Very often parents complain that the child is literally "tortured" by frequent tonsillitis. I ate a cold one - my throat turned red and sore, I shouted a little on the street - the result is the same, and if I caught a cold and fell ill, then these smiptomas appear without fail. Yevgeny Komarovsky, a well-known pediatrician and author of books on children's health, claims that such a thing as "frequent tonsillitis" practically does not exist, in any case, such an attack is extremely rare. And what moms and dads usually describe when they come to an appointment or write letters, is called “chronic tonsillitis”.
What it is?
Angina, although it bears the official medical name "tonsillitis", differs from chronic tonsillitis. Angina always has an acute course, and chronic tonsillitis is the result of a prolonged inflammatory process that develops on the palatine and pharyngeal tonsils. This ailment can be the result of not only the transferred sore throat, but also scarlet fever, measles, diphtheria. Sometimes chronic tonsillitis develops on its own, without prior acute illness.
The disease itself is simple and complicated.
If a child often just has a sore or a sore throat, difficulty swallowing, then we are talking about a simple form. If a regular concomitant enlargement of lymph nodes in the neck and under the jaw, fever, pathology of some internal organs, for example, the heart, ear, nasal sinuses, are added to the sore throat when swallowing, then we can talk about a complicated form - toxic-allergic.
Various pathogens are capable of causing the disease:
- bacteria (pneumococci, moraxella, streptococci, staphylococci, haemophilus influenzae);
- viruses (adenoviruses, Coxsackie virus, Epstein-Barr virus, herpes virus);
- fungi, chlamydia, mycoplasma.
The likelihood of developing the disease increases if the child has a constant source of infection in the body, such as: long-term inflammation in the oral cavity, caries, inflammation in the sinuses, frequent difficulty breathing. Often, chronic tonsillitis develops in children who are intoxicated, inhale strong allergens and chemicals. Breathing in dusty and gassed air also increases the likelihood of illness.
The state of immunity also plays a role - if it is strong enough, then the likelihood of developing chronic tonsillitis is lower. If the baby often suffers from respiratory viral diseases, the illness becomes more likely. Also, if a child sits on cold surfaces, overcooles, then he again falls into the risk group.
Exacerbations of chronic tonsillitis, according to Evgeny Komarovsky, occur when local immunity is weakened, when the child becomes ill with a viral infection and the protective properties of the mucous membranes are violated. If saliva is not enough, or it has a thick consistency, then its protective functions are violated, which means that pathogenic microbes and viruses can calmly do their "dirty work".
Symptoms
Parents and doctors can suspect chronic tonsillitis in a child not only by the frequency of complaints of a sore throat, but also by characteristic signs. Usually 2-3 symptoms from the list below are enough for such a diagnosis to be put on the baby's medical record:
- the palatine arches increase in size and thicken. In this state, they can be not only in a stage of exacerbation, when the throat really hurts, but also in a state of remission;
- adhesions appear between the tonsils and palatine arches. This will be easily noticed by any pediatrician who looks into the throat of a child;
- the tonsils themselves may have a loose appearance. The second option is scars on the tonsils;
- in the area of the tonsils, caseous purulent plugs may formthat look like white or yellowish-gray round spots, often filled with liquid pus;
- lymph nodes under the jaw and in the neck, on which the function of diverting lymph from the focus of inflammation lies, are enlarged and painful with slight pressure.
More than a hundred different diseases are known to medicine, which “owe” their appearance to chronic tonsillitis. These accompanying ailments have their own specific signs and symptoms. The "gifts" from the existing tonsillitis include nephritis, hyperthyroidism, psoriasis, eczema, scleroderma, systemic lupus erythematosus, rheumatism.
Treatment
Curing chronic tonsillitis is difficult, but possible. The main rule is that therapy should be systemic, consistent and persistent.
Most often, the child is shown conservative treatment. These include various rinses, irrigation of the tonsils. If a bacterium is the culprit for tonsillitis, antibiotics may be prescribed for the child. True, this should happen strictly after the tests for bacterial culture from a sore throat are ready. Only after learning which microbe is "guilty" of the disease, the doctor will be able to choose an antibacterial drug that will act on this particular pathogen.
Courses of treatment for the baby are prescribed twice a year, most often in spring and autumn. If he has complicated chronic tonsillitis, then up to 4 courses of therapy can be carried out per year.
Among antiseptics, doctors often recommend Lugol's solution. Evgeny Komarovsky urges parents to stop using this drug, since it is ineffective, like most other antiseptics for chronic tonsillitis. In addition, Lugol's solution can be extremely dangerous for a child's body, since iodine, which is contained in large quantities, can cause disorders in the function of the thyroid gland.
Evgeny Komarovsky claims that all the antiseptics with which the treatment of tonsils can be advised do not have any significant effect on the healing process. If the source of inflammation is found and it is bacterial, then antibiotics should be treated. If viruses are to blame for everything, then specific medication is not required.
In any case, parents should throw all their strength into strengthening local immunity, because there is no better medicine than their own saliva for a child with chronic tonsillitis. To prevent saliva from drying out, Komarovsky recommends:
- sanitize the oral cavityby visiting a dentist;
- follow the drinking regimen - a child with such a disease should drink a lot and often warm drinks;
- tidy up the microclimate in the apartment. Local immunity will work as it should, and saliva will not dry out if the baby does not breathe dry air and sleep in a room with three heaters and a tightly closed window. The best conditions are air temperature - 18-20 degrees, relative air humidity - 50-70%;
- walk more often in the fresh air, remove from the house all things that can accumulate dust and pollute the air - soft toys, carpets, books that are not stored behind tightly closed cabinet doors;
- do not use household chemicals containing chlorine.
Sometimes, fortunately, quite rarely, the child is shown surgical treatment. In case of severe growth of the palatine tonsils, they can be removed promptly. This procedure is called tonsillotomy or tonsilloectomy. During the operation, the surgeon completely or partially removes the affected tonsils, which are the source of infection.
Indications for surgery are few: serious complications from internal organs, complete cessation of the tonsils' protective functions. The operation does not belong to the category of difficult, the recovery period is quite fast. Forecasts after it are most often favorable.
Dr. Komarovsky will tell you more about the removal of tonsils in children with tonsillitis and the disease itself in the next video.
Prevention
Evgeny Komarovsky advises the parents of babies not to prohibit the child from eating cold food, drinking water from the refrigerator, since it is ice cream that is a tasty and useful medicine for increasing the local immunity of the larynx and tonsils. It is quite possible for them not only to pamper the child, but also to harden the throat. In children who drink warm all the time and eat pureed, chronic tonsillitis is much more common.
During a period of mass incidence of respiratory viral infections, it is worth protecting the child from visiting places where a large number of people gather, especially if the meetings are held in closed rooms. You should not take your child to large shopping centers at this time, or use public transport unless absolutely necessary, but walking in the park, away from the crowd, is welcome.
Viral infections, as soon as the child has contracted them, cannot be treated with antibiotics - this increases the likelihood of developing chronic tonsillitis, and if the baby has tonsillitis, it must be treated with a doctor, correctly, and not on the Internet according to the recipes of traditional healers.
The best prevention of chronic tonsillitis, which is easier to prevent than to cure, is to harden the child from a very early age, in compliance with the rules of a balanced and proper diet, rich in vitamins and microelements. Runny nose, even the most insignificant, should be treated quickly and correctly, and caries, stomatitis and any other inflammatory processes in the mouth should be eliminated as soon as possible.
