In Russia, more than 5 million people are diagnosed with chronic tonsillitis annually. The ICD-10th revision code for this pathology is J 35.0. The disease affects the tonsils, which act as a barrier to bacteria and viruses. They are also responsible for immunity. Lack of treatment can lead to severe complications of the cardiovascular system, kidneys and other organs.
Compensated Tonsillitis
Angina, diphtheria, measles, various viral attacks or other infectious diseases can provoke inflammation of the palatine and pharyngeal tonsils, or acute tonsillitis. Pathology requires timely and competent treatment. Otherwise, the disease can take a chronic form. Most often, pathology occurs in children, but adults are not immune from it.
Chronic tonsillitis (ICD-10 code above) has two forms:
- Compensated. This stage may be asymptomatic. Tonsils are still able to protect the body by producing antibodies. From time to time, exacerbations with symptoms of a sore throat can happen, but fade out pretty quickly. In some patients, from the side of the body there is no visible reaction at all.
- Decompensated. This stage is not able to develop, bypassing the compensated. In this case, the tonsils are so affected that they are not able to protect the body. Moreover, they themselves become a source of toxins and infections. This stage poses a real threat to human life, as it can cause the development of rheumatism, renal failure, myocarditis, arthrosis, pyelonephritis. In addition, tonsillitis can provoke a disease such as ozena. It is difficult to treat and significantly affects the quality of life of the patient.
Compensated form of chronic tonsillitis occurs in 10% of the adult population. Its main danger is that it can be asymptomatic. The accumulation of bacteria, viruses and fungi in the gaps occurs gradually. At the same time, toxins enter the bloodstream and quietly poison the body. When a person finally turns to a doctor, the disease may already be in a decompensated form. Most often in this case, surgical intervention is already necessary.
Causes of the disease
The lymphoid tissue that the tonsils are made of is part of the body’s immune system. Its main function is the fight against infection, which penetrates the human throat. In the event that the body is weakened, it is incapable of producing enough lymphocytes and interferons. Pathogenic pathogens win and the inflammatory process begins to develop.
The compensated form of chronic tonsillitis is characterized by the fact that immunity still inhibits the infection, but is not able to defeat it completely. Any weakening of the body, even a slight hypothermia, provokes an exacerbation of the disease.
In most cases, the pathology develops after an acute inflammatory process. The main causes of chronic tonsillitis of a compensated form include:
- sinusitis and sinusitis;
- depression, psychoemotional stress;
- gingivitis, caries;
- adverse living conditions;
- pathology of the structure of the nasal passages;
- tuberculous processes;
- measles, scarlet fever;
- improper nutrition (abuse of sweet and flour dishes, fast food, sugary drinks, lack of minerals and vitamins);
- prolonged hypothermia;
- bad habits (alcohol use, smoking);
- heredity.
The compensated form of chronic tonsillitis can persist in a patient for years. Gradually, without adequate treatment, the lymphoid tissue begins to be replaced by connective tissue. This leads to a narrowing of the gaps and the accumulation in them of food debris, dead white blood cells and bacteria, toxins. Part of this purulent contents enters the bloodstream and poisons the body.
Symptoms
An increase in body temperature or acute sore throat is not characteristic of a chronic form of the disease. Most often, there is a deterioration in well-being in general, and the patient can attribute this to ordinary fatigue. The disease provokes poisoning of the body, so the symptoms of chronic tonsillitis in a compensated form can be as follows:
- Frequent headaches.
- Pustular rashes on the skin of the back and face.
- Low-grade fever.
- Joint aches.
- Sore throat.
- Unstable work of the heart.
- Bad breath.
- Sweating.
- Enlarged lymph nodes of the lower jaw.
With an independent examination of the throat, you can notice that the tonsils are enlarged and covered with a light coating. Sometimes you can notice purulent plugs that look like grains of millet. In the case of an exacerbation of the disease, the symptoms may vary, depending on the individual characteristics of the patient's body.
Drug therapy
Only a doctor can draw up a scheme for the effective treatment of chronic tonsillitis in a compensated form. Antibacterial therapy can be prescribed only according to the results of analyzes after determining the sensitivity of the flora. And also depending on the severity of the disease. Antibiotics must be taken in conjunction with probiotic drugs.
