Chronic tonsillitis as a consequence of an untreated acute form of the disease. Symptoms of acute tonsillitis. Development of the disease and its consequences

Untreated acute tonsillitis often leads to lymphoid tissue the throat and tonsils remain infectious. The development of this microorganism increases under the influence of any unfavorable stimulus and then the sore throat worsens again.

Frequent relapses of tonsillitis indicate that a person has chronic tonsillitis - a disease that requires treatment both during the stage of relapse of the disease and outside periods of exacerbation.

Causes and signs of chronic sore throat

The main reason chronic sore throat is considered to be acute tonsillitis. In addition to this reason, other factors may influence the development of the chronic form of the disease:

• The presence of foci of infection in neighboring organs - caries, adenoids, sinusitis, rhinitis.
• Disruption of normal nasal breathing, which often develops due to a deviated nasal septum, proliferation of polyps
• Decreased functioning immune system.

With prolonged chronic tonsillitis, the tonsils lose their main ability to resist infection. Chronic tonsillitis is the main cause of frequent pharyngitis, bronchitis and many diseases internal organs, the most dangerous of which include rheumatism, endocarditis, and systemic lupus erythematosus. Under the influence of a constant source of infection, heart defects can develop, gastric organs suffer - intestinal tract. That is, a seemingly harmless disease can cause a lot of troubles that a person will have to struggle with for the rest of his life.

Exacerbations of chronic tonsillitis occur up to several times a year; in weakened people, this process can be observed every month. With an exacerbation of the disease, tonsillitis can manifest itself with all the symptoms that often accompany acute tonsillitis, these are:

• Pain and discomfort in the throat.
• Increased body temperature.
• Sore throat also affects the appearance of symptoms of intoxication.
• The appearance of plaque on the tonsils.
• Enlargement of the submandibular lymph nodes.

But at the same time, especially for adult patients, angina during a relapse may not manifest obvious signs. A slight deterioration in health, mild pain when swallowing goes away within a few days and sometimes even without drug treatment. But this does not mean that the infection has left the body; on the contrary, it continues to develop, causing damage to health.

Outside the acute stage, chronic tonsillitis is manifested by bad breath and periodic weakness. Children with tonsillitis constantly develop colds. Upon examination, the doctor sees that the tonsils look swollen, their tissues become loose, and the palatine sacs are thickened. Chronic lacunar tonsillitis is characterized by the constant presence of plugs in the lacunae with a special secretion and an extremely unpleasant odor.

How and how to treat chronic tonsillitis?

It is recommended to treat chronic sore throat only under the guidance of a doctor. Treatment is divided into conservative and surgical interventions. During therapy, it is necessary not only to restore the function of the tonsils themselves, but also to get rid of other foci of infection in the body. Chronic tonsillitis is treated not only by an ENT doctor, but also by a therapist and dentist.

Conservative treatment is carried out using special techniques and medications:

• Rinsing the lacunae with aseptic solutions is necessary to remove plugs and all pathogens from the tonsils. Washing lacunae in modern medicine is most often carried out with the “Tonsillor” apparatus, with the help of which medicinal solutions can be administered. The medicine is administered using an ultrasonic nozzle, which ensures its spraying throughout the submucosal layer.
• Laser therapy can reduce swelling and inflammation in the tonsils.
• Ural irradiation - that is, ultrasound irradiation is considered the oldest, but at the same time effective way to sanitize chronic foci of infection. Ural irradiation not only destroys bacteria, but also increases blood supply and nutrition in the treated area, which affects the rapid regeneration of cells.

All these procedures are carried out in courses consisting of 5-15 sessions. In order to achieve maximum therapeutic effect To avoid surgery, conservative treatment should be carried out several times a year.

Chronic tonsillitis must also be treated with medications. Drug therapy should be aimed at eliminating the infection and restoring the functioning of the immune system. Based on this, the doctor prescribes:

• Antibiotics. In case of chronic tonsillitis, it is necessary to conduct a bacterial culture of microflora taken from the tonsils. Only based on these tests will the doctor be able to select an effective antibiotic. Antibacterial treatment is always prescribed for severe exacerbations of the disease, and during the period of remission it should be carried out until the pathogen completely disappears. Among the antibiotics used are Sumamed, Cefazolin,
• When treating with antibiotics, it is important to also use a course of probiotics. These medications will help restore the intestinal microflora, which has a positive effect on the general state of the immune system. A course of Linex and Bifidum is prescribed.
• During an exacerbation, it is necessary to use gargling solutions, such as Miramistin, Dioxidin. Use inhalation sprays and dissolving tablets.
• Immunostimulating therapy is always necessary in the treatment of chronic infections. For increase local immunity the drug Imudon is indicated in the oral cavity.

Chronic tonsillitis often requires surgical intervention, which consists of partial or complete removal of the tonsils. Doctors often prefer to treat tonsillitis using the EHF method - this method removes the inflamed tissue and reduces the size of the lacunae, while the main function of the tonsils is preserved.

Chronic tonsillitis is a sluggish inflammatory disease that involves the palatine tonsils and is prone to relapse. One of the most common pathologies of the ENT organs. Diagnosed in more than 10% of the total population. The main reason for development is incorrect and untimely treatment acute sore throat.

Chronic tonsillitis develops according to various reasons. But still, the main one is previously untreated tonsillitis. This happens either due to insufficient qualifications of the doctor, or the patient’s failure to comply with all recommendations for drug therapy. According to statistics, angina becomes chronic in those people who stopped taking antibiotics, citing improvement in their condition, or self-prescribed treatment.

Normally, after an acute inflammatory process in the tonsils, it occurs full recovery. Due to various circumstances, the completion of the pathological process does not occur, the infection remains in the organ. Thus, the disease takes on a sluggish form without severe symptoms. During exacerbation, chronic tonsillitis manifests itself typically for acute tonsillitis.

Depending on the type of pathogen, tonsillitis is of three types:

1. Bacterial. It occurs due to the entry of bacteria into the oropharynx, such as streptococci, staphylococci, Escherichia coli and Pseudomonas aeruginosa. In this type, the process is almost always localized only on the palatine tonsils, in advanced cases goes beyond their limits. It does not have an acute onset; symptoms increase gradually. The main difference between bacterial tonsillitis is the presence of purulent foci on the tonsils.
2. Fungal. Appears mainly due to the ingestion of yeast-like and mold fungi into the body. The process does not have a clear localization; the tonsils, mucous membranes of the mouth and pharynx are affected. Fungal tonsillitis is characterized by whitish islands, when removed, bleeding ulcers appear.
3. Viral. The cause is the entry of viruses into the body (influenza, herpes, adenovirus, Epstein-Barr). This species typically has an acute onset with a lightning-fast progression of symptoms. There are no purulent foci with viral sore throat. Inflammation spreads to the tonsils, soft palate, arches, uvula, and pharynx. Almost always accompanied by a runny nose and cough. The plaque is whitish, in the form of a film, the mucous membrane does not bleed when removed.

Viral and fungal tonsillitis in most cases are the primary source of the chronic process. If these two pathologies are not given due attention in the acute phase and the inflammation is not eliminated, a bacterial infection occurs, which already becomes sluggish. Themselves viral and fungal tonsillitis rarely become chronic; this occurs in cases where the pathogen affects the entire body (herpes, candidiasis).

In addition to improper treatment of acute tonsillitis, the development of chronic tonsillitis is facilitated by:

• sluggish inflammatory foci in organs adjacent to the tonsils (rhinitis, pathologies of the paranasal paranasal sinuses, adenoiditis, caries, periodontitis);
• violation of nasal breathing (deviated septum, trauma, neoplasms in the nasal passages);
• other systemic pathologies;
• weakening of the body's protective abilities.

In turn, a decrease in immunity leads to:

• wrong, not balanced diet;
• passive lifestyle;
• hypothermia;
• stress;
• overwork, excessive physical activity;
• unfavorable ecological environment;
• poor working conditions;
• bad habits.

Children in the first six years of life are more susceptible to chronic sore throat. This is due to the underdevelopment of the immune system. Socially unadapted segments of the population, as well as people with HIV status, are also at risk.

Symptoms of chronic sore throat

According to its course, chronic tonsillitis is divided into two forms: compensated and decompensated. With compensated tonsillitis, the tonsils, despite the inflammatory process, cope with their main function. By decompensated it is meant that the tonsils do not fulfill their role in the body, being only a source of infection. Conservative treatment of chronic tonsillitis at this stage is not effective; doctors resort to surgical intervention.

Symptoms of a sluggish process in the tonsils are not pronounced. The presence of chronic tonsillitis is indicated by the following: structural changes tonsils that the doctor can see:

• lymphadenoid tissue atrophies and is replaced by connective tissue;
• the number of lacunae on the surface of the organ is reduced;
• cervical lymph nodes enlarge;
• the number of follicles decreases, they become dense;
• tonsils become smaller;
• scars and adhesions appear between the arches and tonsils.

As for the signs of sluggish tonsillitis that the patient himself feels, these include:

• discomfort in the throat, sore throat, lasting up to several months;
• cough, especially at night;
• periodic increase in body temperature to subfebrile levels;
• increased fatigue, drowsiness;
• exacerbation of the disease several times a year.

Relapses are mostly seasonal. The slightest hypothermia can cause acute tonsillitis, for which the following symptoms are specific:

• acute pain in the throat, worsening when swallowing, often radiating to the ear;
• fever;
• intoxication of the body;
• severe weakness, dizziness;
• loss of appetite.

Conservative treatment of chronic tonsillitis

Before you understand how to treat chronic tonsillitis, you should conduct a full diagnosis of the pathology. First of all, the pharynx is examined, the cervical lymph nodes are palpated, and an anamnesis is collected. To clarify the causative agents of pathology, the following laboratory tests are prescribed:

• Throat and nasal swab for culture. Through this analysis, the type of pathogen and its sensitivity to medications are determined.
• Clinical blood test . After conducting this study, it will become known what type of infection provoked the pathology. Each type of sore throat has its own specific picture on a detailed analysis. Blood sampling is carried out during an exacerbation.
• General urine analysis. This study is carried out to assess the functionality of the excretory system.

After receiving the research results, the doctor will decide how to treat chronic tonsillitis in this case. It is not possible to completely get rid of the sluggish process. Often the process is treated through exacerbation. There are two ways to remove a chronic lesion in the tonsils or stop its activity: conservatively and surgically.

Conservative methods include: systemic drugs, local procedures, physiotherapy.

Medication

How to cure chronic tonsillitis without surgery is a question asked by everyone who has encountered the pathology.

The main thing in the fight against the disease is etiotropic therapy, its goal is to eliminate the cause of the disease. This includes three groups of drugs:

1. Antibiotics. Prescribed for chronic sore throat of bacterial origin. Drugs of the Cephalosporin group (Ceftriaxone, Cedex), Macrolides (Sumamed, Azithromycin), Amoxicillins (Augmentin, Ospamox) are used. Depending on the severity of the process and the age of the patient, drugs are prescribed in the form of injections and internally (tablets, syrups).
2. Antifungal. Used for tonsillomycosis. They have fungicidal and fungistatic properties, killing or stopping the growth of pathogenic fungi. Nystatin, Fluconazole, and Levorin are popular among antimycotic drugs.
3. Antiviral. Eliminate viruses that have entered the body and provoked the inflammatory process (Acyclovir, Isoprinosine).

In addition to etiotropic therapy, the leading role in the fight against chronic sore throat is played by the restoration of the body's protective abilities. To strengthen the immune system, immunostimulants and immunomodulators (Aflubirn, Anaferon) are used.

While taking antibiotics and for candidiasis of the tonsils, medications containing lactobacilli are prescribed. In the first case, this is necessary to prevent dysbiosis, which occurs during the use of antimicrobial agents. For fungal sore throat, probiotics are used to eliminate the imbalance, which in most cases causes the development of pathology.

