Frequent inflammation of the tonsils in adults. Symptoms and treatment of chronic tonsillitis in adults. How is chronic tonsillitis formed?

Today we will talk about chronic tonsillitis, its symptoms, causes and treatment options in adults (medication, surgery, folk), we will tell the site about complications, disease prevention on the website.

What is tonsillitis

Chronic tonsillitis called a long-term inflammatory process of the tonsils, which periodically makes itself felt due to reduced immunity. Usually first passes acute process the same (acute inflammation of the tonsils), or scarlet fever, diphtheria, measles. The focus of infection in this case is the tonsils, not fully treated in the primary disease, the connective tissue of which grows, becomes loose, edematous, purulent foci remain in the thickness of the tonsils.

Causes of tonsillitis

Tonsils play an important protective function in the body. They prevent the entry of pathogenic bacteria into the body, which provoke the development of infectious diseases. They also produce interferons - proteins that are responsible for protecting the body.

The main causes of tonsillitis include a number of diseases, for example:

1. tuberculosis, measles, scarlet fever, diphtheria. These infectious diseases often provoke the development of chronic tonsillitis. Basically, this happens in people who do not treat them correctly, doing it on their own and carelessly.
2. also tonsillitis can develop against the background of poorly treated sinusitis,. With these diseases, an infection from the tonsils can spread to the entire body, which provokes.

There are other factors in the development of tonsillitis. These include:

1. professional activities related to polluted air.
2. bad environmental situation.
3. excessive alcohol consumption and uncontrolled smoking.
4. constant nervous tension and stressful situations.
5. improper nutrition. Excessive consumption of fortified foods fast carbohydrates. Preference should be given to fresh vegetables, fruits, cereals and herbs.
6. not enough fluid intake per day. In this case, we mean pure water.

Symptoms of tonsillitis, photo

Often during an exacerbation of chronic tonsillitis, a person has a feeling that there is a small lump in the throat. Which interferes with the normal swallowing of food. When visually examining the tonsils, you can see the so-called purulent plugs or bacterial plaque. The tonsils, in turn, turn red, become inflamed, there is perspiration, soreness in the throat, there may be pains of varying intensity, a feeling of fullness.

Coughing up pus is accompanied.

The condition worsens when inhaling cold air, drinking cold water or eating unheated food (I won’t say anything about ice cream!).

The most common symptoms of tonsillitis include:

• - usually a slight increase in body temperature to subfebrile figures in the evening (37.1-37.3);
• - general intoxication of the body, headache, irradiation of pain in the ear, neck;
• - enlargement and soreness of the submandibular and cervical lymph nodes;
• - sometimes there are attacks of pain in the heart;
• - general weakness, weakness;
• - sometimes joint pains, aches, torsion join.

Diagnosis of chronic tonsillitis

For correct diagnosis tonsillitis, you need to take a referral from a doctor for a bacterial culture. In the laboratory, doctors will take a swab from the tonsils in order to find out the true cause of the disease and detect its pathogen (streptococcus, staphylococcus, etc.).

Sometimes differential diagnosis with diphtheria is necessary.

Treatment of tonsillitis

The standard treatment regimen for chronic tonsillitis is conservative methods. Surgery is recommended only in extreme cases.

The most common methods are:

1. — antibiotic therapy. With tonsillitis, specialists choose antibacterial drugs for each patient individually. It all depends on the type of bacteria that provoked the disease. But there are cases when the patient's condition is so severe that the doctor prescribes a broad-spectrum antibiotic without doing bacterial culture. The course of treatment with an antibacterial drug (7-10 days) must not be interrupted, otherwise complications are possible.
2. - treatment of tonsillitis with cryotherapy. The essence of this method is the impact directly on the tonsils of low temperature. Under its influence collapses upper layer tonsils, along with pathogenic bacteria. Over a short period of time, the upper layer of the tonsils is restored and immunity is strengthened. The tonsils do not lose their functions. There is no pain during the cryotherapy procedure.

If you have the first symptoms of tonsillitis, you need to seek help from specialists, only they can prescribe the right and correct treatment. Otherwise, there is a risk of complications and undesirable consequences.

Sometimes Bronchomunal, IRS-19, Ribomunil, aloe preparations are used to stimulate the immune system.

Treatment of tonsillitis with folk remedies at home

Concerning folk methods treatment of chronic tonsillitis, the first of them is washing the tonsils. However, at home, this procedure is difficult and sometimes impossible. You need the help of an experienced otolaryngologist. Although many chroniclers, knowing about the effectiveness of this procedure, got the hang of doing it themselves. To do this, you need a syringe or a syringe without a needle for 20 ml. Anti-inflammatory drugs are poured into these auxiliary devices. herbal infusion, Miramistin, Chlorhexidine, Furacilin and other antiseptics. Repeat 4-5 times a day.

Also, the tonsils are lubricated with Lugol's iodine solution, iodine-glycerin, Gramicidin.

Often ethnoscience recommends rinsing throat based natural ingredients. For example, which needs to be mixed with lemon juice and honey. If the solution is too concentrated, you can dilute it with water. Of the preparations, you can rinse with 3% hydrogen peroxide.

From pharmaceutical herbs you can use oak bark, St. John's wort, calendula, yarrow, peppermint, and wormwood. You can rinse with an infusion of chopped garlic in milk (stand for at least 2 hours), cranberry juice with honey, lemon juice with honey, slightly warmed carrot juice, for a week.

For those who are not allergic to bee products, it is recommended for use. It must be chewed several times a day. It well disinfects the mucous membrane of the oral cavity and tonsils. Increases the resistance of the immune system to pathogenic bacteria and has a mild analgesic effect. You can use the pharmacy spray Proposol.

You can use alcohol tincture of propolis (20 g per 100 ml of vodka), drink 25 drops three times a day with water.

Herbalists also recommend fresh sea buckthorn fruits (10 pieces), slowly chewing 3 pieces in the mouth. three times a day, so that the juice irrigates the tonsils well. Before that, thoroughly rinse out all the pus. Long-term treatment - from 1 to 3 months.

It helps to draw out pus juice of fresh red beets - rinse up to 10 times a day.