At the same time, a course of taking immunostimulants is prescribed. For the treatment of the compensated form of chronic tonsillitis, the drug "Imudon" is most often used. This tool, one of the few that can stimulate local immunity at the level of lymphoid tissue of the tonsils. The minimum course of admission is 10 days.
Desensitizing therapy is mandatory. It is necessary in order to relieve swelling, which complicates the absorption of the drugs used. The antiseptic approach is widely used: rinse solutions, sprays and aerosols. In addition to drug therapy, it is recommended to use homeopathic medicines.
The disease is supported by the bacterial flora, so the treatment will be much more effective if you can evacuate it from the gaps. This can only be done by washing the tonsils. Mechanical removal of bacteria in combination with drug therapy significantly increases the chances of success.
Features of washing tonsils
Patients who first came to the otolaryngologist for procedures are interested in how to wash the tonsils and whether it hurts. This is especially important for babies. Despite the formidable appearance of the syringe, the procedure is completely painless. With a special curved and blunt needle, the doctor will wash every gap, removing the plugs from it under the pressure of the liquid.
For the procedure, saline is most often used. This allows the doctor to see what he removes from the gaps. Sometimes saline is replaced with special medicines. For example, a polyvalent pyobacteriophage.
Washing with a syringe has some disadvantages:
- the pressure of the stream may drive some plugs deeper, instead of washing them;
- possibly injured tonsils;
- the volume of the needle does not allow to wash small gaps.
Many otolaryngology clinics use the Tonsillor apparatus or a special vacuum suction. Most often, local anesthesia is needed. The use of these devices is not suitable for patients with severe gag reflex.
After washing, peeled tonsils are treated with Lugol's solution. Then, a laser and vibro-acoustic impact session is performed. As well as ultraviolet irradiation of the surface of the tonsils.
The course consists of 10 sessions. Depending on the condition of the patient, such treatment should be taken from 2 to 4 times a year.
Therapeutic filling of gaps
Therapeutic filling is the introduction of special pastes into the gaps that destroy the pathogenic microflora. The course of treatment can be from 10 to 20 sessions. The procedure is painless, even children can stand it. Full recovery occurs in 95% of cases.
The choice of paste is carried out by the doctor. Propolis-wax gives a good result. The cure after its use may occur after 7 procedures that are performed once a week. The use of propolis-Kalanchoy paste, in a ratio of 1 to 2, also shows good results. It is used 2 times a week. The course can be from 4 to 7 procedures.
ethnoscience
Treatment of compensating chronic tonsillitis at home can be used after consulting a doctor. The use of folk remedies helps to reduce inflammation and avoid exacerbations. For rinsing, you can use:
- decoctions of medicinal herbs (chamomile, eucalyptus, sage, St. John's wort, alley root, mint leaves);
- tincture of calendula;
- a solution of salt and soda with iodine;
- propolis tincture.
Children under 7 years old are allowed to use only saline solutions for rinsing. Procedures are recommended to be performed at least 2 times a day. Adults, after rinsing, tonsils, it is recommended to lubricate with fir oil or aloe juice with honey. It is also useful to dissolve pure propolis.
At home, inhalation is recommended. For the procedure, herbal decoctions with the addition of essential oils are used. Steam must be inhaled through the mouth and exhaled through the nose.
Surgery
Most otolaryngologists try to do without surgical intervention. Tonsils are an important part of the body’s immune system. In a compensated form of chronic tonsillitis, they can still perform their functions.
Removal of tonsils is prescribed only if they themselves have become a source of infection. And also bear a real threat to the life and health of the patient. For example, the heart, joints, or kidneys are affected. In this case, the doctor may suggest:
- electrocoagulation;
- use of a carbon dioxide or infrared laser;
- radiofrequency ablation;
- ultrasonic scalpel;
- classic removal method;
- cold plasma surgery.
Prevention
The main method of prevention of tonsillitis is to strengthen the immune system. It is recommended to regularly perform tempering procedures, avoid hypothermia and eat right. And also take vitamin supplements.
It is important to ensure that the nasal mucosa does not dry out. Only in this case will she fully carry out her work and protect the body from viruses and bacteria. Therefore, it is recommended to use a humidifier at home and at work.
With frequent rhinitis, it is useful to rinse the nasal mucosa with saline solutions. During an influenza epidemic, take immunostimulating drugs, such as interferon. If possible, minimize all contact with carriers of infection.