At elevated temperatures, antipyretics (Paracetamol, Nurofen, Nimesil) are used. In addition to eliminating hyperthermia, this group of drugs has a pronounced anti-inflammatory effect.

If the tonsils swell greatly during an exacerbation of chronic tonsillitis, which makes swallowing difficult, and sometimes even breathing, antihistamines (Fenistil, Eden, Citrine) are prescribed. They help relieve tissue swelling, thereby improving patency in the pharynx.

Complex therapy for sore throat involves the use of local drugs, which act directly at the site of inflammation. Products in this group are produced in the form of aerosols (Eucalyptus, Hexoral) and lozenges (Faringosept, Septifril, Strepsils). Regardless of the form of release, they have anti-inflammatory, antiseptic, and some analgesic properties.

Gargling

Another way to combat chronic sore throat is to gargle. Thanks to this procedure, the tonsils are cleansed of pus and microbes, the mucous membrane is moisturized, and inflammation goes away.

For rinsing, both pharmaceutical preparations and products that can be easily prepared at home are used. Among the recipes traditional healers highlight:

• To a glass of boiled water, cooled to room temperature, add a teaspoon of salt, the same amount of soda, a few drops of iodine (up to 5, no more). Gargle every two hours. Salt relieves inflammatory swelling, soda relieves irritation, iodine has bactericidal properties.
• A tablespoon of pharmaceutical calendula or chamomile is poured into a glass of boiling water, infused, and filtered. Apply every hour.

Pharmaceutical drugs include:

• Furacilin,
• Miramistin,
• Chlorhexidine,
• Chlorphilipt.

The action of such drugs is aimed at relieving inflammatory edema, destroying pathogenic microflora.

The drugs are also administered using an inhaler. This method is new, but is already widely used in the treatment of ENT pathologies.

I would like to note that local procedures do not eliminate the inflammatory process completely; they only remove the unpleasant symptoms that accompany a sore throat. The main treatment is etiotropic therapy.

Physiotherapy

When the inflammatory process subsides in a state of remission, physiotherapy procedures are prescribed, which are part of complex therapy. Most often prescribed:

• treatment with infrared rays;
• magnetic therapy;
• laser;
• ultraphonophoresis.

Ultraphonophoresis works like an irrigator, where antiseptic solutions are supplied to the tonsils under pressure. With this procedure, lacunae are cleared of pus and pathogenic microorganisms, tissue regeneration is improved, and the number of scars is reduced.

At the stage of inflammation subsiding in chronic angina, heat treatment is important. Simple and affordable way– semi-alcohol or vodka compresses. Acute tonsillitis is a contraindication to rewarming.

Cryodestruction

Conservative methods of treating chronic tonsillitis include cryodestruction. Another name for it is “freezing” the tonsils.

After the procedure, the patient’s condition improves significantly, swelling decreases, and swelling goes away. pain syndrome. The state of “calm” can last up to six months. Afterwards it is recommended to repeat the procedure.

Surgical methods

In the decompensated form of chronic tonsillitis, when the tonsils do not perform their function, the main treatment method is surgery.

After full diagnostics and unless contraindications are excluded, a tonsillotomy (removal of part of the tonsils) or tonsillectomy (complete removal of the tonsils) is performed under general anesthesia. These methods of intervention are now rarely used; doctors more often resort to laser correction.

Contraindications to surgery:

• diabetes;
• blood clotting disorder;
• tuberculosis;
• renal failure;
• pregnancy in the second and third trimester.

Complications of chronic tonsillitis

People suffering from chronic sore throat often suffer from diseases of the upper respiratory tract, such as bronchitis, rhinitis, laryngitis, sinusitis, and pneumonia.

In addition, untreated or sluggish tonsillitis can lead to the development of a number of pathologies:

• rheumatism with subsequent inflammation and destruction of joint tissues;
• heart defects;
• pericarditis;
• sepsis;
• meningitis;
• otitis;
• skin diseases.

To prevent this from happening, at the first symptoms of a sore throat you should seek help from a medical facility.

Prevention

Main preventive measure for the prevention of chronic sore throat - timely and correct treatment acute tonsillitis. To prevent the process from becoming chronic, at the first symptoms of pathology it is necessary to contact an ENT doctor and carefully follow all his recommendations.

In addition, you should strengthen protective functions body:

• eat a healthy, balanced diet, including all food groups in your diet;
• to live an active lifestyle;
• maintain cleanliness in the premises;
• eliminate alcohol and smoking;
• exercise;
• Avoid hypothermia and overheating.

Chronic sore throat is difficult to treat and is one of those pathologies that are easier to prevent than to get rid of it. This should be remembered by all patients who will try to cure tonsillitis on their own.

The duration of lacunar angina is about 6-8 days, when complications occur, the duration of the disease increases.
In other cases of tonsillitis, the clinical picture depends on the underlying disease.

Sore throat with diphtheria

Diphtheria - an acute infectious disease characterized by the development of an inflammatory process, as a result of which a dense, adjacent film is formed at the site of introduction of the pathogen. The causative agent is the diphtheria bacillus, which is transmitted by airborne droplets. Typically damaged vocal cords. In some cases, bacteria affect the tonsils.
A severe form of tonsillitis is usually characterized by a sudden onset, after 2-5 days after contact with an infectious carrier. The following symptoms may be added to the general manifestations of intoxication:

• Choking cough
• Dyspnea
• Respiratory failure
• Symptoms of damage to the central nervous systems s (CNS)

The evolution of the disease is unfavorable; lethal outcomes are possible if treatment is not provided or improper treatment.

Sore throat with flu

One of the most common viral infections is flu. Flu is transmitted by airborne droplets, so it is very easy to get infected.

Typically, sore throat is associated with:

• rhinitis (inflammation of the nasal mucosa)
• conjunctivitis (inflammation of the conjunctiva of the eye).

The clinical picture is similar to other forms and is blurred against the general background of influenza. With proper treatment it progresses favorably.

Sore throat with scarlet fever

Scarlet fever - acute infectious disease characterized by acute onset with symptoms of sore throat and pinpoint skin rashes. The main pathogenic pathogen is β - hemolytic streptococcus group A.
The clinical feature is:

• Gray plaque on the palatine tonsils, which, unlike plaque with diphtheria, is easily removed. Purulent plaque can spread to the soft palate, arches, and uvula.

• A pinpoint rash and peeling of the skin, but in the area of ​​the nasolabial triangle the skin remains unchanged.
• A crimson tongue is one of the signs of scarlet fever.
• Regional lymph nodes – enlarged
• Headache
• Chills

Children are most often affected by this form. younger age, and occurs with severe intoxication. Temperature up to 40°C, may be accompanied vomiting.

Sore throat with infectious mononucleosis

Infectious mononucleosis (monocytic tonsillitis) is a disease with airborne transmission and an acute onset. The cause of the origin of this disease has not been fully studied; there are viral and bacterial theories.

Clinical picture
The incubation period takes about 45 days. IN initial stage noted:

• slight malaise
• sleep disturbance

There are several main symptoms:

• Angina
• Leukocytosis (increase in white blood cells) with big amount monocytes and lymphocytes
• Enlarged liver and spleen
• Heat.
• It is also accompanied by an increase in regional lymph nodes.

The palatine tonsils initially show changes of a banal sore throat, then the disease progresses with the formation of permanent dirty-gray plaques. In children, there is a significant enlargement of the palatine tonsils. Having increased in volume, they can converge along the midline, closing the lumen of the respiratory tract.

Bacterial or viral toxins penetrate the blood, spreading with current throughout the body, disrupting the function of other systems: the cardiovascular and central nervous systems.

Diagnosis of sore throat

It can be divided into three main points that are necessary to determine the form and stage of sore throat.

Clinical examination
Clinical examination is the main method in diagnosing almost all diseases; it allows the doctor to study the patient’s condition without auxiliary laboratory tests. This examination is very important as it provides most of the information about the patient. With its help, the doctor can develop a plan for further action (diagnosis and treatment) Includes:

• Finding out the reason for the patient’s request and complaints, that is, all the information about the disease. It is the first step to making a correct diagnosis. It is necessary to find out how long ago the first symptoms began, any treatment was undertaken, if any, what the effect was and other information that the doctor needs. When visiting a doctor, the patient must answer all questions - frankly, without hesitation.
• External examination and palpation of the neck, parotid and occipital areas.
• Pharyngoscopy – examination of the oral cavity and pharynx using a medical spatula. An examination of the mucous membrane is carried out by a general practitioner, pediatrician or ENT doctor.

The doctor examines the following areas under bright light:

• Mucous membrane of the soft palate
• Conditions of the cavity walls
• Gum
• The mucous membrane of the palatine tonsils.

With angina, changes are detected: the palatine tonsils are inflamed, may be increased in size, and depending on the form presented, they may have a purulent coating of a specific color on the surface. The folds in the tonsils can be filled with pus, which can be released into the oral cavity when pressed. In chronic tonsillitis, there may be purulent plugs, which cover the gaps.
To determine the shape of a sore throat, the contents of the lacunae are isolated. Inflammation may spread to adjacent tissues, so the back wall of the pharynx is examined. Normally, small granules of lymphoid tissue can be seen. Thus , pharyngoscopy is a key method in determining the stage of angina and its form.

• Percussion and auscultation of the respiratory, cardiovascular and other systems at the discretion of the physician.

After conducting the above-described clinical examination, the doctor can make a preliminary diagnosis and prescribe additional laboratory and instrumental examinations for getting necessary information.
Laboratory diagnostics:

• CBC (complete blood count) to determine symptoms of inflammation, anemia . For example, mononucleosis tonsillitis is characterized by an increase in the level of monocytes (normal 5-10%), lymphocytes (25-40%)

• The bacteriological method consists of collecting material (pathogens from the mucous membrane) and inoculating it on a nutrient medium. The nutrient medium promotes the reproduction and growth of bacteria, it contains everything necessary for this nutrients and other conditions. After which a pure culture can be isolated for further study. May be uninformative, since the oral mucosa and all its components are normal Nutrient medium with a culture of bacteria grown.

Swab from the throat and nasal cavity to exclude diphtheria process. The contents are collected from the palatine tonsils, as well as from the wall of the pharynx using a spatula. As a result, samples are taken for identification hemolytic streptococcus, since in most cases it is a pathogenic agent. Specific forms of tonsillitis are characterized by the release of other pathogens. For example, for diphtheria - Corynabacterium diphteriae.

Diagnosis of complications of angina

Against the backdrop of an aggressive course of sore throat or its transition to a chronic form, complications often arise that require additional diagnostics.

Frequent studies performed when diagnosing complications of angina:
Laboratory blood tests (serological tests) - make it possible to determine the severity of the body’s inflammatory response and the presence of an autoimmune process.
The infectious process activates all immune processes of the body, and therefore the titer of antibodies to toxins And antigens ( unknown substances for the human body ) streptococcus - streptolysin O, hyaluronidase, streptokinase. Increase titer antistreptolysin O(antibodies) characteristic of:

• sore throat
• scarlet fever
• glomerulonephritis(inflammation of the renal glomeruli)

Very high numbers for rheumatoid fever. As a rule, the numbers increase impressively 7-10 days after infection and decrease after recovery. This study requires repeated blood sampling, as sometimes the numbers may decrease, giving hope for recovery.

Echocardiogram– allows you to identify the anatomical data of the heart
EchoCG is a research method that allows you to determine heart valve defects using ultrasound waves. Since angina with chronic course causes complications in the heart, namely its valve apparatus, an echocardiogram (EchoCG) is necessary before and after treatment.

