Strep throat, tonsillitis, and other throat conditions: How to know if tonsil removal is right for you

Woman holding her throat

If you have reoccurring throat pain, tender lymph nodes, or trouble swallowing, you may wonder if you should have your tonsils removed. Often considered a rite of passage for many children, tonsil removal can also be helpful for adults with reoccurring throat and tonsil issues. Read on to find out if it’s right for you.

What’s the difference between a sore throat, strep throat and tonsillitis?

“Sore throats are extremely common,” says Nebraska Medicine head and neck surgeon Tony Richa, MD. “About 80% of pharyngitis cases are caused by viral infections.”

If you’re experiencing a sore throat, your doctor will likely take a swab of your throat to see if you have an infection. If the results are negative, your doctor may recommend over-the-counter pain medication and general fluids to manage your symptoms.

If the results show bacteria, you may have one of the following:

  • Strep throat – An infection caused by streptococcus bacteria
  • Tonsillitis – A painful inflammation or infection of the tonsils, or the glands located at the back of your throat

In either case, your doctor will likely recommend antibiotics to ensure the infection doesn’t become more serious.

What is a tonsillectomy?

If you meet any of the following criteria, you may be a candidate for tonsillectomy, a procedure to remove your tonsils.

  1. You’ve had seven or more episodes of tonsillitis in a year.
  2. You’ve had five or more episodes per year of tonsillitis for two consecutive years.
  3. You’ve had three or more episodes per year of tonsillitis for three consecutive years.

Additionally, if you’re experiencing one or more of the below symptoms, you should consider seeing an ear, nose and throat specialist or ENT doctor. ENT doctors specialize in the treatment of tonsils and are well-versed in performing tonsil surgery. 

  • Severe throat pain
  • White spots on your tonsils
  • Painful or difficulty swallowing
  • Swollen or tender lymph nodes in your neck

Tonsillectomy can also be a treatment option for sleep apnea, especially in children. Sleep apnea can happen if something blocks the upper airway during sleep. As a result, some people stop breathing, start snoring or wake up gasping for breath. Long-term sleep apnea can lead to fatigue, restlessness, and even high blood pressure. 

“We generally don’t recommend tonsillectomies for adults with sleep apnea unless we see the patient has large or swollen tonsils that are affecting their sleep or overall health,” says Dr. Richa. “It’s recommended more often for children with sleep apnea and other breathing problems.”

Is tonsil removal painful?

Most patients usually experience moderate to severe pain, especially adults. You can also expect discomfort following surgery. Children tend to be less sore and are usually back on their feet quickly. Recovery can take longer for adults since the area that’s healing is often larger. Both groups typically recover within 10 to 14 days.

Immediately following surgery, you may experience:

  • Swelling of the tongue or throat
  • A globus sensation or feeling like you have something stuck in your throat
  • A mild fever that goes away on its own
  • Halitosis or bad breath that doesn’t resolve by brushing your teeth or using mouthwash
  • Referred ear pain

As your throat heals, it will naturally form a scab that should fall off within a week. To help manage your pain, your doctor may recommend pain medication. Soft, bland foods, like apple sauce, mashed potatoes and ice cream, as well as plenty of liquids, are ideal during this time. You’ll want to avoid eating anything hard or sharp, or participating in strenuous activity, as these things can increase your risk of bleeding while your throat heals. If you notice bleeding, call your doctor right away.

The Nebraska Medicine ENT specialists are some of the most skilled doctors in the Midwest, specializing in the diagnosis and treatment of ear, nose and throat conditions. For more information or to schedule an appointment, call 800.922.0000.