Removal of the tonsils in chronic tonsillitis - tonsillectomy

There is an opinion that if you remove the tonsils, the immune system will weaken and the body will become more susceptible to colds. But any experienced specialist will confirm that all organs in the human body are needed for its full-fledged work. Tonsils are no exception. They perform an important protective function in the body. However, when tonsillitis becomes chronic, the question arises of their removal. They increase in size, interfere with full breathing and eating.

Previously, it was recommended to remove the tonsils for every patient with chronic tonsillitis. Over time, medicine improved, but many physicians remained unconvinced. They believe that tonsils are good for children up to 5 years of age. Further, they practically do not perform their natural functions.

1. - those who, due to chronic tonsillitis, have severe complications (rheumatism, disorders in the liver and kidneys).
2. - people who have a sore throat more than 4-5 times in one year.
3. - for those who do not help conservative methods, there is hypertrophy of the tonsils of 3-4 degrees (accompanied by snoring in a dream, there is difficulty breathing in a dream up to apnea).

Professionals who do not adhere conservative methods recommend more modern method treatment is medication. Pharmaceuticals today offer drugs that help relieve inflammation from the tonsils, thereby reducing their size.

Along with them, physiotherapy is prescribed (inhalation, UHF, UVI, ultrasound). Such a combination of treatment well reduces the risk of severe complications tonsillitis.

Complications of tonsillitis

As the doctors say: "The disease is not so terrible as its consequences." Tonsillitis is directly related to this. At the slightest disruption in the body with a disease, autoimmune failures are possible. Which in turn can affect the work of the heart. There is also a risk of disorders in the functioning of the kidneys, liver, vascular system, thyroid gland. There were cases when tonsillitis gave complications in the form of diseases of the joints and even the eyes.

Quite often, rheumatism, pyelonephritis, cardiopathy, endocarditis, arthralgia, polyarthritis, paratonsillar abscess develop. In very severe cases - sepsis.

Prevention of chronic tonsillitis

Of course, the first rule for the prevention of tonsillitis, like many diseases, is personal hygiene. This applies to the cleanliness of the hands, face, mucous membranes of the nose and oral cavity. An equally important link in this chain is Fresh air in the room where a person spends most of his time. It is necessary to ventilate the room, office or any other place.

It is also very important to have a humidifier, or humidify it with wet towels hung on radiators. Otherwise, the mucous membrane of the nasopharynx dries up and cannot “work” normally. Useful salt caves.

If the body is prone to frequent colds, it is necessary to rinse the nasal passages with salt water. It can be bought at a pharmacy or prepared at home. To do this, you need to take 10 g of kitchen salt (sea salt will also be good) and dissolve it in 1 liter of boiled cold water.

Worth the cure carious teeth or inflammation of the gums, if any, a constant focus of infection in the oral cavity provokes exacerbations of tonsillitis with any unfavorable factor(hypothermia, overwork, stress, etc.).

next preventive measure tonsillitis is correct, healthy eating. If the body is sufficiently saturated with vitamins, minerals and essential trace elements, the risk of colds and other respiratory diseases is minimized.

Not for everyone, but the method of hardening the body is also recommended. But it must be approached with extreme caution. For example, you can start by taking a shower in warm water. Then gradually reduce the temperature. When the body gets used to cold water, you can try pouring on the street. But such water procedures not allowed for everyone. For example, they should not be given to people with severe heart disease and central nervous system.

The chronic form is characterized by a violation of the general reactivity of the body. This is due to the constant flow of toxic infectious agents from the tonsils into the body.

Etiology of the disease

Most often, in patients with such a diagnosis, P-hemolytic or is found in the lacunae of the tonsils. Seeded pathogens have pronounced pathogenic properties.

The frequency of exacerbations is influenced by chronic lesions located in nearby organs.

These include carious teeth,.

In the process of development of the disease, the mouths of the crypts of the tonsils narrow. This is due to the growth connective tissue. As a result, the drainage function is disturbed, stagnation occurs. This leads to the rapid multiplication of microbes.

signs

Understand that the disease has passed into chronic form possible upon examination. Against the background, there are changes in the structure of the tonsils. Can see:

• Scar tissue and seals.
• Hyperemia and thickening of the palatine arches.
• The presence of purulent plugs, which are curdled in nature.

There are patients with chronic tonsillitis who have never had a sore throat. In this case we are talking about the nonanginal form.

Signs of tonsillitis

Symptoms

Unlike acute form on the background of sore throat. Patients complain of shortness of breath, frequent,. Chronic tonsillitis is always characterized by a sluggish course. The disease may fade, and then worsen.

Between relapses, people often complain about the general, appearing. In some patients, body temperature is always at subfebrile levels. General state slightly violated.

Etiology and signs of chronic tonsillitis:

How to treat chronic tonsillitis during exacerbation

Used in the acute stage A complex approach. It includes:

Medically

Local treatment includes antiseptic solutions. These include inexpensive. Can be used , . Antibacterial sprays help well, for example, Bioparox and.

You can lubricate the tonsils with antiseptic and regenerating agents, wash the lacunae of the tonsils with them.

An auxiliary method of treatment are. Procedures are carried out saline solution or medicinal. With such an impact, you should not do deep breaths. Doctors warn that such manipulations cannot be carried out with the body, and with a decompensated appearance, they are simply ineffective.

Inside, funds are prescribed for the correction of local immunity, and calcium preparations. In the acute stage, antibiotics and antihistamines are prescribed. The latter allow you to remove swelling. Non-steroidal anti-inflammatory drugs are good for a variety of pains.

Folk remedies

The most effective herbs for the treatment of tonsillitis are:

• Yarrow.

They can be used singly or in combination. The most common infusions for rinsing:

A spoonful of yarrow, sage is diluted with a glass of boiling water. The broth is infused for about 15 minutes. After straining, rinse your throat well. You can eat and drink only one hour after the procedure.

Take a teaspoon of calendula and chamomile. This composition is poured with a glass of boiling water and infused for a quarter of an hour. The throat can be gargled up to 7 times a day.

They also have antibacterial properties essential oils. Sage, basil, tea tree will help to cope with the disease.