X-ray of bones and joints
This examination is prescribed for suspected autoimmune joint damage in rheumatic diseases.
The clinical picture includes:

• high temperature
• joint pain and limitation of movement
• symmetrical joint damage
• swelling in the joints, which may last for about a week, then subsides for a period of time.

Modern methods of treating sore throat

To begin with, it should be noted that treatment should begin with improving the general condition and restoring the immune system. No medicine will help, like good sleep, proper balanced nutrition, drinking plenty of fluids and avoiding stressful situations. Stress is unfavorable factor, as it contributes to a decrease in immunity and a deterioration in the general condition of the patient. For recovery, the following points of non-drug treatment must be observed.

Non-drug treatment consists of following a diet, regimen, hygiene

• Bed rest, that is, the patient should not endure the disease physically exhausted. Eliminate physical stress.
• Ventilate the room in which the patient is located at least twice a day.
• Proper nutrition, mainly plant-based and easily digestible foods high in vitamins (especially vitamin C)
• Various warming compresses (alcohol) in the area of ​​inflamed lymph nodes.
• Herbal inhalations: chamomile, sage.

Herbal infusion of sage used for inhalation and rinsing. It is made as follows: two tablespoons of crushed sage leaves are poured into 1 or 2 glasses of boiled water and heated for about 20 minutes. Then leave for about half an hour and remove the leaves. To reduce the concentration, add a glass of water. You can rinse several times a day. This solution can also be used for inhalation.

Herbal infusion of chamomile It is done as follows: 1-2 teaspoons of chamomile are poured into 1 glass of water. Boil, then leave for about half an hour, then strain and use for rinsing several times a day or orally one teaspoon after meals.

It is necessary to remember that warming compresses and inhalations can be carried out at normal temperatures.
Drug treatment
In some cases, without treatment with medications, it becomes impossible to avoid complications and recover within a reasonable time - in this case, doctors are forced to resort to prescribing medications that can help your body cope with infectious process.

Treatment with antibiotics

The need to prescribe antibiotics depends on many factors: the form of sore throat, concomitant diseases, and the presence of complications. Catarrhal sore throat is a mild form of sore throat, so local treatment is used in the form of rinses. Antibiotic treatment is prescribed for:

• Follicular and lacunar form, when purulent foci of infection are present.
• When β - hemolytic streptococcus of group A is isolated in a smear and other types of microorganisms with a characteristic clinic.
• Complicated forms of bacterial infection.

When antibiotics are prescribed in mild forms, resistant forms develop, which in the future will no longer respond to these drugs. Consequently, treatment will be much more difficult. Proper treatment is very important, so in any case you should consult a doctor.
Antibiotics are prescribed first wide range actions. There are different groups of antibiotics, the mechanism of action of which is different. The main importance of using antibiotics is to prevent the development of complications of streptococcal infection. The most common are the following:

Penicillins - amoxicillin, benzylpenicillin and others. Drugs in this series have the best results in the fight against streptococcal infection.
Injectable forms of benzylpenicillin are used in the dose:

• for teenagers and adults - 1.5-4 million units per day
• for children 400,000-600,000 units.

Augmentin (Amoxicillin and Clavulanic acid) is one of the drugs of choice. This drug more stable and protected from streptococcal toxin. The course of treatment should not exceed 14 days.
The dosage regimen is selected individually depending on
-masses
-age
-stages of the infectious process

Approximate destination scheme:

• In mild forms of the disease for children up to 2-6 years Prescribe 5 ml (body weight 12-20 kg), divided into 2-3 doses. Children over 6 years old - 10 ml (body weight - up to 40 kg)
• In severe forms, the dose is doubled, that is, for children from 2-6 years appoint 10 ml, children over 6 years old 20 ml. 2 times a day at intervals 12 hours.
• For adults calculated 40 mg/kg/day, if the reception is divided into 3 receptions and 45 mg/kg/day for 2 appointments.

This diagram is provided for internal use. It is recommended to use the drug before meals.

Cephalosporins - cefazolin, ceftriaxone and others
It is used parenterally (intramuscularly or intravenously). The dosage is selected individually and calculated by the doctor. The course of treatment should not exceed 14 days.
Dosage schedule:
Adults from 500 mg-2 g, 2-3 times a day (every 8-12 hours)
Children under 12 years old 30 mg/kg/day with an interval of 12 hours

Macrolides – erythromycin, clarithromycin and others
Used less frequently than the first two groups. Erythromycin is dosed individually. The course of treatment is up to 7 days. Treatment regimen:

• For adults 0.5-2 g 4-6 times a day.
• For children under 14 years old 20-40 mg/kg. Also 4-6 times a day.

Antibioticogram - identifying the most suitable antibiotic for a specific infectious agent that caused a sore throat is prescribed to speed up and reduce possible complications of the disease.

Antihistamines (antiallergic)

Due to the fact that antibiotics often cause allergic reactions, antiallergic drugs are prescribed in parallel. Eg:

• Diazolin
• Diphenhydramine

Preference is given to Suprastin, as it has fewer side effects. Prescribed to prevent allergic reactions. One tablet contains 25g active substance. Prescribed:

• 2-3 tablets for adults.
• For children from 1 month to 14 months, ¼ tablet 2-3 times a day
• For children 1 year to 6 years 1/3 tablet 2-3 times a day
• For children 7-14 years old ½ tablet 2-3 times a day

Antifungal drugs

Due to the fact that antibiotics suppress the development of normal positive microflora of the gastrointestinal tract. Digestive disorders (bloating, constipation, diarrhea) may occur. Immunity also decreases, which makes it possible to develop various types of fungal infections.
Antifungal drugs include:

• Nystatin
• Levorin

Fluconazole is available in tablets or capsules (50 mg or 150 mg)
Scheme for using fluconazole:
50 mg per day for 7-14 days, depending on how long the antibiotic therapy lasts.

Immunity Boosters

Imudon has a local anti-inflammatory effect and increases protective properties oral mucosa. Possesses:

• Antifungal
• Antivirus
• Antibacterial

It is prescribed individually, depending on how much the immune system is damaged.

Antiseptic solutions

Mouth rinse solutions are used. The following can be used as antiseptic drugs:

• Furacillin solution Available in tablets of 0.02 g, 10 pieces.

- It is very easy to prepare the solution at home. It is necessary to crush two furacillin tablets, pour a glass of boiling water and stir thoroughly. It dissolves quickly in hot water.
-Then allow the solution to cool to an acceptable temperature. Afterwards the solution is ready for rinsing (5-6 times a day).
-This solution Can be stored in the refrigerator, but must be reheated before use.

• A weak solution of potassium permanganate.

A 0.1% solution is used.
- Take 1 gram of powder and pour 1 liter of water at a temperature of 37 degrees. Then stir well and rinse through a thick layer of gauze. The solution should have a faint purple tint. It is necessary to ensure that the solution does not contain crystals.
- The throat is washed several times a day

• Sprays are used (Tantum verde, Cameton), which possess locally
• painkillers
• antiseptic
• anti-inflammatory effect

These sprays are created on a herbal basis. They alleviate the general condition and promote recovery.
They have a local antimicrobial effect.
Treatment of acute tonsillitis lasts on average 7 days, in severe cases can last up to 14 days. To prevent the emergence of resistant forms of bacteria, a full course of antibiotic therapy is carried out, regardless of the patient’s condition.

Tonsillectomy - removal of tonsils, when is surgery necessary?

With frequent occurrence of tonsillitis, the disease develops into chronic form, this creates conditions for local destruction of the tonsils. Over time, the lymphoid tissue ceases to perform its functions, and the infection present can penetrate into the general bloodstream, thereby affecting other organs and systems. To exclude complications associated with this phenomenon, it is necessary to remove pathologically altered tonsils.
Indications for surgery:

• Frequent repeated exacerbations of sore throat (at least 3 times a year)
• Lack of effect from conservative treatment (medicines)
• Chronic tonsillitis, complicated by the spread of infection to nearby areas

Contraindications for surgery:

• Heart defects of 2-3 degrees of severity
• Hemophilia - a bleeding disorder
• Severe diabetes mellitus

Prevention of sore throat

Considering all the possible consequences of a sore throat, it is easier to avoid recurrences by following some simple rules.

• Hypothermia should be avoided. As a result of local cooling of the oral cavity, a layer of mucus forms on the surface of the tonsils, which promotes the proliferation of bacterial agents (streptococci, staphylococci and others). Also, under the influence of cold, the blood supply to the mucous membrane decreases due to vasoconstriction, which contributes to the process of sore throat. Thus, it is necessary to limit the consumption of cold drinks and ice cream, especially when the body is heated. It is also necessary to avoid cold rooms, swimming in cold bodies of water, and dress appropriately for the weather conditions.
• Temper the body. To gradually accustom the body to temperature changes, it is necessary to take contrast showers. At the same time, reduce the water temperature gradually so that it is slightly cool. Systematic exercise and morning exercises also contribute to hardening the body. Exercises may include running, swimming and others.
• Dental control. It is necessary to monitor the condition of your teeth. Dental caries is a breeding ground for pathogenic pathogens of sore throat. Therefore, independent control over dental condition is required. To remove food debris and bacteria from the mouth, rinse your mouth warm water, or furacillin solutions and other antiseptics, for those at risk of recurrent sore throat.
• Control by an otorhinolaryngologist. Nasal breathing affects the condition of the palatine tonsils. Therefore, curvature of the nasal septum and other damage, disrupting normal breathing, contribute to the development of sore throat. Also, patients who often suffer from rhinitis (inflammation of the nasal mucosa) are at risk. In such cases, an examination by a doctor (otorhinolaryngologist) should be performed at least 2-3 times a year.
• Balanced diet, including a variety of fruits and vegetables. It is necessary to eat food that does not irritate the oral mucosa. This diet includes soups, cereals, cooked meat, exclusion of spicy and salty foods.

In cases where there is a person with a sore throat in the family, it is necessary to observe the following measures prevention.

• Using separate utensils for patients
• Periodic ventilation of premises
• Wearing a medical mask

How does angina occur in children?

Sore throat in children occurs with a sharp increase in body temperature. The temperature level can reach 39 – 40 degrees, and in some cases even higher. The temperature value can fluctuate from minimum to maximum limits. So, on the first day the temperature can be 40 degrees, and the next day it can reach 36.6, and then jump sharply again. Regardless of its form, childhood sore throat has a number of similar manifestations. Children complain of a sore throat, which gets worse when swallowing, refuse to eat, and are capricious. Patients are worried about headache, weakness, nausea. In some cases, stool upset or vomiting may occur. The inflammatory process affects the vocal cords, so a sick child may have a hoarse voice. When examining children, enlarged and painful lymph nodes are revealed ( cervical and submandibular). The tissues of the palate, palatine arches and tonsils swell and turn red. A purulent plaque forms on their surface.
The intensity of symptoms is determined by the stage of angina, which can be acute or chronic.

Manifestations of acute sore throat in children
Acute tonsillitis occurs with pronounced symptoms and is characterized by rapid development. Most often, no more than a day passes from the moment of infection to the appearance of the first symptoms. Against the background of infection, children develop intoxication of the body, which is accompanied by deterioration or lack of appetite, apathy, discomfort in abdominal cavity. Patients experience severe headaches that can radiate to the ears. With viral tonsillitis, the symptoms, in most cases, are milder than with bacterial tonsillitis.

Other signs of acute tonsillitis are:

• unpleasant taste in the mouth;
• coating on the tongue;
• hoarse or missing voice;
• sore throat;
• nausea;
• vomit;
• the presence of pus on the tonsils;

In some cases, children become irritable, nervous, and whiny. Often a sore throat occurs with a cough, in which the patient coughs up clots of pus. Sometimes tonsillitis is accompanied by diseases such as rhinitis and otitis media.
With adequate treatment, the child’s condition improves on days 5–7 ( depending on the form of sore throat).

