(Er Zhao Q&A 200318) Tonsils are lymphoid tissue in the pharynx. The systemic immune system is not fully developed in childhood. The lymphatic tissue in the pharynx is prone to frequent responses when dealing with pathogens. At this time, the size of the tonsils appears. Enlargement is a common phenomenon. Most people will shrink their tonsils when they enter adulthood, but a few people will continue to maintain their original shape.

In the long run, the size of tonsils depends on the state of the body's immune system. There is no clear drug that can accurately control its size, and it cannot be done manually. If the tonsils are so large that they block the airway, causing difficulty in breathing or even apnea during sleep (shown by sleep apnea monitoring), surgical removal needs to be considered. Fortunately, such cases are rare.

For acute infections, mild cases can heal on their own, while severe cases need to identify the pathogen and use targeted drugs. There is no single drug that can cure 10,000 people.

You can have it checked by a pediatrician or an ENT department. You can wait until you are over 15. If you are over 15 years old, you won’t be able to do that. If you want, see an internal medicine department! .

I am a pediatrician. The parent’s problem is that a 5-year-old child has swollen tonsils and a fever. Judging from the current symptoms, the child may have a respiratory infection. As for what the pathogen is and what positive signs there are now, it is recommended to go to the hospital again for examination before treatment.

Your child’s condition is constantly evolving. Maybe you didn’t have obvious symptoms and signs when you took your child to see a doctor before, but as time goes by, they may appear. This is normal. The most common upper respiratory tract infections in children are acute pharyngitis, tonsillitis, or herpetic pharyngobucculitis. Only professional doctors can diagnose them. Different diseases have different pathogens, and the principles of medication are also different.

What is the difference between acute pharyngitis, tonsillitis, and herpetic pharyngobucitis? What are the processing principles? Acute pharyngitis:

Mostly caused by viral infection, such as adenovirus, respiratory syncytial virus, etc.;

The main symptoms are fever, with body temperature usually between 38 and 39, sore throat, Symptoms of upper respiratory tract infection such as nasal congestion, runny nose and eyeball conjunctivitis;

General medical examination shows a red pharynx, but the surrounding lymph nodes are not swollen.

Routine blood tests were generally normal.

Treatment is mainly antiviral and symptomatic treatment.

Acute tonsil enlargement:

Mostly caused by viral infection, but also bacterial infection, affecting children over 2 years old.

The onset of illness is rapid, with high fever and body temperature between 39 and 40. The first symptom is obvious pharyngeal pain, aggravation of swallowing, and sometimes vomiting and abdominal pain.

Specialist examination revealed bilateral tonsil enlargement accompanied by white secretions and pus plugs, obvious congestion and even follicles around the throat wall, and palpable swelling and tenderness of lymph nodes around the neck.

If it is a continuous viral infection, the blood count is not high, and the duration of the disease is 1 week, but if it is a bacterial infection, it is characterized by persistent high fever for 5 to 7 days, an increase in the total number of white blood cells, a significant increase in neutrophil classification, and C Reactive protein increases. Most are streptococcal infections, with increased erythrocyte sedimentation rate and hemagglutinin A (anti-"O") doubling.

If it is a viral infection, take active antiviral and symptomatic treatment. Bacterial infections are treated with antibacterial drugs with bacteriological support. If recurrent tonsil enlargement III and recurrent suppuration affect development and normal life, surgical treatment may be considered.

Herpetic pharyngitis:

Mainly caused by coxsackie virus infection, more common in children under 7 years old, mostly in spring and summer season.

Herpetic pharyngeal buccal inflammation usually has an incubation period of 2 to 4 days. The onset is sudden, with fever and large temperature fluctuations, up to 40 degrees Celsius, leading to febrile convulsions. However, the disease seems to be menacing, and the prognosis is good. It can heal on its own in 4 to 6 days. Some children may develop mumps.

Herpetic pharyngolaryngitis is characterized by typical oral symptoms, is contagious, and is transmitted through feces-oral transmission; therefore, once oral herpes ruptures, it will easily cause obvious burning sensation in the mouth, pharynx and cheeks, and the child Pain, irritability, crying, unwillingness to open the mouth to eat due to oral inflammation, obvious drooling, nausea and vomiting, abdominal pain, and muscle pain.

Specialist examination showed that herpes-like mucosal destruction was seen in the pharynx and palatine tonsils, and the redness around the herpes was about 1 to 3%, followed by ulcers.

Pharyngeal blood routine examination showed low white blood cells.

Generally, there is no targeted antiviral treatment for herpetic pharyngitis and buccal inflammation. Clinically, it mainly involves basic care, oral care, and eating more liquid and easily digestible food.

When a 5-year-old child has enlarged tonsils, it is necessary to distinguish whether it is physiological enlargement or pathological enlargement.