The main area of ​​​​application of oils is. Since they are potent, their minimum doses are used. For treatment, you need to use one drop per liter of boiling water. The vapor inhalation session should last no more than 5 minutes.

Simple recipes of traditional medicine:

What to do for prevention

During remissions, you should carefully monitor your health. Various drugs and folk remedies will help maintain immunity.

Preparations

In a simple form, preventive treatment for 1-2 years in courses of 10 sessions. To maintain immunity complex vitamins, . In the stage of remission, it is possible to use physiotherapeutic methods. FROM various drugs assigned, for example.

There are positive effects of probiotics. They allow you to normalize the intestinal microflora. If they are also used in antibiotic therapy, then antibiotic-resistant probiotics should be used. It could be Narine, Acipol and some others.

During the course maintenance treatment, oral cavity sanitation is carried out, tonsil lacunae are washed with antiseptic preparations. They will also help at the first signs of illness.

Folk remedies

safe and effective tool, which can be used for both adults and children, is a decoction of beets.

You need to take 300 gr. beets. It is washed and crushed. After that, the vegetable mass is combined with 300 ml of water and placed on fire.

The resulting mixture is boiled on fire for an hour. Gargle with warm liquid throat 3 times a day for 10 days.

It will strengthen the immune system, prevent infections from developing and another recipe. For this, it is taken in the same amount. With the resulting composition, sick tonsils are lubricated for 14 days three times a day. The next two weeks, the tonsils are smeared every other day.

Garlic juice will also help cure the chronic form. To obtain a medicinal product, the juice is mixed with the same amount of water. For a month, twice a day, the mixture is applied to the tonsils.

How to properly treat chronic tonsillitis, reviews and advice from a doctor:

Regime, spa treatment, diet for prevention

14 days after the acute phase, preventive sanitation should be performed using an iodine solution. In the future, Miramistin courses are repeated 4 times a year. good results can be achieved with the use of climatotherapy. Sea resorts are effective, since moist iodized air favorably affects the condition of the respiratory tract.

If you want the remission to last as long as possible, you need to avoid any stressful situations, ensure good rest. In the acute stage, it is necessary to observe bed rest until full recovery. This can help reduce the likelihood of complications.

Doctors recommend to reconsider and your diet. Prevention involves eating healthy foods that don't cause irritation. It is not recommended to eat salty, bitter, sour or other foods that can cause adverse reactions from the mucosal side.

All dishes should be consumed steamed, boiled or stewed. The emphasis is on liquid foods that are easy to chew and swallow. It is good to eat various soups, jelly, drink compotes. Do not eat too hot or cold food.

As already noted, treatment for chronic tonsillitis should be comprehensive. It can be provided in the conditions of various sanatoriums. In the summer, it is better to spend 35-40 days in them, and in winter time-2 months. With persistent phenomena of tonsillogenic intoxication, a sparing regimen is prescribed. Effective air baths, exercise therapy.

Forecast

The prognosis for the chronic form is favorable. A full recovery may occur, but in most cases the disease simply goes into a stable remission stage. If it is detected, then the prognosis worsens, because even without exacerbations a person may feel bad.

Tonsillitis is an inflammation in palatine tonsils ah, which occurs due to the effect of bacteria or viruses on the lymphoid tissue. As the disease progresses, the focus of inflammation can spread further, affecting the surrounding soft tissues. The disease can take an acute and chronic form. Acute tonsillitis is for everyone famous name"angina", chronic is a infectious disease general. Next, consider what kind of disease it is, what are the first symptoms of tonsillitis and treatment methods in adults.

What is tonsillitis?

Tonsillitis (lat. Tonsillitis) is infection, affecting one or several tonsils, often palatine, caused by a bacterial or viral infection. The leading symptoms of the disease in adults are sore throat and bad smell from the mouth. If you look at the throat of a patient with tonsillitis, then enlarged and inflamed palatine tonsils can be seen with a loose surface, the lacunae of which are filled with purulent plugs. The tonsils can enlarge to such an extent that they completely close the lumen of the pharynx.

Tonsils are necessary to perform the protective function of the body. It is the tonsils that become the first barrier to viruses and bacteria trying to get into the throat or nose. The immune system is not always able to cope with the attacks of viruses and bacteria from the environment, and then the tonsils become inflamed. Perhaps acute and chronic course of the disease.

Is tonsillitis contagious?

Only one form of tonsillitis is non-contagious- allergic angina. A person who suffers from this disease is absolutely safe for others.

With regard to susceptibility to the disease, it can be noted that it is not the same for each patient, being determined to a large extent by the state inherent in the local immunity of the tonsils. So, the lower the immunity, the higher the risk of the disease, respectively.

The incubation period for tonsillitis can last from 6-12 hours to 2-4 days. The deeper the tissues are affected, the more difficult the disease is, the longer the infectious and inflammatory process progresses, and the higher the risk of complications.

ICD code:

• Acute tonsillitis: ICD-10: J03; ICD-9: 034.0
• Chronic tonsillitis: ICD-10: J35; ICD-9: 474

The reasons

The causes of tonsillitis are various pathogenic microorganisms:

• Streptococcus in the throat;
• candida;
• chlamydia;
• staphylococci;
• adenoviruses;
• pneumococci;
• moraxella;
• herpes viruses;
• Epstein-Barr virus.

You can also identify factors that precede the onset of the disease. It:

• decreased immunity;
• local hypothermia of the body;
• entry into the throat of allergens that irritate the mucous membranes - dust, smoke;
• recent illnesses that reduce protective functions epithelium, for example, acute respiratory infections;
• violation of nasal breathing;
• overwork;
• stress;
• avitaminosis;
• mucosal injuries;
• sensitization of the body, or increased susceptibility to pathogens of the disease.

Also, allergic reactions can form the basis for the appearance of tonsillitis, which not only affect the progression of the disease, but also often cause complications.

Classification

Depending on the course of tonsillitis, doctors distinguish between acute and chronic forms of tonsillitis.