Manifestations of chronic sore throat in children
During remission, chronic tonsillitis is manifested by periods of weakness, bad breath, often developing colds. The tonsils in children with chronic tonsillitis look swollen and their tissues are loose. In some forms of the disease, the lacunae of the tonsils are filled with plugs of secretion, which has an unpleasant odor. Exacerbation of chronic tonsillitis occurs in a milder form, and the child’s condition may improve after a few days. In some cases, relief occurs even without treatment.

Signs of relapse of chronic tonsillitis in children are:

• increased body temperature;
• feeling of discomfort in the throat;
• general deterioration of health;
• the formation of white plaque on the tonsils.

How does viral tonsillitis proceed?

Features of the course of viral sore throat depend on the specifics of the virus that caused the disease, as well as on the individuality of the organism.

The causes of viral sore throat are:

• herpes viruses;
• adenoviruses;
• rhinoviruses;
• coronaviruses;
• syncytial virus.

The main risk group for this disease is children. Cases of viral tonsillitis in adults are extremely rare. In 95 percent of cases, children from one to three years old suffer from sore throat of viral origin. This age range largely determines the subsequent course of the disease. A peculiarity of this period is that, regardless of the location of the infectious focus, gastrointestinal tract disorders are observed. Thus, to the classical syndromes ( general intoxication syndrome and local manifestations syndrome) with viral sore throat, abdominal syndrome is associated.

Therefore, despite the fact that the child will have inflamed tonsils, he will complain of abdominal pain. Also, the first symptoms to appear are nausea, vomiting, and diarrhea. Local symptoms, such as sore throat and cough, will appear later and fade into the background in intensity.

Abdominal symptoms of viral sore throat are:

• nausea, vomiting;
• stomach ache;
• refusal to eat;
• bowel disorder ( often in the form of diarrhea).

Often this onset of the disease mimics a gastrointestinal infection. To avoid this, a nearby parent must look at the baby’s throat.
It is known that in young children preschool age (that is, up to 3 years) with any infectious disease, symptoms of general intoxication predominate. These are symptoms such as fever, weakness, body aches. However, its manifestations depend on the type of pathogen. If the source of the sore throat was rhinoviruses or adenoviruses, then the standard symptoms ( temperature) symptoms such as runny nose, cough, conjunctivitis are added.

The syndrome of general intoxication with viral sore throat is determined by the following criteria:

• temperature;
• body aches;
• lethargy, weakness;
• cough;
• runny nose;
• conjunctivitis;
• Possible convulsions due to fever.

As a rule, the temperature with viral sore throat reaches 38 - 39 degrees. It is accompanied by chills and muscle pain. Children who are unable to express all their complaints become lethargic and apathetic. They refuse to eat because of a sore throat.

Local symptoms of viral sore throat are:

• a sore throat;
• redness and enlargement of the tonsils;
• formation of small pink bubbles on the tonsils;
• redness of the back of the throat.

These symptoms are detected by a detailed examination of the throat. Often the blisters on the tonsils burst, and ulcers remain in their place.

If this is a secondary sore throat, that is, it occurs against the background of some viral disease, then the main symptoms are joined by the symptoms of the underlying disease. For example, with angina against the background of infectious mononucleosis, symptoms such as regional enlargement of lymph nodes and specific blood changes appear.

How does herpes sore throat occur?

Herpes sore throat occurs with clear clinical manifestations that occur after the end of the incubation period. After contact with the virus, it takes 7 to 14 days until the first symptoms appear. During this period, nothing bothers a person, but he is already a spreader of the infection. At the end of incubation, the first sign that begins to worry the patient is a high temperature.

Other manifestations of herpes sore throat are:

• damage to the mucous membrane in the mouth;
• body aches;
• a sore throat;
• runny nose;
• cough;
• headache;
• gastrointestinal disorder;
• inflammation of the lymph nodes.

The temperature rise occurs sharply and can reach 38 - 40 degrees. In most cases, temperatures peak on the first and third days. The temperature is accompanied by general malaise, lethargy, and depression. In children, herpes sore throat is more severe than in adults.
If herpes sore throat is provoked by intestinal viruses, patients are bothered by severe abdominal pain and intestinal colic. Diarrhea, vomiting and other digestive disorders may occur. Against the background of these sensations, other symptoms appear less pronounced.

A distinctive sign of herpes sore throat is changes in the structure of the mucous membrane of the pharynx. The mucous tissue first turns red, after which small papules, the diameter of which reaches 1–2 millimeters, form on it within 1–2 days. The neoplasms turn into purulent blisters, which burst after 3–4 days. In place of the burst bubbles, erosions form, surrounded by a red border and covered with a grayish-white coating.

The areas where bubbles form are:

• language;
• palatal arches;
• solid sky;
• soft sky;
• tonsils.

In the larynx, mucosal lesions are smaller in size than in the area of ​​the palate and tonsils. In places largest accumulation the bubbles can join together to form large areas of affected tissue. Erosion of the mucous membrane causes pain during swallowing and intense salivation. Because of the pain, patients refuse to eat and drink, which can lead to dehydration. This leads to indigestion, unpleasant sensations in the mouth, and muscle spasms.

Painful sensations due to lesions of the mucous membrane are accompanied by a sore throat and cough. A runny nose may develop, which is accompanied by mucous-watery discharge, sometimes mixed with pus.
Herpes sore throat occurs with changes in the lymph nodes located in the mandibular and parotid zones. Palpation reveals an increase in size and tenderness of the lymph nodes. With timely and correct treatment, the symptoms of herpes sore throat begin to subside on the 7th to 12th day.

How to treat simple sore throat?

Treatment of angina should be comprehensive and aimed not only at eliminating pathogenic microorganisms, but also at preventing possible complications. It is known that angina itself is not as terrible as its consequences. Therefore, a wide range of drugs with different mechanisms of action are used in the treatment of angina.

The principles of treating angina are as follows:

• Etiotropic treatment– aimed at eliminating the source of infection. For this purpose, either antibacterial drugs, or agents with antiviral action.
• Symptomatic treatment– aimed at eliminating symptoms. Antipyretics are prescribed to reduce the temperature.
• Local treatment– aimed at eliminating pathological plaque on the tonsils and restoring the normal flora of the tonsils.
• General restorative treatment– aimed at increasing the body’s resistance and preventing the development of complications.

Drugs used in the treatment of sore throat

Treatment principle	Group of drugs	Representatives
Eliminating the source of infection	Antibiotics for bacterial sore throat. Considering that very often the source of sore throat is streptococcus, drugs from the group of penicillins and cephalosporins are prescribed. In the case of viral sore throat, antiviral drugs are rarely prescribed. More often, interferons are prescribed, which also have an antiviral effect. They also increase the body's resistance.	oxacillin; ticarcillin; mecillam. Viferon; leukocyte interferon.
Eliminating symptoms	Antipyretic drugs – to eliminate fever. Antihistamines - to relieve swelling of the throat.
Local treatment	Irrigation of the throat and tonsils is carried out using special sprays or infusions, as well as homemade products.	inhalipt; givalex; stopangin; camomile tea.
Prevention of complications	Immunomodulatory drugs are prescribed that strengthen the body and reduce the risk of relapse ( repeated exacerbation of the disease). Also, in order to minimize the risk of complications, it is necessary to maintain bed rest. Strict bed rest must be adhered to during the acute period of illness, when the temperature persists.	immunomax; florin forte; lycopid; Echinacea tincture.

Physiotherapeutic procedures play an important role in the treatment of sore throat. This includes periodic inhalations, throat irrigation with special antiseptics and other procedures.

How to treat chronic sore throat?

Chronic sore throat must be treated based on the form of the disease, external manifestations, general condition of the patient and the presence accompanying pathologies. Taking these factors into account, the doctor may suggest conservative and/or surgical treatment.

Conservative treatment
Conservative treatment of chronic tonsillitis includes a large number of methods that can be used individually or in combination.

Types of treatment are:

• washing the tonsils;
• injections into the tonsils and surrounding tissues;
• physiotherapy;
• complex treatment.

Due to chronic inflammation in some patients in the lacunae ( natural depressions) tonsils, purulent plugs form. They provide favorable conditions for the growth and development of pathogenic bacteria. Washing is carried out using a special instrument or medical equipment. The purpose of the procedures is to remove the contents and destroy harmful microorganisms using antiseptic agents.

Preparations for washing can be:

• furatsilin;
• boric acid;
• iodinol;
• sodium albucid in solution;
• penicillin solution.

Washing is carried out in a course of 7 – 10 procedures, which are carried out every other day. After 3 months, it is recommended to undergo this type of treatment again.

Injections into the tonsils and surrounding tissues
The introduction of drugs into the tonsils and adjacent tissues makes it possible to act directly on the sites of infection. As a result of this treatment, inflammatory processes are stopped, and the tonsils are reduced in size. Most often, not one, but several drugs are used, among which one is an antibiotic and the other is an anesthetic. The medication can be administered using a needle or a special nozzle with a large number of small needles. When choosing this type of therapy, the condition of the affected tissues has a great influence, since due to injections the possibility of developing abscesses in the tonsil area increases.

Physiotherapy
Physiotherapeutic treatment methods involve the impact of various physical and chemical factors on the affected tonsils.

Physiotherapy methods are:

• ultraviolet irradiation;
• inhalation therapy;
• ultrasound therapy.

All physiotherapeutic methods can be divided into three groups according to the type of influence used. The first group includes procedures that involve exposure to dry heat using light rays or electricity. Warming the tonsils allows you to destroy the pathogenic environment and reduce tissue swelling.
The second group includes physiotherapy methods that are based on the use of ultrasonic waves. Such conservative treatment methods are not recommended for young children. The third group includes treatment methods based on the effects of moist heat. Inhalation therapy is the optimal method of treatment, which has a minimum number of contraindications.

Complex treatment
Complex treatment is carried out using special medical equipment (most often using a tonsil machine) and a number of medications.

The stages of complex treatment are:

• washing– the doctor uses a specialized nozzle and antiseptic to rinse the tonsils;
• ultrasonic irrigation – medicinal solution is broken down by ultrasound into a finely dispersed suspension, which is supplied to the affected areas;
• tonsil treatment– carried out using drugs that contain iodine;
• laser exposure– aimed at reducing swelling of mucous tissues;
• wave action– allows you to improve tissue nutrition and oxygen supply;
• ultraviolet irradiation– carried out to suppress pathogenic microflora located on the tonsils.

Such treatment must be carried out in courses for which optimal quantity procedures are determined by the doctor.

Surgery
Surgical treatment is prescribed in cases where other methods of therapy have not brought effective results. Surgical treatment involves removal of the tonsils and can only be performed during a period of stable remission. Surgery to remove the tonsils is called a tonsillectomy and may involve complete or partial removal. For surgical intervention, strong indications are required.

Indications for tonsil removal are:

• recurring abscesses ( purulent inflammation );
• endocarditis ( inflammation of the lining of the heart);
• glomerulonephritis ( inflammatory process in the kidneys).

Tonsil removal can be performed using classic surgical instruments or using laser or ultrasound. Also, for small tonsils, cryo can be used surgical method, which involves freezing the tonsils.

How to treat a sore throat at home?

It is necessary to treat a sore throat at home, regardless of the form of the disease, under the supervision of a doctor. The essence of home treatment is to provide conditions conducive to recovery and follow the recommendations given by the physician.

Treatment for sore throat is as follows:

• taking self-help measures before the doctor arrives;
• compliance with the instructions given by the physician;
• fight against intoxication ( poisoning of the body);
• security special diet nutrition;
• organization of certain living conditions.