A 5-year-old child is in the physiological enlargement stage of the tonsils. If there are no symptoms and he does not snore at night, no treatment is required. If you snore at night because of enlarged tonsils, you may need surgery to remove them.

If tonsil inflammation and fever occur repeatedly, you need to choose the appropriate drug based on the results of routine blood tests and other tests, and use the drug according to the course of treatment. You cannot stop or change the drug at will. If tonsillitis occurs several times a year, or once a month, and the patient does not grunt while sleeping, no surgical treatment is required. If tonsils become inflamed 3-4 times a month or more, surgery may be necessary.

Traditional Chinese medicine treatment is very effective.

1. Tonsillar swelling is mostly caused by exogenous wind-heat and internal accumulated heat. There are also cases of combined wind-cold and external evil, cold, depression and heat. The basic pathogenesis of this disease is the accumulation of evil heat, which fights with phlegm and accumulates in the throat. If it does not heal over time, it often leads to symptoms of yin deficiency, heat and blood stasis. 2. This disease is clinically divided into acute and chronic forms. Acute cases often have a rapid onset, with aversion to cold and fever, headache and cough, or vomiting, sore throat, difficulty swallowing, redness and swelling of the throat core, or suppuration, or even febrile convulsions; chronic cases may not have fever, or occasionally have low-grade fever. Dry throat, itchy throat and discomfort, red and swollen throat that does not heal for a long time, and dry cough with little phlegm. In the chronic course, there may be acute attacks. Treatment is mainly based on dispersing wind and heat, detoxifying and soothing the throat. Those that work on the exterior can relieve the exterior and eliminate evil; those that work on the inside can clear the inside and resolve phlegm. ① Wind-heat blockage: Fever, slight chills, cough, runny nose, thin white fur, floating pulse, etc. can be seen. Heat and poison accumulate in the throat, causing the throat to become red and swollen. For mild syndrome, use Yinqiao Powder to dispel wind and clear away heat, which is pungent and cool to dispel wind and clear away heat. Add Mabo and Shegan to soothe the throat. Severe cases are treated by clearing away heat and detoxifying, soothing the throat and resolving phlegm. Use Burdock Ganji Decoction, which contains Forsythia suspensa, Scutellaria baicalensis, Coptis chinensis, and Gardenia jasminoides to clear away heat and detoxify; Platycodon, burdock, Scrophulariaceae, Shegan, Tonka root, and Shicao. , detoxify, soothe the throat, resolve phlegm and dissipate stagnation. If constipation makes you irritable, add rhubarb and thenardite to clear away heat and relieve pain. ② Cold depression and heat syndrome: aversion to cold and fever, no or less sweating, cough and runny nose, headache and body aches, red and swollen throat or suppuration, thin white or greasy tongue coating, floating and tight pulse. It should relieve the surface and dispel cold, clear away heat and soothe the throat. Use the decoction for clearing away heat and relieving sore throat. The prescription contains Schizonepeta, Fangfeng, and Pediculus, which are pungent and warm to dispel cold, soothe the lungs and resolve phlegm; Forsythia suspensa and Gardenia jasminoides clear away the evils caused by heat; Platycodon, licorice, mountain beanroot, and Scrophulariaceae are used to clear and soothe the throat. , detoxify and dissipate stagnation. ③ Yin deficiency and heat stasis: throat redness and swelling that persists for a long time, or are more obvious on one side, or both sides are swollen, often feeling discomfort in the throat, difficulty in swallowing, dry cough with no or little phlegm, often dry stools, and red tongue coating A short and thready pulse indicates internal heat caused by yin deficiency. You should nourish yin and clear away heat, moisten dryness and soothe the throat, and use Yangyin Qingfei Decoction. In the prescription, Rehmannia glutinosa, Scrophulariaceae, Ophiopogon japonicus, and White Peony are used to nourish yin and moisturize dryness; paeonol bark clears blood and separates heat evil; Scrophulariaceae, peppermint, licorice, and Sichuan Fritillaria are used to reduce phlegm and soothe the throat. Sudden root, Platycodon, and Shegan are added as appropriate. Good for the throat. ④Liu Shen Pills, one pill for one year old, two pills for two years old, three pills for three years old, four to six pills for four to eight years old, ten pills of eight beans for nine years and above, three times a day. Blow an appropriate amount of Xilei Powder or Bingbo Powder onto the red and swollen throat, three times a day. 3. Prevention and care: Be careful to avoid wind and cold and prevent colds. Pay attention to oral hygiene. For those who have repeated attacks and do not heal for a long time, they should be actively treated. If necessary, tonsils can be removed to prevent edema and syndrome.

It was caused by a long-term cold. My children also coughed when they caught a cold. The tonsils and adenoids were swollen, which affected breathing, so I had surgery. Good now! Enlarged tonsils alone are not a problem.