Acute tonsillitis

Acute tonsillitis (or tonsillitis) is an infectious disease that affects the palatine tonsils, as well as the lingual, laryngeal and nasopharyngeal tonsils. Characterized rapid rise temperatures up to 39 ° C, chills, headache, sore throat, aggravated by swallowing, pain in muscles and joints. At improper treatment or its absence, a weakened body or the presence of other chronic diseases, acute tonsillitis can turn into a chronic form, which is characterized by periodic exacerbations.

Tonsillitis in the photo looks like inflammation of the palatine tonsils with a porous surface covered with purulent plugs

Chronic tonsillitis

It is characterized by the development of a constant inflammatory process in the palatine tonsils, the course of the disease is accompanied by a change in periods of remission with exacerbations. Chronic tonsillitis, the symptoms of which do not always make themselves felt, can cause the development of various pathological processes from almost all systems and organs. Due to violations of the neuro-reflex and endocrine regulation of the body, depression, menstrual disorders, Meniere's syndrome, encephalopathy, etc. can occur.

Distinguish:

• primary tonsillitis: an acute lesion of the palatine tonsils against the background of general hypothermia of the body, a decrease in immunity, due to thermal effects on the tissues of the throat;
• secondary tonsillitis: develops as a result of other diseases (, leukemia, scarlet fever), as a complication or concomitant symptom of an infectious disease;
• specific tonsillitis (caused exclusively by infectious agents).

According to the localization of the process, the following types are distinguished:

• Lacunar - inflammation only in the gaps;
• lacunar-parenchymal - lymphoid tissue is included in the inflammatory process;
• parenchymal - tonsillitis develops in the lymphadenoid tissue;
• sclerotic - proliferation of connective tissue.

Based on the nature of the lesion and its depth, the following types of tonsillitis are determined:

• catarrhal angina;
• angina;
• angina;
• necrotic angina.

Of the listed forms of tonsillitis, the most easy current noted at catarrhal form disease, and the most severe - with its necrotic form.

Symptoms of tonsillitis

Common symptoms of tonsillitis in adults are:

• signs of intoxication: pain in muscles, joints, head;
• malaise;
• pain when swallowing;
• swelling of the palatine tonsils, soft palate, uvula;
• the presence of plaque, sometimes there are ulcers.

Sometimes symptoms of tonsillitis can even be pain in the abdomen and ears, as well as the appearance of a rash on the body. But most often the disease begins with the throat. Moreover, the pain with tonsillitis is different from a similar symptom that occurs with SARS or even the flu. Inflammation of the tonsils makes itself felt very clearly - the throat hurts so badly that it is difficult for the patient to just communicate, not to mention meals and swallowing.

On the picture - advanced stage tonsillitis

Symptoms of acute tonsillitis:

• sore throat when swallowing;
• temperature rise (up to 40°C);
• redness and enlargement of the tonsils;
• purulent formations on the tonsils (purulent plugs);
• soreness and swollen lymph nodes (lymphadenopathy);
• headache;
• general weakness.

Signs of a chronic form of tonsillitis:

• Symptoms of tonsillitis in chronic form are similar, but somewhat less pronounced.
• Pain and fever are usually absent
• can only be slight pain when swallowing
• interferes with the feeling of sore throat,
• bad breath.

The general condition of the body suffers, but not as pronounced as in acute tonsillitis.

Additional symptoms:

• Pain in the joints;
• rashes allergic nature on the skin, not amenable to treatment;
• "Aches" in the bones "
• Weak cardiac colic, malfunctions of the cardiovascular system;
• Pain in the kidney area, dysfunction genitourinary system.

Diagnostics

On examination, there is redness and swelling of the mucous membrane of the tonsils and adjacent tissues (see photo). On palpation of the anterior ear and cervical lymph nodes, their increase and soreness are recorded.

Diagnosis of tonsillitis in adults is carried out using the following methods:

• examination by an ENT doctor, collection of an anamnesis of the disease;
• pharyngeal swab for flora with determination of sensitivity to antibiotics and bacteriophages;
• general analysis blood, urinalysis;
• blood test for antistreptolysin-O, rheumatoid factor, C-reactive protein;
• According to indications, ultrasound of the kidneys, Echo-KG, consultation with a cardiologist, urologist.

Treatment of tonsillitis in adults

Treatment of tonsillitis is usually carried out in outpatient settings. Its severe course requires hospitalization. A sparing type of diet rich in vitamins B and C is prescribed, as well as plenty of fluids for detoxification.

Antiseptics for adults with tonsillitis:

• Fukortsin;
• Pro-ambassador;
• Bioparox;
• Gramicidin;
• Aqualor;
• Oracept;
• Tonsilotren;
• Givalex and others.

To lubricate the throat, solutions are used:

• Lugol;
• Chlorophyllipt.

If this is justified by the indication, the doctor prescribes antiviral drugs. Often, antiviral drugs have an immunomodulatory effect, which is why they are prescribed to support a weakened immune system. But, again, self-administration of this group of drugs can harm the body, the dosage and variation of such drugs are selected by the attending physician according to individual requirements.

Antibiotics for tonsillitis

The appointment of antibiotics (antibacterial drugs) is justified only in severe forms of the disease. This usually helps the body cope with the microbial agent faster and bring recovery closer, however, it should be remembered that antibiotics are useless in treatment. viral diseases. This causes bacteria to become resistant to antibiotics.

To select an antibacterial drug, it is necessary to take a smear from the lacunae of the affected tonsils to determine the causative agent of the disease.

How to treat chronic tonsillitis?

Chronic tonsillitis should be treated comprehensively, because this is the only way to get rid of its symptoms for a long time. During an exacerbation, the same therapy is carried out as with acute inflammation tonsils. But for a complete recovery, it is necessary to eliminate not only the symptoms of the xp form of the disease, but also its causes.

If you have chronic tonsillitis, then the therapy with it is the same as with acute, but with some features:

1. Antibiotics are prescribed by determining the pathogen by analysis, but the course of their administration is longer.
2. Prevention of exacerbations is very important. Need to lead healthy lifestyle life, avoid hypothermia, monitor nutrition and take all necessary measures in order to strengthen the body and protect it.
3. Immunostimulants and probiotics are recommended to drink not during exacerbations, but for prevention during those periods when the risk of infection is too high.
4. Gargling with chronic tonsillitis is not always advisable, because purulent plugs appear in the lacunae, which are too tightly connected with the lymphoid tissue. More effective in this situation washing.
5. Radical treatment is advisable. In this case, the tonsils are removed surgically or in other ways, which helps to minimize the frequency of exacerbations.