Taking self-help measures before the doctor arrives
If your health worsens due to angina, the patient must be provided with bed rest. You should not fight fever on your own, because this creates favorable conditions for the development of infection. You can alleviate the patient's condition with cool compresses or rubbing the body. cool water. It is not recommended to use alcohol-containing liquids for wiping. Alcohol vapors entering the body can cause nausea, headache, fainting Teas made from linden or raspberries will help improve your well-being at high temperatures.
To reduce a sore throat, you need to gargle every 3 to 4 hours.

Among the rinsing solutions are:

• herbal decoction ( chamomile, sage) – use 2 – 3 tablespoons of dry herbs per glass of water;
• beet juice with vinegar– add 20 milliliters of apple cider vinegar to a glass of freshly squeezed juice;
• solution of soda and salt– Mix 1 teaspoon each of baking soda and table salt with a glass of water.

Compliance with medical instructions
After starting medication, improvement is likely to occur within 2 to 3 days. This is not a reason to stop drug therapy. For adequate treatment, you must take the full course of medications prescribed by your doctor. It is necessary to observe not only the duration of treatment, but also the rules for using drugs. This applies to such items as the daily dose of medication, time of administration ( before or after meals), drug compatibility, and so on.

Fighting intoxication
Poisoning the body during a sore throat provokes headaches, weakness and other symptoms of the disease. Drinking plenty of fluids will help remove toxins, the optimal volume of which is determined according to the patient’s body weight. Drinking enough liquid is also necessary to restore the water balance, which is disturbed with sore throat due to increased sweating.
To count the quantity daily norm, you need to multiply your body weight in kilograms by 30 ( milliliters of liquid) and add 500 ( milliliters). So, for a patient weighing 60 kilograms, the recommended volume of fluid is 2300 milliliters. Preparing and drinking drinks during a sore throat follows a number of rules.

Support rules drinking regime are:

• the drinking temperature should be moderate; hot or cold liquid can worsen the patient’s condition;
• adding vitamin-containing ingredients to drinks will help speed up the healing process;
• it is necessary to ensure that juices and teas are not too acidic, as this can cause irritation of the mucous membranes;
• if the drink has a strong taste, it should be diluted with water;
• You should avoid drinking industrially produced juices, as they contain a large amount of flavor enhancers and other chemical components.

One of the recommended drinks for angina is berry juice. To prepare it, you need to grind 150 - 200 grams of berries, squeeze out the juice and combine with 2 glasses ( 500 milliliters) boiled water. If desired, you can add 1 – 2 teaspoons of natural honey. Cranberries, viburnum, raspberries, and currants can be used as the main component.

• Tea with lemon;
• milk with honey;
• Herb tea;
• dried fruits compote;
• rosehip decoction.

Ensuring proper diet
Great importance in the treatment of angina has an organization proper nutrition. Rough and hard foods should be avoided as they may have difficulty swallowing. You need to give preference to easily digestible foods to reduce the body’s efforts to digest food. Products with a high content of fat, hot seasonings and spices should be excluded from the diet. The best option for preparing food is to grind food using a blender. Of the types of heat treatment, the most preferable is steaming or baking in the oven.

• porridge ( oatmeal, buckwheat, rice);
• broth ( vegetable, meat, fish);
• dairy products (kefir, yogurt, cottage cheese);
• puree ( potato, zucchini, pumpkin).

Organization of certain living conditions
Sore throat is a contagious disease, so the patient must be isolated from other family members. The patient should be provided with utensils and personal hygiene products. After each use, all items should be rinsed with boiling water if possible. In the room where there is a patient with a sore throat, systematic ventilation must be provided. The air must be moist, so wet cleaning should be done at least once a day.
With fever, which is the main symptom of tonsillitis, the patient sweats profusely. Therefore, the patient must be frequently changed and changed bed linen. If a child who wears a diaper has a sore throat, it must be removed, since this underwear retains heat.

How to gargle for a sore throat?

Gargling for a sore throat can cleanse the affected areas of germs and reduce pain. The procedure must be carried out 4 – 5 times a day ( unless otherwise indicated). The temperature of the solution should be average, and the duration of the procedure should be 3 – 4 minutes.

For gargling you can use:

• antimicrobial and antiseptic agents;
• herbal pharmaceutical preparations;
• folk remedies.

Antimicrobial and antiseptic gargles for sore throat

Name	Release form	Effect	Mode of application
Furacilin	Pills	Has an antimicrobial effect. Reduces the inflammatory process.	Prepare a solution of 200 milliliters of water and 0.02 grams of the drug. Crush the tablets, then stir the solution intensively for 5 – 10 minutes. Before use, rinse your mouth with water or soda solution.
Hexoral	Spray Solution	Stops the activity of pathogenic organisms. Promotes healing of mucous membranes. Reduces the intensity of cough.	The spray is sprayed for 2 seconds onto the affected areas. The undiluted solution is used for rinsing, the duration of which should not exceed 30 seconds. Apply 2 times a day.
Miramistin	Solution	Fights microbes and viruses, reduces the resistance of pathogenic microorganisms to antibiotics. Eliminates plaque on mucous membranes, combats the feeling of dryness in the throat.	Adults can use an undiluted solution of the drug to rinse. For children under 14 years of age, the drug should be diluted with water in a ratio of 50 to 50.
Lugol's solution	Spray Solution	Glycerin, which is part of the drug, softens the affected areas of the mucous membrane, and iodine fights pathogenic microorganisms.	The solution is applied to a gauze swab, which is used to treat the palate and tonsils. The spray irrigates the inflamed areas. Use no more than 3 times a day.
Iodinol	Solution	Has a bactericidal effect against a large number of bacteria. Accelerates the healing of mucous tissues.	The solution is used in diluted form. For a glass of water ( 250 milliliters) 1 tablespoon of the drug is used.
Chlorhexidine	Solution	Actively fights both bacterial and viral infections. Has a long-term healing effect.	For rinsing, adults use undiluted solution in the amount of 1 tablespoon. Children under 14 years of age should dilute the drug halfway with water. Before use, rinse your mouth thoroughly. After rinsing, refrain from eating and brushing your teeth for 2–3 hours.
Rivanol	Pills	Has a disinfecting effect. It has the greatest effect on follicular tonsillitis.	To rinse, you need to prepare a solution at the rate of 0.2 grams of the drug per 200 milliliters of water.
Tantum verde	Aerosol	Fights inflammation and has an analgesic effect.	The solution is used in the amount of 1 tablespoon. The aerosol is sprayed in 5 to 7 sprays for adults and 4 sprays for children from 6 to 12 years old. Before using any form of the drug, you must rinse your mouth with water.

The drugs are purchased at the pharmacy and used an hour before or after meals.

Herbal pharmaceutical preparations
Such products contain extracts medicinal plants. To preserve the healing properties of the drug components, they should be mixed with water at room temperature.

Pharmaceutical preparations based on herbs for gargling with sore throat

Name	Release form	Effect	Mode of application
Rotokan	Solution	Has a healing and anti-inflammatory effect. Helps reduce pain and resolve swelling.	The drug contains a large number of plant components that can cause allergies. Therefore, it is necessary to start using small doses. For the first rinse, 1 teaspoon of the drug is mixed with a glass warm water. If after the first procedure no allergic reactions occur within 4–5 hours, the concentration must be increased to 3 teaspoons of the medicine per glass of water.
Chlorophyllipt		Accelerates the healing process of mucous tissues, destroys and prevents the further development of bacteria. The drug also improves the overall resistance of the body and improves the supply of oxygen to tissues.	The spray irrigates the tonsils ( 1 spray for each) 3 – 4 times a day. The drug in solution is mixed with water at the rate of 1 teaspoon per glass of liquid. Rinse the mouth with the solution 2 – 3 times a day.
Malavit	Solution	Using the drug can reduce the intensity of pain and swelling of tissues.	To carry out the rinsing procedure, 100 milliliters of water should be mixed with 5 - 10 drops of medicine.
Inhalipt	Spray	Has an antiseptic and anesthetic effect. Fights microbes and promotes rapid healing of the mucous membrane.	One session of irrigation of the affected areas includes 2 - 3 sprays.

Folk remedies
Rinse products prepared according to folk recipes, have a fairly mild effect on the affected mucous membranes. Therefore, it is recommended to combine them with medications recommended by your doctor. The effect of rinsing with folk remedies lasts less, so the procedure must be carried out every 2 to 3 hours.

Folk remedies for gargling with sore throat

Name	Ingredients and method of preparation	Effect
Sea water	Food sea ​​salt (tablespoon) mixed in a glass of water.	Reduces pain.
A solution of iodine, salt and soda	For a glass of liquid, use 5 drops of iodine and 1 teaspoon each of baking soda and table salt.	Fights the inflammatory process, eliminates tissue swelling.
Lemon juice	Freshly squeezed lemon juice is mixed in an amount of 2 parts with 3 parts water.	Effectively fights the feeling of sore throat and suppresses the development of the inflammatory process.
Herbal tea number 1	Equal parts of calendula, chamomile and eucalyptus in a total amount of one tablespoon are brewed with a glass of boiling water.	Helps restore damaged tissues and fights infection.
Herbal tea number 2	Herbs such as wormwood, plantain and calendula are mixed in equal quantities. A tablespoon of the collection is steamed with 200 milliliters hot water.	Has anti-inflammatory properties.
Clove decoction	Carnation ( spice) is steamed with boiling water at the rate of 10 - 12 granules per 1 glass. The finished solution should have a dark brown color.	Renders antiseptic effect.

What folk remedies exist for the treatment of sore throat?

There are a large number of folk remedies for the treatment of sore throat, which, depending on the type of effect, are divided into several categories.

In groups traditional medicines used to treat angina are:

• antipyretics;
• restorative drugs;
• rinsing agents.

Antipyretics
The use of medicinal plants that have an antipyretic effect helps fight the main symptom of sore throat - high fever.

The following plants have an antipyretic effect:

• chamomile;
• cranberry;
• raspberries;
• rose hip;
• Linden.

Chamomile
In addition to lowering temperature, chamomile increases sweating, which reduces intoxication. Also, preparations based on this component normalize intestinal activity and stimulate appetite.
A decoction is prepared from chamomile, for which a tablespoon of the raw material is brewed with boiling water. After 2 hours of infusion, the decoction should be given to a patient with a sore throat throughout the day. In addition to using chamomile internally, this plant is used for enemas. Chamomile infusion prepared from a glass of water and 2 tablespoons of dry inflorescences, combine with sunflower oil (50 milliliters) and use a syringe to inject the solution into anus. This procedure allows you to reduce the temperature by 0.5 - 1 degree.
Contraindications for the use of chamomile are intolerance to this component.

Cranberry
Cranberries not only help fight fever, but also have an antiseptic effect, inhibiting the activity of harmful microorganisms. Also, cranberry preparations enhance immune functions and improve the general condition of the body. To prepare a cranberry drink, crush 150 grams of berries and squeeze the juice out of them using a gauze cloth. Cake ( leftover berries) pour in a liter of water and bring to a boil over heat. Combine the resulting broth with cranberry juice and honey.
Cranberry is not recommended for those patients who suffer from liver disease or increased acidity gastric juice. You should drink cranberry drinks after meals, and after drinking you should rinse your mouth with water.

Raspberries
Raspberry drinks are used as a means to reduce the temperature and level of intoxication of the patient. This plant also has an analgesic effect. Raspberry jam can be added to tea 1 - 2 teaspoons, and from fresh berries prepare juice. For juice, you need to grind 150 - 200 grams of berries with sugar or honey and dilute the resulting pulp with 2 cups of boiling water. You can also prepare a medicine against sore throat from raspberry leaves. To do this, fresh leaves in the amount of 100 grams should be poured with hot water and steamed for 10 - 15 minutes. You need to drink the decoction throughout the day.
, heart failure . People who suffer from ulcers or gastritis should also refrain from drinking rosehip drink. The acids contained in rose hips can damage tooth enamel. Therefore, after consuming it, you should rinse your mouth with water.

