All you need to know about tonsillitis

Written by: Mr Nick Hamilton
Published: | Updated: 27/04/2023
Edited by: Sophie Kennedy

Along with the well-known symptoms of a sore throat and pain on swallowingtonsillitis can also cause tiredness, a loss of appetite and fever. In this informative article, highly respected consultant ENT surgeon Mr Nick Hamilton shares his expert insight on the signs and symptoms of tonsillitis as well as its causes. The leading specialist also details how tonsillitis is commonly treated and when a referral to an ENT specialist is necessary.



What is tonsillitis?

Tonsillitis describes inflammation of the tonsils. The tonsils are fleshy glands that sit on the left and the right side of the throat. In many adults, the tonsils are not visible when looking through the mouth. Tonsillitis typically involves the tonsils becoming swollen and a white coating can develop on the tonsil surface.


It is important to separate tonsillitis from pharyngitisPharyngitis describes inflammation of the throat and occurs without tonsil swelling.



Tonsillitis is well known to affect children. Can it affect adults too?

Tonsillitis can affect both children and adults although it is more common in children. Recurrent sore throat, requiring a GP appointment, is believed to affect one in every ten people within the UK each year.



What are the symptoms of tonsillitis?

Tonsillitis causes several symptoms. The most common symptom of tonsillitis is soreness in the throat associated with a feeling of swelling that can cause pain when swallowingFevers can also occur and the glands in the neck can become swollen. Tonsillitis can also cause tirednesssnoring and a loss of appetite.



What are the causes of tonsillitis?

Seventy per cent of all cases of tonsillitis are believed to be caused by viruses. A small number of viral tonsillitis cases are caused by Epstein Barr virus that leads to glandular fever. In the remaining cases, the majority are caused by a bacteria called streptococcus. The symptoms with simple viral tonsillitis are usually milder than the symptoms with glandular fever or bacterial tonsillitis.



How is tonsillitis treated?

The treatment of tonsillitis depends on the severity of the symptoms and the individual’s health status. In healthy people with mild symptoms, tonsillitis is likely to settle within one week with simple measures such as rest, hydration and paracetamol medication.


In patients with more severe or prolonged tonsillitis symptoms, a doctor should assess and decide on the need for antibiotics. Antibiotics such as penicillin are usually effective to treat most cases of bacterial tonsillitis. Antibiotics are also used in those with underlying health conditions that put them at risk of a severe infection.


In a small subset of those with tonsillitis, oral antibiotics fail to effectively treat the infection. These patients are usually referred to an ENT specialist for assessment and consideration of stronger intravenous antibiotics. Some individuals suffer from recurrent episodes of tonsillitis that can result in them needing lots of time off work or away from education. These patients are often referred to an ENT specialist for consideration of a tonsillectomyTonsillectomies removes the tonsils with surgery to prevent episodes of tonsillitis from recurring.




If you are concerned about recurrent tonsillitis and wish to schedule a consultation with Mr Hamilton, you can do so by visiting his Top Doctors profile.

By Mr Nick Hamilton
Otolaryngology / ENT

Mr Nick Hamilton is a respected consultant ENT surgeon and laryngologist who specialises in all aspects of ENT and has a sub-specialist interest in voice, swallow and airway disorders. His private practice is at The Harley Street ENT Clinic, OneWelbeck ENT, Highgate Hospital, and The London Clinic. His NHS base is the Royal National Ear Nose & Throat Hospital which is part of University College London Hospitals NHS Foundation Trust.

Mr Hamilton, became a consultant at UCLH in 2022 and is expertly qualified. His primary medical qualification is from the University of Manchester and he also holds a first-class bachelor of science degree from University College London (UCL). His specialist training in ENT was based within the North Thames Deanery where he worked at the Royal National Throat & Ear, Royal Free and University College London Hospitals. He gained expertise in all areas of ENT and laryngology, and completed his training in 2021.

After completing specialist training, Mr Hamilton undertook a fellowship in Laryngeal Surgery at Massachusetts General Hospital in the USA and was a Research Associate at Harvard University. Mr Hamilton is also a Fellow of the Royal College of Surgeons.

Alongside Mr Hamilton's exceptional clinical practise and educational achievements, he has significant clinical research and teaching experience. He has a PhD in Regenerative Medicine from UCL, has published over 40 peer-reviewed research papers and has won a number of national awards for his research. He is an Associate Professor at UCL and his current research is focused on developing new treatments for the effects of ageing and fibrosis on the vocal cords. He is also interested in the long-term effects of COVID-19 within the throat as well as developing new treatment pathways for common throat conditions.

He is a member of various professional organisations including the Royal College of Surgeons of England (RCS Eng), ENT UK and the British Laryngological Association (BLA). He is also a member of the Royal Society of Medicine (RSM).

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