Gargling for tonsillitis

Gargling can be done independently at home. There is a large selection various means, which can be purchased at pharmacies or prepared independently.

The following solutions are very effective for rinsing:

• Chlorophyllipt;
• Hexoral;
• Chlorhexidine;
• Furacilin;
• Bicarmint;
• Iodinol;
• Lugol.

At home, you can use:

1. Washing the throat with propolis extract. It is sold in a pharmacy, it is not expensive. It has a very good antiseptic effect, and also cleans the tonsils from purulent plugs and plaque. It also has an analgesic effect on the oral mucosa.
2. Gargling with salt. Method of preparation: add half a teaspoon of salt to a glass of water. room temperature. Stir. Rinse as often as possible. You can add half a teaspoon of soda there, then rinsing will have a more pronounced anti-inflammatory effect.
3. Pour boiling water over 15 g of finely chopped celandine, let it brew for 10-15 minutes. Rinsing should be carried out using a warm solution - it is advisable to warm it up a little before each procedure.

Physiotherapy:

• inhalations with herbal decoctions (calendula, chamomile);
• phonophoresis - ultrasound treatment;
• UHF therapy;
• ultraviolet irradiation;
• laser therapy.

These methods are used only in combination with the main therapy. They are not intended for self-treatment tonsillitis.

The lack of results of several courses of intensive care for chronic tonsillitis, frequent (from 2 to 4 per year) relapses of the disease, as well as signs of rheumatic damage to other organs (heart, kidneys, joints) are indications for surgical removal palatine tonsils.

Surgical removal of the tonsils for tonsillitis

Surgical methods are used to treat tonsillitis in a number of cases:

• In the absence of a therapeutic effect with conservative methods;
• In case of development against the background of tonsillitis of an abscess;
• In the event of tonsilogenic sepsis;
• With suspicion of malignant pathology.

Tonsillitis can be permanently cured. Treatment methods are completely different. Sometimes massive antibiotic therapy is enough, and in some cases without surgical intervention not enough.

Nutrition and diet

If you are suffering from tonsillitis, it is suggested that you switch to a liquid diet within a few days. All meals should be consumed steamed, boiled or stewed. Emphasis should be placed on liquid food or food that will not cause difficulty in chewing and swallowing. That's why it is recommended to use soups, kissels, compotes, vegetable puree, ginger tea.

Any food should be consumed warm (it warms the tonsils, relieves inflammation and kills germs). Sugar during the period of illness is better to replace with honey, and warm the milk a little before taking it.

How to treat tonsillitis with folk remedies

At home, you can use folk remedies for tonsillitis. However, we recommend that you consult with your doctor before use.

1. Gargling with beetroot juice. Grate the beets on a fine grater and squeeze the juice. To a glass of juice, add 1 tablespoon of table vinegar (not essences!). Gargle 5-6 times a day.
2. Gargling decoction of white willow bark(willow, willow). 2 tablespoons chopped bark pour 2 cups hot water, bring to a boil and simmer for 15 minutes over low heat.
3. Rinsing the throat with a decoction of chamomile, calendula, sage, oak bark.
4. Boil milk and add a pinch of turmeric powder and ground black pepper. Drink this mixture at bedtime for at least three nights in a row for effective treatment inflamed tonsils.
5. Take 1 gram of a mixture of medicinal herbs: chamomile (flowers), string (grass), black currant (leaves), peppermint (leaves), calendula (flowers). Mix everything and pour a glass of boiling water. Insist in a thermos, after straining, take half a cup inside 3-4 times a day.

Prevention

To reduce the incidence of the disease, the following measures should be taken:

• it is necessary to ensure that nasal breathing is always normal,
• eat right and balanced;
• carefully monitor oral hygiene;
• timely sanitize foci of infection and treat teeth.

After a sore throat, preventive washing of the lacunae and lubrication of the tonsils with drugs recommended by the doctor should be carried out.

Tonsillitis in adults serious illness which should be treated as early as possible. If you take measures in the early stages of the disease, you can quickly recover, prevent relapses and complications.

The treatment of chronic tonsillitis differs from the treatment of the acute form of the disease - tonsillitis. It often occurs in connection with a decrease in the immune system, frequent hypothermia, severe fatigue or colds. Its causative agents can be viruses, bacterial or non-specific infections, acute leukemia etc. The chronic process takes a long time in the palatine tonsils and in most cases develops as a result of ineffective or incomplete therapy acute tonsillitis.

The main differences between these forms of pathology are the symptoms and the degree of their manifestation. In an acute course, the signs of the disease are pronounced. Patients quickly and significantly increase body temperature (up to 41 ° C), they complain of headache, lack of appetite, malaise and general weakness, pain in the throat and joints. They have an increase in lymph nodes and tonsils, as well as the formation of purulent plaque and plugs on the second and their staining in red.

The chronic course of tonsillitis is characterized by a sluggish inflammatory process in the throat, with periods of remission and exacerbation. A significant increase in body temperature, as well as purulent plugs, are extremely rare. hallmark This type of pathology is nasal congestion, which never occurs with angina.

Diagnosis and selection of effective treatment of chronic tonsillitis in adults is carried out by an otolaryngologist, in children - by a pediatrician or pediatric ENT. Conservative therapies can be used last resort- removal of the tonsils. Self-treatment at home folk remedies without consulting a doctor is not recommended.

Causes, types and symptoms of chronic tonsillitis

Made up of lymphoid tissue, the palatine tonsils are part of the body's overall immune system. Their main function is to protect against infectious agents that enter the throat.

The human microflora consists of opportunistic and pathogenic microorganisms that are in a state of balance due to the overall work of all parts of the immune system. If this balance is disturbed, and penetrate pathogenic organisms, through the tension of local immunity, bacteria, fungi or viruses are destroyed. Lymphoid tissues with a general decrease in the body's resistance, the presence of a large number pathogenic flora and frequent tension immunity do not produce enough gamma globulins, lymphocytes and interferons to resist infectious agents.