Linden
Linden has an antipyretic, diaphoretic and expectorant effect. Linden contains a large amount of vitamin A and C, which allow you to better cope with sore throat. To make linden tea, brew a tablespoon of inflorescences with a glass of boiling water. Linden drinks put strain on the heart, so people with heart disease should limit themselves to one cup linden tea in a day.

General restorative drugs
The composition of such products includes plants that contain large amounts of vitamins, organic acids, and microelements. These substances strengthen the body's defenses, allowing it to fight sore throat.

Recipes for strengthening the body are (one part of the raw material is equal to a tablespoon, part of water is equal to one glass):

• Rowan tea. Pour 1 part dry berries with 1 part boiling water and leave to steep for several hours. Take one third of a glass three times a day.
• Radish with honey. You should take a black radish, cut off the top and pour honey into the resulting hole. Leave overnight, then take one teaspoon of honey infused in the radish. In the evening, repeat the procedure with honey and radish.
• Propolis. Propolis should be cut into small fractions and sucked after eating. You can also put a piece of propolis behind your cheek or under your tongue before going to bed.
• Fig decoction. Cut the dry berries into small pieces, then add 1 part of the raw material to 2 parts of water. Leave on fire for about 5 minutes, then divide the entire volume into several parts and drink throughout the day.
• Aloe with honey. 1 part aloe pulp must be mixed with 3 parts honey. Take the mixture one teaspoon after meals.
• Apple with onion. You should take an apple and a medium-sized onion and grate them or grind them in a blender. Add 2 parts honey to the apple and onion pulp. Take the product 3-4 times a day, one teaspoon.

Rinses
Gargling with preparations based on herbal ingredients can reduce tissue swelling, reduce pain and prevent the proliferation of bacteria on the mucous membrane. Procedures should be carried out 5–6 times a day.

Rinse aids are (one part of the raw material is equal to a tablespoon, part of water is equal to one glass):

• Beetroot juice. Grate the beets, squeeze out the juice and gargle with it. Using the same analogy, you can prepare carrot juice, either used alone or diluted with beet juice.
• Cranberry juice. Crush 3 parts fresh or thawed berries, mix with 1 part water. Add honey and carry out procedures, after which the mouth should be rinsed with water.
• Garlic infusion. Dilute 1 part chopped garlic with 1 part warm water. Leave for 5 – 10 minutes, strain and use for rinsing.
• Pine decoction. Spruce needles ( 100g) should be finely chopped, pour 2 parts water and keep on fire, avoiding strong boiling, for 20 minutes.

You can also use decoctions of St. John's wort, sage, chamomile, calendula, and thyme for rinsing.

How long does it take to treat a sore throat?

How long it takes to treat a sore throat depends on its form and the degree of reactivity of the body. For bacterial sore throat, the duration of treatment is determined by the course of antibiotic therapy. So, on average, a course of antibiotic treatment lasts from 7 to 10 days. The minimum course is 5 – 7 days, the maximum is 10 – 14 days. However, this does not mean that the treatment of sore throat ends here. After a basic course of antibiotics, local and restorative treatment continues. Thus, on average, the duration of treatment will take about two weeks. If it is a viral sore throat, then the time frame for its treatment is approximately the same. However, if a viral sore throat is complicated by the addition bacterial flora, then her treatment is delayed. Attachment of purulent flora ( let's say staphylococcus) delays the treatment of sore throat up to three to four weeks.

As for the treatment of chronic forms of angina, their duration increases. Courses of conservative treatment of chronic tonsillitis are carried out twice a year. This can be washing the tonsils, inhalation, irrigating the throat with antiseptics and other methods. All these methods work gradually, slowly increasing resistance ( resistance) organism. If relapses ( repeated exacerbations) chronic tonsillitis is very frequent, then courses of treatment are carried out four times a year. Each course lasts from 10 to 14 days.

Another parameter that determines the duration of treatment is temperature. As a rule, sore throat is accompanied by an increase in body temperature. Maximum temperature rises ( 39 degrees) are observed with purulent, bilateral sore throats. Most often, the temperature rises to 38 degrees and lasts 3 to 5 days. This temperature is typical for viral, fungal and unilateral bacterial tonsillitis. Antibacterial treatment should be continued for several more days after the temperature normalizes. It happens that the patient subjectively feels better, but the temperature continues to persist. This may indicate either the development of complications or the persistence of an infectious focus. In this case, the doctor may change the antibiotic, and treatment will continue until the temperature stabilizes. After the thermometer shows 36.6 degrees, it is necessary to continue antibiotic therapy for another 3 to 5 days. If treatment is interrupted at this point, the infection may reactivate after a few days ( resume again).

There are cases when no increase in temperature is observed, or a slight increase is observed. For people with weakened immune systems ( for example, those suffering from immunodeficiency (HIV)), as well as for older people, erased forms of sore throat with mild subfebrile symptoms are typical. In such cases, the temperature ranges from 37 to 37.2 degrees, and sometimes it even remains within normal limits ( 36.6 degrees). In this case, the doctor is guided by the parameters of laboratory tests. If leukocytosis characteristic of angina ( increase in the level of blood leukocytes above 9x 10 9) disappears, which means that antibiotics can be discontinued, and treatment moves to the stage of restorative procedures.

What antibiotics are used in the treatment of sore throat?

Antibiotics from a wide variety of groups are used in the treatment of sore throat. Considering that more than 50 to 70 percent of sore throats are caused by beta-hemolytic streptococcus, penicillin antibiotics are mainly used. For tonsillitis of other etiology ( for example, in the case of staphylococcal sore throat) antibiotics from the group of cephalosporins and macrolides are also used.

Groups of antibiotics used in the treatment of sore throat

Group of drugs	Representatives	Mechanism of action
Penicillins	Naturally occurring penicillins: penicillin G; penicillin V; benzathine benzylpenicillin. Penicillins of synthetic origin: bicillin-1; bicillin-5. Semi-synthetic penicillins: oxacillin; ampicillin; amoxicillin.	They have a wide spectrum of action and are effective both for streptococcal sore throat and sore throat of other etiologies. A significant disadvantage is the high frequency of allergic reactions.
Cephalosporins	First generation: cephalexin; Second generation: cefuroxime Third generation: ceftazidime; ceftriaxone. Fourth generation: cefepime.	They have a wide spectrum of action and are effective against streptococci, staphylococci, and enterobacter.
Macrolides	Natural origin: oleandomycin; spiramycin. Synthetic origin: clarithromycin;	Drugs in this category are reserve drugs. They are used in extreme cases, when there is intolerance to penicillins and cephalosporins.

In the treatment of sore throat, antibiotics are used systemically and locally. Systemic antibiotics are used both in tablet form and in injection form ( intramuscular and intravenous). Local antibiotics are used in the form of sprays that are sprayed onto the tonsil area.

The antibiotic therapy algorithm for angina is as follows:

• If there is extensive inflammation of the tonsils ( the doctor sees multiple purulent plaques), then treatment begins immediately with cephalosporins. It is preferable to start with representatives of the third generation.
• If a culture has been previously done and the exact pathogen has been identified, then a strictly specific antibiotic is selected. For example, if gram-positive flora has been identified, penicillin is prescribed.
• Antibiotic therapy is necessarily accompanied by the prescription of antifungal drugs. This is done in order to avoid candidiasis.
• In case of moderate and severe forms of sore throat, antibiotics are prescribed by injection.

What does a throat look like with a sore throat?

What the throat looks like with a sore throat depends on the form of the disease. There are quite a few forms of sore throat, and only a qualified specialist can accurately determine which form of the disease a person is suffering from. An incorrect diagnosis entails an incorrect treatment regimen and, consequently, all sorts of complications of the disease.

Characteristics of the throat various forms sore throat

Forms of sore throat	Throat view
Catarrhal sore throat	The throat appears red and swollen. The back wall is also bright red. The tonsils are enlarged either on one side or both. There is no pathological plaque. The tongue is dry and slightly coated.
Follicular tonsillitis	Redness of the throat, soft palate, and tonsils is noted. On the surface of the bright red tonsils, rounded yellow-white formations appear, which are nothing more than accumulations of pus.
Lacunar tonsillitis	There is redness and swelling of all the walls of the throat. The tongue is dry, with a brown coating. On the tonsils, pus takes the form of yellowish spots or plaque. Pus thus fills the crypts of the tonsils. Sometimes plaque in the form of films covers most of the tonsil.
Fibrinous tonsillitis	The tonsils are entirely covered with a gray-white coating. Plaque is a mixture of fibrin and dead cells. Plaque can not only cover the entire surface of the tonsil, but also extend beyond it.
Herpangina	Small pink bubbles are visible on the surface of the back wall of the pharynx, tonsils, soft palate, tongue and arches.
Fungal tonsillitis	The pharynx is red and swollen. The tonsils are sharply enlarged and covered with a white, loose, cheesy coating.
Sore throat with scarlet fever	The throat with scarlet fever looks bright red, even flaming ( "flaming throat" - specific symptom with scarlet fever). At the same time, a clear boundary is visible between the flaming throat and the pale sky. The tonsils themselves are swollen and covered with a gray-dirty coating.

What complications can a sore throat cause?

Despite the fact that sore throat seems to be a minor disease and many people ignore its comprehensive treatment, it is fraught with numerous complications. Complications of angina are conventionally divided into local and general. Local complications- these are those that develop within the tonsils and surrounding tissues. General complications affect the entire body.

Local complications of angina are:

• peritonsillar abscess or cellulitis;
• swelling of the larynx;
• purulent lymphadenitis;
• otitis.

Abscess or cellulitis
An abscess is a localized collection of pus. In a peritonsillar abscess, pus accumulates around the inflamed tonsils. Cellulitis differs from an abscess in size and boundaries. It is somewhat more extensive than an abscess and affects not only the tonsils themselves, but also the surrounding tissues. The boundaries of phlegmon are more vague. Both abscess and cellulitis are very dangerous complications that require prompt resolution. Pus from an abscess or cellulitis can spread through the blood or lymphatic vessels, thus facilitating the generalization of infection.

Laryngeal edema
Laryngeal edema is extremely dangerous condition, which can lead to death. The larynx is not only an organ of speech production, but also a part respiratory system. Through it, air penetrates from the external environment into the bronchi and lungs. Therefore, if the larynx swells, difficulty breathing occurs. Patients attempt to cough, but this does not bring results. As the larynx swells, breathing becomes more difficult, and oxygen deficiency occurs.

Purulent lymphadenitis
Purulent lymphadenitis is purulent inflammation of the lymph nodes. Develops due to the spread of pathogenic microorganisms from the tonsils to the lymph nodes. In this case, the lymph nodes become enlarged, tense and painful. The surrounding tissues also become tense and adherent to the lymph nodes. If the process is two-way ( that is, the lymph nodes of the right and left sides are affected), then the entire neck increases in volume. It becomes difficult for the patient to turn his head or make any movements. Due to compression of the lymphatic vessels, the outflow of lymph is disrupted, as a result of which the tissues swell even more. In addition to the lymphatic vessels, blood vessels are also compressed. As a result, the blood does not circulate, but stagnates ( venous stasis), giving the neck a purple tint.

Otitis
Otitis is called acute inflammation middle ear. Due to the close proximity of the mouth and ear, otitis media is one of the most frequent complications tonsillitis. Through eustachian tube (which connects the oropharynx and the ear cavity) bacteria easily penetrate from the tonsils into the middle ear. The first symptom of otitis media is moderate hearing loss. Hearing loss is followed by pain.

Common complications of tonsillitis are:

• glomerulonephritis.

