Do you suspect you have tonsillitis and are wondering how to recognize it and what you can do about it? Here you can find out what types of tonsillitis there are, how they are diagnosed and treated, and what you should eat when your throat is burning up!

Tonsillitis is the term used when the tonsils are inflamed. In most cases, tonsillitis can be treated with medication, but if the tonsils become inflamed frequently, the doctor will consider removing the tonsils.

There are three different types of tonsillitis:

Acute viral tonsillitis

This tonsillitis is usually caused by known viruses that are also responsible for the common cold. In addition to adenoviruses and coronaviruses (not Covid-19), however, rarer viral infections can also inflame the tonsils. These include

• Hepatitis A (the most harmless form of hepatitis)
• HIV
• Rhinovirus

Acute bacterial tonsillitis

In rare cases (mostly in children), tonsillitis can also be caused by bacteria. In most cases, it is streptococcus bacteria that cause a sore throat. This type of tonsillitis is usually easily treatable with antibiotics.

Chronic tonsillitis

If a person is affected by acute tonsillitis several times a year, this is known as chronic tonsillitis. Particularly in the case of frequent inflammation at short intervals, treatment with antibiotics is not recommended. In most cases, the only sensible treatment is removal of the tonsils (medical tonsillectomy)

Symptoms of acute bacterial inflammation

The typical sign of bacterial tonsillitis is pus-filled tonsils. In the mirror you can recognize these deposits as white or slightly yellowish spots. In many cases, it is difficult to tell whether the tonsillitis is viral or bacterial. If you are 15 years or older, the doctor will use a scoring system to assess how likely it is that your tonsillitis is caused by a streptococcal infection. If the following four criteria apply, it is approximately 55 percent strep throat:

• No cough
• Swollen, tender, painful lymph nodes in the throat area
• Enlarged tonsils with plaque
• Fever of 38+ degrees¹

If only three symptoms are present, approximately one third of cases are bacterial tonsillitis due to streptococci. This assessment only provides information about the probability of the cause, but cannot be used to clearly diagnose the type of tonsillitis. In order to clearly determine whether streptococci are involved in the inflammation, your tonsil swab must be analyzed in the laboratory.

Viral, acute tonsillitis

Since viral tonsillitis is caused by various types of cold viruses, many people with tonsillitis are affected by a cold at the same time. Therefore, most patients with viral tonsillitis also have the following symptoms:

• Cough
• headache
• aching limbs
• Cold or blocked nose

Chronic tonsillitis

In chronic tonsillitis, the typical irritating symptoms of acute tonsillitis usually occur, although the intensity of these symptoms varies greatly. In addition, people with chronic tonsillitis are often also affected by the following symptoms:

• Difficulty swallowing (dysphagia)
• Swollen lymph nodes in the throat area that never subside
• Sore throat
• Foreign taste in the mouth
• bad breath

Chronic inflammation of the tonsils can also lead to the formation of tonsil stones, where materials such as dead cells, saliva and food accumulate in the crevices of the swollen tonsils. Eventually, the debris can harden into small stones. These may dissolve on their own, or they may need to be removed by a doctor. People with tonsil stones often also suffer from bad breath²

Tonsillitis is not normally a serious illness. You should only see your family doctor if one of the following situations applies:

• The symptoms last longer than four days and there are no signs of improvement in sight
• The symptoms are so severe that they affect your quality of life, e.g. if you no longer want to eat or drink because of the pain.

In rare cases, bacterial infections can spread to other parts of the body, which can lead to complications. If there are signs of these complications, it is also advisable to consult your family doctor or an ENT specialist:

• obstructive sleep apnea - where the walls of the throat relax during sleep, causing breathing difficulties and poor sleep
• middle ear infection - the fluid between the eardrum and the inner ear becomes infected by bacteria.
• Peritonsillar abscess - an abscess (collection of pus) that develops between one of the tonsils and the wall of the throat³

What does the doctor do?

The GP will examine your throat and ask you about your symptoms. They may take a swab of your throat and send it to a laboratory for analysis to confirm their suspicions.

Since tonsillitis can be a symptom of other diseases as well as a disease, the doctor should check the likelihood of one of the following diseases, among others:

• Glandular fever
• scarlet fever
• angina
• Gonorrhea
• Syphilis
• Thrush

For example, if you have severe tonsillitis, the family doctor may order a blood test to rule out glandular fever.4

Antibiotics for acute bacterial tonsillitis

If the analysis of your throat swab clearly indicates that your tonsillitis is of bacterial origin, the doctor will usually prescribe a short course of antibiotics first. If the oral antibiotics are not effective, you may be given an intravenous antibiotic in hospital.

In the case of acute viral tonsillitis, the only thing that helps is to wait and see

Curative treatment of viral tonsillitis is of course not possible with antibiotics. In the case of viral tonsillitis, you should simply wait and let your body rest and take measures to alleviate the symptoms as best you can.

Tonsillectomy for chronic tonsillitis

Most tonsillitis only lasts a week. However, if the tonsillitis is chronic, removal of the tonsils is the only treatment option. This should only be carried out if you suffer from tonsillitis frequently and it affects your everyday quality of life.

Relieve the symptoms of tonsillitis (acute, viral or chronic)

Ibuprofen, acetaminophen or paracetamol are sometimes prescribed as symptomatic treatment. They have an anti-inflammatory and pain-relieving effect, but cannot combat the cause of the inflammation.

How to combat the symptoms at home:

You can try the following symptomatic treatment methods at home to relieve your sore throat. They are not always effective, but definitely worth a try:

• Drink plenty of fluids
• Get plenty of rest
• Gargle with warm salt water several times a day
• Suck on sage lozenges or other sore throat tablets
• Eat cold or frozen food that is easy to swallow
• Increase the humidity in your bedroom with a humidifier
• Do not smoke

During tonsillitis or after a tonsillectomy, you usually suffer from a severe sore throat, which can sometimes severely affect your mood and appetite for food. Swallowing is simply too painful to be able to enjoy solid food. When choosing food, you should pay particular attention to the consistency, temperature and nutritional content.

Ice cream for tonsillitis - an unhealthy tradition

Many parents comfort their recently operated children with several scoops of ice cream. Even if this temporarily relieves the pain (for a few minutes!), it is not advisable. Most types of ice cream consist mainly of milk and sugar. There is ample evidence that consuming large amounts of sugar has an inflammatory effect on the body and even inhibits the anti-inflammatory properties of other nutrients.5⁶

Cow's milk itself consists largely of saturated fatty acids. The effect of saturated fatty acids on the human body is partly controversial. However, they can exacerbate existing inflammation (and this includes tonsillitis or an irritated throat following a tonsillectomy) by increasing the absorption of inflammatory molecules.7 In addition, the processed carbohydrates in the ice cream cone are also pro-inflammatory⁸

If you still want to offer yourself or your kids cooling comfort food, you can try a 100% fruit sorbet.

Gentle nutrition for tonsillitis with drinkable meals

With tonsillitis or after a tonsillectomy, eating can be painful. During this time, drinking meals from Saturo can offer a valuable alternative. They are gentle on an irritated throat while providing all the necessary nutrients the body needs for a speedy recovery. These easily digestible, nutritious drinks provide you with energy without irritating the pain-sensitive area. In addition, the cool and smooth consistency of the drinkable meals can provide pleasant relief and help to ensure that eating is not only possible but also pleasant.