Chronic inflammation is dangerous because in the body there is always a focus of infection, which contributes to the occurrence severe violations from the side of work various organs and systems.

Protracted and/or frequent inflammatory processes in the pharynx lead to the palatine tonsils losing their ability to cleanse tissues and resist pathogenic flora, thereby they turn into a focus of infection and lead to the development of chronic tonsillitis. The presence of reservoirs (lacunae) of the accumulation of various microorganisms and epithelial cells makes them most susceptible to the chronic course of inflammation.

Inflammation can be caused by damage to adenoviruses, staphylococci, enterococci, green or hemolytic streptococcus. Also, the disease may be associated with the activation of non-pathogenic saprophytic flora of the upper respiratory tract against the background of a violation of the protective and adaptive mechanisms of the body. In this case, chronic tonsillitis is referred to as a disease caused by autoinfection.

The factors leading to the occurrence of pathology include:

• untreated angina;
• anatomical and topographic and histological features palatine tonsils;
• presence of vegetation conditions in microflora crypts;
• adenoiditis, sinusitis or sinusitis of a purulent course, as well as inflammatory processes and pathologies of the structure of the nasal passages, leading to impaired nasal breathing;
• gingivitis, caries and other foci of accumulation of pathogens in the oral cavity;
• recently transferred scarlet fever, measles, the presence of tuberculosis and other infections at the current time;
• hereditary predisposition;
• monotonous or insufficient nutrition, lack of minerals and vitamins in the diet;
• low fluid intake;
• prolonged hypothermia, frequent and sharp drops ambient temperature;
• depression, mental exhaustion, pronounced psycho-emotional overstrain;
• gas content, presence harmful substances in the air;
• alcohol abuse, smoking.

There are the following types of chronic tonsillitis, depending on general reaction organism, the frequency of exacerbations and the nature of the course of the disease:

• toxic-allergic;
• simple recurrent, with frequent acute tonsillitis;
• simple protracted, with a constant sluggish inflammatory process;
• simple compensated, with rare relapses and long periods of remission.

Toxic-allergic tonsillitis has two varieties. Against the background of the first in the patient, functional disorders of organs and systems are not observed. At the same time, allergization and intoxication of the body increase, manifested by pain in the joints and in the region of the heart, increased fatigue and hyperthermia. Against the background of the second, violations of cardiac activity, inflammatory processes in the liver, kidneys, organs of the genitourinary system and joints are revealed.

Common signs of a chronic course of the disease are:

• frequent exacerbations of tonsillitis during hypothermia, starvation, overwork, bacterial or viral infection(for example, with a simple form - from 3 to 5 times a year);
• feeling foreign body and pain when swallowing;
• dryness of the mucous membrane of the pharynx;
• periodic, and in the toxic-allergic form of the second type - a constant increase in body temperature up to 37.5 ° C;
• bad breath;
• soreness and an increase in the size of the mandibular lymph nodes;
• decreased body resistance, headache, general fatigue;
• lacunar plugs, thickening, hyperemia and swelling of the tonsils and palatine arches.

Tonsillitis as a disease is more typical for the childhood period, although it is often observed in adults, differing in the predominance of local symptoms above common features illness. Chronic tonsillar symptom in adulthood is most often the result of self-treatment of angina or adenovirus infection at home.

Elderly patients have natural process a decrease in the total volume of lymphoid tissues and a decrease in the concentration of immunocompetent cells. Because of this, both acute and chronic forms of pathology proceed with erased symptoms. In the clinical picture, general intoxication of the body and prolonged hyperemia in the subfebrile range are often noted, and severe pain and febrile body temperature (37.1–38.0 °C), on the contrary, are extremely rare.

Chronic inflammation is dangerous because there is always a source of infection in the body, which contributes to the occurrence of severe disorders in the work of various organs and systems. Often, patients develop the consequences of a rheumatic nature - inflammatory lesions of the skin of the rheumatic type, rheumatic fever with damage to the nervous system, rheumatic arthritis, rheumatic heart disease. Factors contributing to the appearance of rheumatism include:

• the effect of toxins released by pathogenic microorganisms on the heart tissue;
• similarity of antigens human body those that are secreted by some strains of streptococci.

Diagnosis of chronic tonsillitis

To make a diagnosis, the otolaryngologist pays attention to local and systemic symptoms, collects an anamnesis, analyzes the patient's complaints and general clinical picture diseases. Since objective and subjective manifestations of pathology are not always detected simultaneously, both the cumulative assessment of all symptoms and the clinical significance of each of them are important. If necessary, a photo of the throat is taken to confirm the diagnosis and control therapy.

The diagnosis carried out during an exacerbation is unreliable, since in this state all complaints and signs will indicate the severity of the process, and not its chronic course. The most reliable signs of chronic tonsillitis include purulent content in the crypts of the tonsils and anamnesis data indicating frequent tonsillitis.

How to treat chronic tonsillitis

With an exacerbation of the disease, an acute process develops - tonsillitis, which is accompanied by such manifestations as:

• severe swelling and redness of both the tonsils and palatine arches;
• a sharp increase in body temperature;
• general intoxication of the body - weakness, nausea, fever, headache, aching joints and muscles.

Patients also complain that they constantly have a sore throat. Treatment of chronic tonsillitis during exacerbation may vary depending on individual characteristics patient and the cause of the pathology. In this regard, in order to differential diagnosis and the appointment of a course of therapy, consultation with an ENT is necessary. During the period of subsiding inflammation, the doctor may recommend hardening the body, regular physical exercise and proper nutrition.

Made up of lymphoid tissue, the palatine tonsils are part of the body's overall immune system. Their main function is to protect against infectious agents that enter the throat.

How to cure chronic tonsillitis once and for all? For this, conservative and surgical methods. The goals of the treatment are:

• reduction or elimination of exacerbations;
• reduction or elimination of pharyngoscope signs;
• reduction or disappearance of toxic-allergic manifestations of the disease.