Rheumatism
Rheumatism, or rheumatic fever, is a systemic lesion connective tissue autoimmune nature. Its pathogenesis is based on the body’s specific response to the penetration of beta-hemolytic streptococcus. Thus, in response to the penetration of streptococcus ( the most common causative agent of sore throat) the human body begins to synthesize antibodies. These antibodies are produced to all components of streptococcus, namely streptolysin O and S, M protein, hyaluronic acid. These antibodies then bind to antigens ( components of streptococcus) and settle in the kidneys, on the heart valves, and joints. Next, the “antigen + antibody” complex triggers an inflammatory reaction, which unfolds where this complex settles. The main target organs for rheumatism are the heart, kidneys, and joints.

Myocarditis
Myocarditis is an inflammatory lesion of the heart muscle. This complication can develop both during the sore throat itself and after it. In the first case, the cause of myocarditis is specific damage to the muscle by the pathogenic microorganisms that caused the sore throat. Most often, myocarditis develops with viral tonsillitis, because viruses have the greatest affinity for heart tissue. Since viral sore throats most often occur in children, viral myocarditis is usually observed in children and adolescents. Since in myocarditis they themselves are affected muscle fibers, then the heart, being a muscular organ, becomes weak and ceases to perform its functions. The main symptoms of myocarditis are weakness, shortness of breath, rapid heartbeat, heart rhythm disturbances.

Myocarditis can also be of an autoimmune nature. Such myocarditis develops a couple of weeks after suffering from a sore throat. The mechanism of development of this myocarditis is similar to rheumatism. Immune complexes settle on the heart muscle, triggering a cascade of inflammatory reactions.

Glomerulonephritis
Glomerulonephritis is a bilateral kidney disorder. The cause of the development of this complication is an autoimmune process that develops in response to the penetration of streptococcus into the body. As with rheumatism, in response to this the body produces antibodies, which specifically bind to antigens and form immune complexes. These complexes initially circulate in the blood. If rheumatic tests are done at this moment, they will reveal the presence specific antibodies. The best known is the anti-streptococcal streptolysin antibody, abbreviated as ASLO.

These complexes then settle on the glomerular vessels of the kidneys. An inflammatory process develops, which gradually ( within 10 – 15 years) leads to kidney failure. Glomerulonephritis is difficult to treat, so its development should be feared in the first place. Symptoms of glomerulonephritis are high blood pressure, swelling, and blood in the urine.

Chronic tonsillitis is an infectious disease that regularly affects the tonsils. Otherwise they are called tonsils. Located on the sides of the velum palatine, in the cavity between the tongue and soft palate, they are a component of the lymphoid pharyngeal ring, which creates a protective barrier for harmful microorganisms that try to penetrate from the outside.

Causes in the tonsils

A systematically recurring protracted inflammatory process that is difficult to treat, in other words, advanced tonsillitis, leads to the fact that the tonsils cease to cope with their natural functions. Microorganisms that have penetrated inside are not destroyed and are sources of the onset of the inflammatory process, first acute and then chronic.

The cause of its occurrence is infectious pathogens remaining in the lymphoid tissue of the tonsils and throat after poorly treated acute tonsillitis, the appearance of which occurs due to:

• disturbances in natural nasal breathing, often developing due to a curved nasal septum;
• the presence of infectious foci in other organs - sinusitis, rhinitis, caries, adenoids;
• deterioration of the immune system;
• polyp growth.

Possible consequences of the disease

During the period of chronic tonsillitis, the tonsils are characterized by bright red, they are enlarged, swollen, compacted, adhesions form in the holes, liquid pus collects and toxins are released. They cannot exit normal channels, thereby affecting other organs (kidneys, skin, intestines), which causes immune disorders and the development of side diseases: sepsis, psoriasis, thyrotoxicosis, eczema.

Chronic tonsillitis is the key cause of frequent pharyngitis, bronchitis, diseases of internal organs (rheumatism, systemic lupus erythematosus, endocarditis), allergic and autoimmune diseases. Under the influence of a constantly present infectious focus, heart defects and gastrointestinal diseases can develop. The role of “provocateurs” is unfavorable clinical conditions, poor nutrition, and as a result, sore throat after sore throat. The transition of an ordinary disease to the chronic stage is most common in the adult category of the population. It is an adult who, due to the crazy pace of life and constant employment, most often suffers from illnesses on his feet, without thinking about what complications of sore throat may arise in the future. Sometimes chronic tonsillitis develops as an independent disease: microbes that fall on the tonsils “inhabit” other places: the nose or oral cavity.

How is angina transmitted?

There are several ways to transmit this disease from one person to another:

1. Airborne droplets arising from social contacts. The peak of epidemics is observed in the off-season or winter - the time when a person coughs and sneezes most often.
   How is angina transmitted from loved ones? During the use of personal hygiene items, dishes, or through a kiss.
2. The nutritional route is through the consumption of foods contaminated with staphylococcus. Therefore, before eating, you should always thoroughly wash your food.
3. Autoinfection. This is hypothermia, stress, any decrease in immunity, which causes the activation of pathogenic bacteria that live on the tonsils of any healthy person.

Symptoms of the chronic form of the disease

Chronic tonsillitis is a disease that requires therapeutic therapy both in the stage of repetitions and outside of periods of exacerbation, because the tonsils under the constant influence of infection lose their protective properties. Exacerbations occur up to several times a year; weakened people may experience this process monthly. Symptoms characteristic of this disease:

• discomfort and painful sensations in the throat;
• red, swollen and hot tonsils with a white or yellow coating;
• feeling of stiffness when turning the neck;
• increased body temperature;
• difficulty swallowing saliva, water, food;
• hoarseness of voice;
• abdominal pain;
• the appearance of symptoms of intoxication.

Temperature during sore throat is one of the main signs of the presence of an active inflammatory process in the body. In the first 2-3 days, its indicator is often 38-39 o C, then it gradually decreases. Sometimes, extremely rarely, there is no temperature with a sore throat. This phenomenon occurs after suffering a severe infection and indicates a pronounced suppression of the immune system.

At the same time, during the period of relapse, untreated tonsillitis may not manifest itself with the above symptoms, but may be limited to some deterioration in well-being, tolerable pain when swallowing, which quickly passes, sometimes even without drug therapy. This does not mean that the disease has left the body. On the contrary, it is in the process of development, which persistently causes damage to health. Outside the period of exacerbation, chronic tonsillitis is manifested by periodic attacks of weakness and bad breath.

Treatment of the disease

Treatment of angina is carried out only under the supervision of a doctor and consists of restoring the function of the tonsils themselves and getting rid of accompanying foci of infection.

Conservative therapy consists of the use of special techniques and medications and consists of a whole range of measures, such as:

• Modern medicine offers hardware treatment for this; most often this is the most effective method for this form of the disease. The essence of this treatment is a special injection, after which the lacunae of the tonsils are cleaned using a vacuum, and the resulting voids are filled with a drug.
• Laser therapy, the result of which is a reduction in swelling of the throat and inflammatory processes occurring in the tonsils.
• Ultraviolet irradiation, considered the most proven and effective method of sanitation of foci of chronic infection, causes the destruction of bacteria, rapid healing of cells, increased nutrition and blood supply in the treated area.

The above manipulations are carried out in courses ranging from 5 to 15 sessions.

Drug therapy

Drug therapy in the treatment of chronic sore throat is aimed at eliminating the infection, regenerating the immune system and includes:

• Antibiotics. These drugs are taken during severe exacerbations of the disease, until the pathogen completely disappears. Sumamed, Azithromycin, and Cefazolin are often used. Belonging to the group of macrolides, such drugs are characterized by high efficiency in treatment and the ability to accumulate in the focus of inflammation - lymphoid tissue. Antibiotics of this group are active against the causative agents of frequently exacerbating atypical pneumonia and tonsillitis: chlamydia and mycoplasma. They also have an antimicrobial effect, which is especially useful for preventing oral thrush, which often occurs after prolonged use of other antibiotics.
• Probiotics. Helps restore intestinal microflora, which has a positive effect on the immune system. Popular drugs are “Bifidum”, “Linex”.
• Dissolving tablets, inhalation sprays.
• Immunostimulating drugs. To increase local immunity in the oral cavity, doctors often prescribe Imudon.

Sore throat: how to gargle a sore throat?

A mandatory method of therapy in the treatment of chronic tonsillitis is gargling, for which you can use different solutions.

The simplest and most effective is considered to be a medicinal composition of salt, iodine and soda. To do this, dissolve a teaspoon of soda and salt and 5 drops of iodine in a glass of boiled water.

Beetroot juice is a powerful remedy that relieves inflammation. To prepare it you will need a glass of beet juice and 20 ml of apple cider vinegar. Gargle the sore throat with the resulting mixture every 3 hours.

Herbal decoctions promote rapid recovery. This could be an infusion of wormwood, plantain, calendula, chamomile or eucalyptus. A composition of elderberry, mallow and sage flowers is also effective. You can find many ready-made preparations at the pharmacy. A tablespoon of any of them should be brewed in a glass of boiling water, strained and used for its intended purpose. Of the medicinal compositions that are effective in the treatment of angina, “Chlorophyllipt”, “Iodinol”, “Furacilin”, “Lugol”, “Miramistin”, “Octenisept”, “Dioxidin”.

Features of nutrition during illness

While paying attention to the correct use of medications, you should definitely monitor your diet. Food should be warm and semi-liquid. An important factor in the treatment of chronic sore throat is drinking plenty of warm water, the effect of which is aimed at preventing dehydration and warming the throat.

If drug treatment is ineffective, as a last resort, doctors use a surgical method consisting in partial or complete removal of the tonsils. A timely visit to a doctor will help you avoid surgery.

Traditional methods

Drug treatment of chronic sore throat can be successfully combined with traditional methods, tested by more than one generation of connoisseurs of their properties. A decoction of 50 grams of sage, plantain and sundew flowers is effective. This composition needs to be crushed and boiled for a couple of minutes in a liter of boiling water. Then leave for an hour and filter. Take a tablespoon three times a day. Regular consumption of honey, lemon, onions and green onions is very beneficial.

It is worth increasing the amount of strawberries, raspberries, blueberries and wild strawberries in your diet.

for sore throat

When treating chronic sore throat, you should examine not only the oral cavity, but also gastrointestinal tract. After all, the tonsils, which have ceased to fully fulfill their natural functions, could allow infection to enter the body. If a one-time sore throat requires regular irrigation of the oral cavity, taking antibiotics, vitamins and other medications, then with its chronic form, in order to identify the cause of the disease, it is important to see all medical specialists: from an immunologist to a dentist. After all, timely identification of foci of infection helps save a person from much suffering.

Chronic tonsillitis - infectious inflammation tonsils (tonsils), which is protracted. With this disease, tonsils are constantly present harmful bacteria and microbes (streptococci, staphylococci), ready to begin to actively multiply at any favorable opportunity, causing acute sore throat in the host (human). The peculiarity of chronic tonsillitis is that it is difficult to treat, since it is almost impossible to completely eliminate the bacteria that cause it. But you can help the body live peacefully with them and prevent the infection from exacerbating and further spreading.

Chronic tonsillitis occurs among children and adults, regardless of place of residence and climate. Several factors can lead to infection of the tonsils:

• untreated infectious diseases (usually tonsillitis);
• frequent pharyngitis (sore throat);
• allergy;
• inflammation in the sinuses;
• deviated nasal septum;
• caries and gum disease;
• low immunity.

In most cases, the disease develops after poorly treated acute tonsillitis - tonsillitis. In this case, tonsillitis simply becomes chronic when the infection chooses the lymphatic tissue of the palatine tonsils as a permanent place of residence. In normal times, pathogenic bacteria are dormant and may not cause serious discomfort.

