PHYSICIAN'S DIARY: Are you having a hard time swallowing food? Here’s why

Monday November 26 2018



Dr Lugano Wilson

Dr Lugano Wilson 

By Dr Lugano Wilson

One of the most common symptoms of enlarged tonsils is when a person/child experiences difficulty in swallowing food.

Most often than not, many Tanzanians would come with complains saying ‘Daktari, nina tonsil’ [Doctor, I have tonsils]. And that, they cannot enjoy their meals as it hurts whenever they try to swallow, including water.

Tonsils are two miniature-rounded masses of tissue that can be seen in the back of the throat, and they are said to cushion the body against infection during the first year of life.

But, the condition of inflammed, painful tonsils is what is knows as tonsillitis, a common diagnosis in the Ear Nose and Throat (ENT) departments across Tanzania.

From my own experience, it is a leading diagnosis and many surgeries, known as tonsillectomy, done in ENT theatres are due to tonsillitis.

Many people are at least aware of tonsillitis so they seek medical treatment in hospitals or buy over-the-counter medications.

But sometimes I think there is over diagnosis of tonsillitis and at times people are subjected to surgeries unnecessarily.

The challenge is that many fail to understand and distinguish between viral and bacterial tonsillitis; some are subjected to antibiotics unnecessarily.

It is important to note that there are few hospitals with fully fledged ENT services in the country.

Some clinicians do not adhere to indications set for surgical approach, hence many unnecessary surgeries for tonsillectomy/tonsillitis.

I will explain briefly about tonsillitis.

Tonsillitis is the inflammation of tonsils brought on by bacterial or viral infections whereby tonsils get swollen and red and you may see a yellow or whitish coating.

Tonsillitiss are said to occur mainly in children, however adults have tonsils too.

Thus symptoms of tonsils include sore throat, swollen tonsils, difficulty in swallowing, fever and swollen glands in the neck.

Causes

Majority of tonsillitis are due to viruses with only 15-30 per cent of cases caused by bacteria.

Tonsillitis is contagious if caused by bacteria, most common bacteria being streptococcal pyogens.

How do doctors diagnose it?

A doctor will ask you about aforementioned symptoms. Then he/she will examine your throat and neck, he may also collect a sample from the tonsils and back of the throat.

Treatment

If the cause is streptococcal bacteria, a doctor will give you antibiotic, if its viral ,antibiotics won’t help. Just allow the virus to run its course, the body will fight the infection off automatically, but is it seemly practiced in our facilities? At times surgery may be needed in those with frequent episodes of tonsillitis despite antibiotics use, depending on the grade and presentation and its complication such as peritonsilar abscess.

Prevention

Many doctors do forget to tell their patients about how to prevent it.

Prevention involves avoi staying close to people with tonsillitis condition. Children and family members should be kept away from people with tonsillitis.

Hygienic measures that include washing and drying your hands, use tissue to cover cough and sneezes should be practised.

Home care tips to ease a sore throat

• Drink plenty of fluids

• Get lots of rest

• Gargle with warm salt water several times a day

• Use throat lozenges

• Use a humidifier to moisten the air in your home

• Avoid smoke

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