The form of pathology directly affects the tactics of treatment. So, with a simple form, conservative methods and physiotherapy can be used. The course lasts for 10 days and is repeated 2-3 times a year. If this technique is ineffective, they resort to the standard treatment for the disease - tonsillectomy.

In cases of toxic-allergic form of the first type, 1-2 courses are carried out conservative treatment. In the absence of a pronounced positive effect, the tonsils are removed. In the second type of this form of pathology, only surgical intervention is used.

Conservative treatment

Conservative therapy should be comprehensive and include restorative treatment and methods of local action on the tonsils.

Almost all patients are advised to wash the tonsils. The procedure is carried out by alternately introducing a special thin cannula through each gap into the crypt. It is connected to a syringe and passes under pressure antiseptic solution, washing out the contents of the gaps. Antibiotics for this purpose are not recommended, since greater effectiveness is not achieved from their use, but the development of various side effects. Usually 2-3 upper crypts are washed, but since they are connected with other crypts by their branches, many of them are drained and cleaned. In total, 10–15 procedures are carried out after 1 day, and after each of them, the surface of the tonsils is lubricated with a solution of Iodinol, Lugol or Collargol 5%.

Rinsing the mucous membrane of the pharynx or inhalation with antiseptics, squeezing out the contents of lacunae by means of a hook or suction is not desirable and is usually not practiced, since these methods are ineffective and traumatic.

• ultraviolet irradiation: has an antimicrobial effect, stimulates local and general immunological processes, increases the barrier function and resistance of the tonsils. It is carried out by means of a special tube, it affects both the region of regional lymph nodes and directly on the tonsils. On average, patients are prescribed from 10 to 15 sessions;
• UHF therapy: through the effect on the lymph nodes and tonsils, it expands small blood vessels and provides a rush of blood to the site of inflammation. For the procedure, ultrasonic aerosols are used, which are directed to precipitate drugs on the mucous membrane of the tonsils (Gumizol, Hydrocortisone, Dioxidine 1% solution, Lysozyme). Carry out from 8 to 12 procedures lasting 10-15 minutes every other day;
• ozokerite and therapeutic mud in the form of applications: they have a hyposensitizing and anti-inflammatory effect. The materials are heated to 42–45 °C and applied externally for 15 minutes. The recommended course varies from 10 to 12 sessions.

It should be borne in mind that the appointment of physiotherapy is contraindicated in pregnancy, angina pectoris, decompensation of the cardiovascular system and oncological diseases.

The complex of conservative treatment also includes drug therapy. It is recommended to take drugs that increase the body's resistance, namely:

• immunostimulants (Ribomunil, Imudon, IRS-19);
• vitamins B, C, E, K;
• biostimulants (Apilak);
• immunocorrectors (Derinat, Polyoxidonium).

Surgical intervention

With the ineffectiveness of conservative methods of treatment, the presence of serious complications from the internal organs or the transition of the disease to a decompensated form, the palatine tonsils are completely removed along with the capsule adjacent to them.

However, not in all cases it is possible to perform tonsillectomy due to a number of contraindications, which include:

• pulmonary tuberculosis in active form;
• diseases hematopoietic system accompanied by hemorrhagic diathesis, including hemophilia;
• chronic kidney disease with severe renal failure;
• severe degree diabetes, in the presence of ketonuria;
• heart disease with symptoms of severe heart failure II-III degree.

Temporary contraindications to surgery are acute inflammatory diseases, including tonsillitis, the presence of carious teeth, the period of menstruation and the last weeks of pregnancy.

The operation is performed under local anesthesia with possible use if necessary, intubation anesthesia. The patient is in a sitting position with the head thrown back. Removal can be performed by laser, cryodestruction or through excision. How to carry out a tonsillectomy is determined by the surgeon on an individual basis.

During the day after the intervention, patients are not recommended to talk, drink or eat. For the next 5-6 days, warm liquid food is preferable. Bed rest is only necessary for the first 48 hours.

Since the functions of the tonsils are associated with immune protection organism, after their removal, the mechanism of protection of the respiratory tract from infections is weakened. In most cases, the immune system functions normally without them, but it takes some time to rebuild.

It should be borne in mind that the appointment of physiotherapy is contraindicated in pregnancy, angina pectoris, decompensation of the cardiovascular system and oncological diseases.

According to reviews, the operation is not painful, and only in rare cases there are complications after it. Among them, they mainly indicate bleeding, temporary pain and discomfort in the throat, slight increase body temperature (up to 37.2 ºC) for up to several weeks. If bleeding occurs, as well as an increase in body temperature to 38–39 ºC, it is recommended to consult a doctor, as this may indicate the development of an infectious process.

Chronic tonsillitis is a serious disease that requires timely treatment to the ENT and fulfillment of all its clinical recommendations.

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AT anatomical characteristics In the human body, seven places of accumulation of lymphoid tissue can be distinguished. One of them is the peripharyngeal ring with the tonsils located here - a paired organ, located on both sides of the oropharynx. Functionally, the tonsils are a rather significant organ - they perform two functions: protective and hematopoietic.

Why does a person need tonsils

Lymphoid tissue mainly consists of special cells - macrophages and lymphocytes, located in a cellular fibrous basis. Accumulations of this tissue (which include the tonsils) that are in the way lymphatic vessels, filter lymph for harmful substances, including infectious agents. When they encounter bacteria and viruses, they increase in size, become inflamed and, accordingly, can cause corresponding changes throughout the body. Besides, in lymph nodes there is the formation of immune cells that provide the proper level of self-defense of the body from pathogenic agents.

Inflammation of the tonsils etiologically can be due to endogenous and exogenous ways:

1. microbes enter the tonsils internal environment organism (for example, foci are carious teeth, acute otitis media, rhinitis, conjunctivitis);
2. pathogenic microorganisms and viruses enter the oral cavity with inhaled air, encountering the first obstacle on their way - the pharyngeal tonsils.

With the deposition of pathogens on the epithelium of the tonsils and their vital activity, the lymphoid tissue begins to be replaced by connective tissue. The resulting lacunae are the first stage of acute tonsillitis - lacunar tonsillitis. Later, scarring of lacunae and the formation of purulent follicles occur - follicular tonsillitis, which subsequently ends with the formation of plugs of pus, as if glued together by cells of dead epithelium.