The following factors can provoke their activity:

• hypothermia of the oropharynx or the whole body;
• mechanical injury to the tonsil, chemical or thermal burn(for example, spicy, hot food, strong alcohol);
• severe decrease in immunity due to the presence of other infections in the body;
• improper and unbalanced diet;
• prolonged nervous tension, severe stress.

All these factors work to reduce immune defense organism, resulting in the creation of a favorable environment for the rapid proliferation of bacteria. Tonsillitis worsens, another sore throat begins.

A visual examination of the throat of patients with chronic tonsillitis reveals:

• enlargement and redness of the tonsils;
• looseness and grooves on the tissue of the tonsils;
• the presence of white pustules on the tonsils, from which a cheesy mass with a purulent odor periodically emerges.

Visual changes are accompanied by severe sore throat, fever, chills, and weakness. There may also be enlargement of the lymph nodes in the neck.

IMPORTANT! If a person suffers from a sore throat more than once a year, most likely he has chronic tonsillitis.

Pronounced signs of chronic tonsillitis may appear and disappear, as periods of exacerbation are followed by periods of remission. In this case, we are talking about a compensated form of the disease, when the tonsils are able to cope with inflammation, preventing its development. However, over time, especially if a person’s immunity is suppressed, periods of remission may completely disappear, and tonsillitis will acquire a decompensated form. In this case, the tonsils will be constantly inflamed and enlarged, as well as persistent weakness, drowsiness, and incessant sore throat.

Therefore, it is very important to start proper treatment on time. Moreover, chronic tonsillitis, left unattended, can lead to complications from the cardiovascular system, kidneys, respiratory organs, and musculoskeletal system.

Is it possible to get rid of chronic tonsillitis once and for all?

Unfortunately, it's not possible. It is not possible to eliminate all pathogenic bacteria and microbes, because they lie in wait for a person everywhere: in the air, water, food. But a healthy and strong human body copes well with the infection that has entered it on its own. The immune response guards health, quickly identifying and destroying harmful bacteria. If immunity decreases, any infection that enters the body lingers in it and causes various inflammations and diseases.

Another reason why it is problematic to eliminate tonsillitis completely is the ability of microbes to quickly adapt and develop resistance to adverse conditions. The widespread modern habit of treating even minor ailments with antibiotics has helped pathogenic bacteria develop reliable defense mechanisms. In response to the action of the antibiotic, microbes produce special enzymes that neutralize and destroy the active components of the drug. As a result, the antibiotic does not clear the infection.

But that's not all. One of the culprits of chronic tonsillitis is Staphylococcus aureus– forms colonies living in multilayer films. Therefore, even if the medicine destroys the top layer of bacteria, the remaining layers continue to function actively.

Lifestyle to help relieve tonsillitis symptoms

Because the main reason the development of infection is reduced immunity; in the process of treating chronic tonsillitis, one cannot do without restorative procedures.

You can increase your immunity and resist exacerbations by:

• sufficient physical activity;
• balanced diet;
• hardening;
• refusal bad habits(cigarette smoke and alcohol irritate the tonsils and reduce immunity);
• maintaining indoor air humidity at 60-70% (using a humidifier).

The point about the need for hardening causes a justified protest in many people, because chronic tonsillitis is often aggravated due to hypothermia. But the hardening technique involves a gradual and very slow decrease in water or air temperature, allowing the body to adapt to changes and gently expand its comfort zone. You can pay attention to the hardening system Porfiria Ivanova. There are other methods for children: Komarovsky, Grebenkin, Tolkachev.

You can also carry out hardening with the help of a contrast shower, when hot (up to 45 degrees) and cool (up to 18 degrees) water is turned on alternately. The temperature contrast increases in stages: in the first days the temperature drops and rises by only two to three degrees from the comfortable level, then the temperature gap widens.

IMPORTANT! Procedures for hardening the body cannot be carried out during an exacerbation of any diseases, including chronic tonsillitis.

Drug therapy

In case of chronic tonsillitis in remission, antibiotics are used extremely rarely, and preference is given to antihistamines, antiseptic sprays. The doctor also prescribes inhalations with medicines: Furacilin, Tonsilgon N, Dioxidin and others.

To treat exacerbations of chronic tonsillitis, antibiotics are almost always used. They allow you to quickly and reliably suppress the activity and growth of pathogenic bacteria, eliminating the infection and alleviating the patient’s condition.

The following groups of antibacterial agents are used to treat chronic tonsillitis:

• penicillins ( Flemoxin Solutab, Panclave, Ampisid);
• macrolides ( Sumamed) and cephalosporins ( Cefspan);
• aminoglycosides ( Amikacin).

IMPORTANT! Only a doctor can choose medications, prescribe dosages and duration of treatment. Self-medication with antibiotics can lead to irreversible changes in the body.

Penicillins

These drugs not only relieve symptoms during exacerbation, but also protect the body from complications caused by streptococci.

Flemoxin Solutab

Available in tablet form. This semi-synthetic antibiotic actively fights staphylococci, streptococci and other bacteria. The exact dosage is determined by the doctor, but usually it does not exceed 750 mg per day for children and 1500 mg for adults. The duration of treatment is at least 10 days.

Ampisid

Presented in the form of tablets, powders for suspension and injections. The active ingredients of the drug make it effective even against resistant strains of bacteria. The drug is taken orally in dosages of up to 25 mg per day for children and up to 2000 mg for adults. Duration of treatment is up to two weeks.

Macrolides and cephalosporins

Macrolides have a bacteriostatic effect, blocking the reproduction and growth of bacteria. In addition, they are able to easily penetrate the body's cells and destroy the microbes in them. And cephalosporins act on all bacteria resistant to penicillins.

Sumamed

Presented in the form of tablets, capsules, lyophilisate, powder and granules for suspension. Active against a wide range of bacteria, including streptococci and staphylococci. Adults are prescribed 0.5 g per day for three days, children - 10 mg per day per kilogram of weight for three days.

Cefspan

Cefspan, available in the form of capsules and granules for suspension, contains the antibiotic cefixime, which suppresses pathogenic bacteria and is resistant to the protective enzyme they secrete - beta-lactamases. Children weighing more than 50 kg and adults are prescribed 400 mg of the drug per day, children weighing less than 50 kg - up to 12 mg per day. The course lasts up to 10 days.

Aminoglycosides

Aminoglycosides treat even the most severe infections, but are highly toxic, so their use is justified only in the case of decompensated chronic tonsillitis. It is advisable to use third-generation drugs with reduced toxic effects.

Amikacin

Amikacin is available exclusively in the form of powder and solution for injection. It is effective in the fight against staphylococci resistant to penicillin and cephalosporin. The dosage is prescribed by the doctor. During the treatment period, it is necessary to check the functions of the kidneys, auditory nerve and vestibular apparatus every week.

Washing the tonsils

The procedure for washing the tonsils is often prescribed during an exacerbation of chronic tonsillitis. To carry it out, antibacterial drugs are used - Furacilin, Chlorhexidine, Miramistin, bacteriophages against staphylococci and streptococci.

A stream of the drug solution is directed under pressure into the lacunae of the tonsils, washing out the infection and disinfecting the affected area. Additionally, suctioning of the infected contents of the lacunae using a special device can be used. The result of the procedure is the elimination or significant reduction of inflammation, improvement in the condition of the tonsils and general well-being, and a reduction in the frequency of exacerbations.

IMPORTANT! The procedure for washing the tonsils can only be done by a specially trained ENT specialist.

Herbal medicine recipes

When chronic tonsillitis occurs in a compensated form, it can be dealt with using simple folk remedies. The most common of them are gargling and inhalation with herbal decoctions. And if tonsillitis has worsened, you cannot do without rinsing and inhalations.

The most effective herbs in the treatment of tonsillitis:

• sage;
• yarrow;
• calendula;
• chamomile;
• eucalyptus leaves.

You can use each herb separately or together. For inhalation, both the old method with a saucepan and special devices – inhalers and nebulizers – can be used.

Simple and effective recipes against tonsillitis

Purpose	Dosages	Cooking method	How and how much to use
Infusion for rinsing No. 1	A tablespoon of yarrow or sage, a glass of boiling water	Pour boiling water over the herb in a mug, cover, leave for 15-17 minutes, and then strain	Gargle with warm infusion five to seven times throughout the day immediately after meals. Do not drink or eat for an hour after the procedure. Treatment period: three days
Infusion for rinsing No. 2	A teaspoon of calendula and chamomile flowers, a glass of boiling water	Pour boiling water over the herb in a mug, leave for 18-20 minutes, strain	Gargle up to seven times a day with warm infusion an hour and a half before meals. Course – week
Decoction for inhalation	One tablespoon each of eucalyptus leaves, sage grass and chamomile flowers, two liters of water	Bring the herbs covered in water to a boil, cook over low heat for three to four minutes, remove the pan and leave to cool (to 60-65 degrees)	Bend over the pan (distance 20-30 cm), inhale the steam shallowly with your mouth for five minutes. Course – one inhalation per day for a week
Solution for inhalation with mineral water and eucalyptus infusion	A tablespoon of eucalyptus leaves, a glass of boiling water, a liter of mineral water	Pour boiling water over eucalyptus and leave for 15-25 minutes. Release the gas from the mineral water, heat it in a saucepan to a temperature of 55-60 degrees, remove from the stove, add eucalyptus infusion	Bend over the pan at a distance of 20-30 cm (it feels like it), inhale the steam shallowly with your mouth for ten minutes. You can do five to seven inhalations every two days

IMPORTANT! The use of recipes for rinsing and inhalation is contraindicated in the presence of allergic reactions to any herb, since additional swelling caused by the allergy will only aggravate the condition of the tonsils.

Video - How to treat tonsillitis with folk remedies

Aromatherapy

All essential oils have excellent antibacterial properties.

Essential oils will help cope with the manifestations of tonsillitis:

• sage;
• basilica;
• eucalyptus;
• tea tree.

The main area of ​​application of oils for chronic tonsillitis is inhalation. Since essential oils are potent compounds, therapeutic (minimal) doses are used for inhalation.

Any of the selected oils is added in the amount of just one drop per liter of hot water. You need to inhale the steam through your mouth, but not deeply. The session lasts no more than five minutes. It is possible to carry out 10 procedures every other day.

IMPORTANT! The water temperature should not exceed 60 degrees to avoid burns to the mucous membrane.

Before using any oil, an allergy test is required. To do this, a drop of undiluted ether is applied to the inner bend of the elbow for 30 minutes. Slight redness of the skin - normal reaction. If itching or rash occurs, you should stop using this scent and choose another one.

Rinsing the nasopharynx with salted water

This, unpleasant at first, but proven and effective method will help relieve inflammation and partially wash away the pathogenic flora from the tonsils.

Dilute a quarter teaspoon of salt (preferably sea salt) in a glass of water at body temperature. Draw in water through one nostril, closing the other, then spit it out through your mouth. The procedure will initially cause unusual or even unpleasant sensations, but they are worth enduring in order to get a good result. therapeutic effect. You can wash twice a day for an unlimited time.

Surgery

Tonsil removal surgery – extreme case. You should resort to it only when other means do not help, and the situation only worsens. Despite the fact that surgery allows you to get rid of chronic tonsillitis forever, doctors today try to avoid such a drastic method.

Tonsils perform a lot of useful functions in the body, protecting against infections and allergies. They also produce beneficial macrophages and lymphocytes. Thus, having lost the tonsils, the body is deprived of its natural defenses, and immunity decreases.

Therefore, you should not rush into the operation. To begin with, it is better to try to get rid of chronic tonsillitis with the suggested conservative methods. A complex approach in treatment will eliminate the symptoms of the disease, improving the quality of life, and over time, completely forget about any manifestations of chronic tonsillitis.

Video - Tonsillitis in children

Video - Chronic tonsillitis and its treatment