurrent bacterial or viral infections can lead to chronic inflammation. Streptococcus bacteria are common culprits in tonsillitis.

2. Allergies: Your allergic rhinitis may contribute to throat inflammation. Allergens can cause post-nasal drip, leading to irritation of the throat and tonsils.

3. Gastroesophageal Reflux Disease (GERD): Acid reflux can irritate the throat and contribute to inflammation. The acidic contents of the stomach can reach the throat, causing discomfort and inflammation.

4. Environmental Factors: Exposure to irritants such as smoke, pollution, or dry air can exacerbate throat inflammation.

Connection to Allergies:
Allergies can indeed play a significant role in your throat and tonsil issues. Allergic reactions can lead to increased mucus production, which may drip down the back of your throat (post-nasal drip), causing irritation and inflammation. This could explain why you experience throat discomfort alongside your allergic symptoms. Additionally, the act of licking your tongue over the roof of your mouth may be a response to irritation or discomfort, which could further exacerbate inflammation.

Antibiotic Use:
Regarding your concern about the frequent use of antibiotics, it is important to note that while antibiotics can be effective in treating bacterial infections, overuse can lead to several issues:
1. Antibiotic Resistance: Frequent use of antibiotics can lead to the development of antibiotic-resistant bacteria, making future infections harder to treat.

2. Gut Health: Antibiotics can disrupt the balance of beneficial bacteria in your gut, potentially leading to gastrointestinal issues.

3. Side Effects: Common side effects of antibiotics include gastrointestinal upset, allergic reactions, and, in some cases, yeast infections.

Recommendations:
1. Consultation with an ENT Specialist: Given your recurrent symptoms, it may be beneficial to consult an Ear, Nose, and Throat (ENT) specialist. They can evaluate your tonsils and throat more thoroughly and may recommend treatments such as tonsillectomy if your condition is severe.

2. Management of Allergies: Consider working with an allergist to manage your allergic rhinitis. This may include allergy testing and treatments such as antihistamines or nasal corticosteroids.

3. GERD Management: If you suspect that GERD is contributing to your throat issues, discussing this with a gastroenterologist may be helpful. Lifestyle modifications and medications can help manage reflux symptoms.

4. Limit Antibiotic Use: Discuss with your healthcare provider the necessity of antibiotics for your recurrent infections. They may suggest alternative treatments or a more targeted approach to managing your symptoms.

In summary, chronic tonsillitis and throat inflammation can be influenced by a variety of factors, including infections, allergies, and GERD. A comprehensive approach that addresses these underlying issues will likely provide the best outcome for your health.

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