All these stages are accompanied by the development clinical symptoms tonsillitis in adults and general intoxication of the body. Observed:

• soreness and discomfort in the throat;
• bad breath;
• an increase in body temperature (initially to subfebrile numbers, later - higher);
• malaise;
• first tenderness in the joints, then pain in them;
• headache;
• periodic chills;
• caseous plugs or characteristic plaque on the tonsils;
• changes in clinical analyzes blood (increased ESR and leukocytosis) and urine (the appearance of traces of protein);
• cardiopalmus;
• ear discomfort, etc.

Possible microbial landscape of tonsillitis

Most often inflammation of the tonsils can be caused by hemolytic streptococcus, staphylococcus, incl. golden, pneumococcus, Pseudomonas aeruginosa. Less often, diseases develop from the ingress of viruses (adenoviruses, rotaviruses, cytomegalovirus, virus herpes simplex) and pathogenic fungi.

Knowing the etiology of the disease will allow the doctor to prescribe targeted treatment. So, having the fact of the bacterial nature of the disease, it is enough to determine the sensitivity of the microbe to antibiotics and use the most effective of them. It is more difficult with viruses and fungi: antibiotics do not have a detrimental effect on them. In such cases, antiviral and antifungal treatment is provided.

Approaches to the treatment of tonsillitis in adults

Lack of timely and full treatment tonsillitis can lead not only to the transition of the disease to a chronic form, but also to the formation of complications of a rather serious nature, such as:

• rheumatic heart disease, endocarditis;
• inflammation of the joints;
• glomerulonephritis and cystitis;
• other systemic diseases.

Therefore, the treatment of tonsillitis in adults should be aimed at the destruction of pathogens, reducing negative impact products of their vital activity and decay (toxins), therapy of symptoms and manifestations of the disease.

First of all, the patient is prescribed bed rest and heavy drinking (intended for the fastest flushing of toxins from the body). It should be noted that drinking, like food, should be at a warm physiological temperature ( hot food, as well as too cold, promotes irritation of epithelial cells and the appearance nonspecific inflammation). As a drink, carbonated drinks and juices rich in acids should not be used.

Food should be complete in terms of a balanced content of proteins, fats and carbohydrates, as well as prepared by the most simple ways(steamed, by simple boiling, stewing, etc.).

The main component of treatment bacterial sore throats is an antibiotic. If it is possible to determine the sensitivity of the isolated microorganism to antibacterial drugs, it is necessary to use this particular drug, if not, broad-spectrum drugs are prescribed.

The dose and frequency of use of the drug will be determined by the doctor. The main thing is to strictly observe it throughout the treatment, so that the body does not have a “dormant” focus of infection.
The next component of the treatment is local rinsing, ie. mechanical rinsing of the pathogen, pus and dead epithelial cells. For rinsing, you can use:

• furacillin;
• decoctions of herbs (chamomile, St. John's wort, calamus root, calendula, sage);
• potassium permanganate,
• boric acid solution
• gramicidin,
• bicarbonate and sodium chloride.

In addition, lubrication of the tonsils with antiseptics (Lugol's solution, chlorophyllipt) is shown.

To prevent allergic reaction body, it is advisable to supplement therapy antihistamines such as suprastin and tavegillus.

Appointment of auxiliary medicines based on accompanying symptoms. Usually assigned:

1. drugs that have anti-inflammatory, antimicrobial, as well as wound-healing effects (proposol),
2. preparations with a bacteriostatic effect (faringosept, bioparox),
3. anti-inflammatory, immunomodulating agents (tonsilotren),
4. non-steroidal anti-inflammatory drugs local application(aqualor, strepfen).

You can not do without drugs that strengthen the body's defenses and stimulate the immune system (simple multivitamins, vitamin C, vitamin B).

Physiotherapy treatments such as:

• applications,
• magnetotherapy,
• electrophoresis,
• mud treatment and others.

Somatic treatment of tonsillitis is not the only one. In some situations, shown surgical path- removal of the tonsils. modern medicine in addition, offers painless laser removal damaged surface of the tonsils.

Surgical treatment is indicated for:

1. frequent sore throats (more than four times a year);
2. the development of serious complications from the heart, joints, urinary system;
3. accumulation of pus in the tonsils without signs of an inflammatory process.

Folk remedies for the treatment of tonsillitis

Nature is so wise that it enables a person to cure a number of diseases without harm to other organs and systems. For this you can use homeopathic preparations, as well as herbs, vegetables, honey, bee therapy. Among the proven positive side the following treatments for tonsillitis:

1. gargling with beetroot decoction;
2. the use of propolis oil an hour before meals for 14 days;
3. a few drops alcohol tincture propolis in tea with honey and lemon;
4. steam bath for the respiratory system, composed of sage, dill, lime blossom, plantain;
5. antibacterial and anti-inflammatory herbal tea, consisting of St. John's wort and thyme, calamus and peony roots, calendula and chamomile flowers, coltsfoot, eucalyptus leaves;
6. garlic drops to strengthen the immune system;
7. use according to the scheme of infusion of cloves (5 cloves per 300 ml of boiling water);
8. myrtle decoction for rinsing and myrtle tincture - for ingestion;
9. tincture fresh fruit maclura;
10. sea ​​buckthorn fruits for chewing before going to bed.

In addition, purified kerosene is very effective for lubricating inflamed tonsils.

How to prevent tonsillitis

Prevention of tonsillitis is reduced primarily to hardening the body and strengthening its defenses. Hardening must be carried out in healthy condition, ranging from local dousing of the legs and ending with general contrast showers.

The tempering procedures also include aerotherapy, heliotherapy, walking barefoot, wiping, physical exercises.

You can strengthen and develop defenses with the help of immune-strengthening special preparations and a host of other ways:

• protein rich food,
• vitamins and microelements;
• healthy lifestyle;
• full sleep;
• adequate exposure to fresh air.

Of great importance timely treatment inflammatory diseases of the nasopharynx and eyes. Untimely rehabilitation of such foci leads to a constant threat of the development of tonsillitis and their serious complications.