This can only be done by going to the hospital. Some people’s answers may not necessarily be yours, and they may have the opposite effect!

Find a doctor to prescribe medication for treatment

Parents need to first understand what tonsils are, what they do, why they become enlarged, the difference between physiological and pathological tonsil enlargement, and finally What to do if your tonsils are red, swollen and painful. Let’s answer the first question first: What are tonsils and what are their functions?

Let me mention the adenoids here by the way, because usually these two "good brothers" will become hypertrophic at the same time and become inflamed at the same time.

The adenoids are located at the intersection of the nasal cavity, ear canal, and throat. They are an immune barrier for the upper respiratory tract to enter the lower respiratory tract. They are invisible to the naked eye and require medical testing to determine the extent of the disease.

The tonsils are flat and oval lymphoid organs. They are located in the triangular depression between the palatopharyngeal arch and the lingual arch. They are connected to the nasal cavity and Eustachian tube upwards, to the trachea and esophagus downwards, and to the oral cavity outwards. Together with the adenoids, Eustachian tubes, tonsils and lingual tonsils, they form the pharyngeal lymphatic ring, which is the gateway for immune defense in our respiratory tract. It is the first line of immune defense in our human respiratory tract and plays an immune role.

The second question: Why is there hypertrophy?

When a child is just born, the tonsils and adenoids are very small and cannot exert immune function. They mainly rely on the antibodies given by the mother for protection. itself, but the "antibody" inventory is gradually depleted, which requires tonsils and adenoids to start producing immune cells and immune antibodies.

To start production, additional equipment is needed, so these two immune glands will gradually "expand their production capacity" and proliferate. This is normal physiological hypertrophy.

Generally, when 3 to 6 years old reach the kindergarten stage, children are driven by strong curiosity to explore the surrounding environment. They come into contact with more and more people, and the probability of contracting diseases will increase, and they will enter the "catarrhal stage" "Status" is characterized by "sickness that occurs every three days", such as coughs and colds, diarrhea every now and then, otitis media, etc. Although children are particularly sick during the catarrhal stage, most of them can recover on their own or with a little intervention and treatment. In addition, the catarrhal stage is also a stage to enhance the function of the child's immune system. In order to protect the body's health during this troubled period, the tonsils and adenoids will also increase their "production" and the proliferation level will reach the highest peak.

After the age of 10, the child's immune system matures, the adenoids gradually shrink, and the tonsils no longer serve as the main immune glands, and their functions are replaced by other immune tissues.

Childhood is the stage of "big development" and "big construction" of the immune system. Physiological hypertrophy of tonsils and adenoids is a normal phenomenon, and intervention is only required when pathological hypertrophy seriously affects normal breathing. Some people ask how to know whether a child has physiological hypertrophy or pathological hypertrophy. I have compiled a degree table in the book "Who Moved My Little Nose"

The difference between physiological hypertrophy and pathological hypertrophy of tonsils

Tonsils and adenoids play an important role in immune defense during the growth and development stages of children, and physiological hypertrophy is a normal phenomenon.

However, under the stimulation of chronic inflammation of the respiratory tract, such as rhinitis, sinusitis, repeated colds, etc., pathological hyperplasia and hypertrophy of tonsils and adenoids will occur, causing nasopharyngeal cavity and airway stenosis. The child's trachea is originally It is relatively thin, and two "big balls" are placed in the middle of the airway to make the space for gas in and out even narrower. Therefore, children with enlarged tonsils and adenoids often feel suffocated and chest tight, and they open their mouth to breathe when sleeping. Children snoring and sleeping with their mouths open are often signs of tonsil and adenoid hypertrophy. Don’t miss the opportunity for early detection and early intervention. What to do if tonsillitis is very red and swollen

You can try the following emergency measures

Many parents are confused about whether to take cold medicine or not. They are afraid of hurting the spleen and stomach, and if they don’t take it, their children will have a sore throat. It is powerful, so parents should pay attention to the medication time and use Yinqiao Tablets and Isatis Root (the dosage is halved for children under three years old) 1 to 2 times a day.

Medicinal properties of honeysuckle, forsythia, and isatis root are cold and cool. Do not take them after the redness and swelling subside to avoid damage to the spleen and stomach due to the cold and cool properties of the medicine.

Acupuncture point cupping can also be used:

A large number of children have red and swollen tonsils due to food accumulation and stomach heat rushing up to the throat. When children have food accumulation, they can use magnetic beads to point it. Knead the upper, middle, lower, Jingqu, Taiyuan, and Lieqi for 1 to 3 minutes, and then use a small cup to cup the upper, middle, and lower abdomen.

Pinching and rubbing Shaoshang and Shangyang points are effective in treating sore throat, especially acute sore throat, which requires strong stimulation and pinching and rubbing with fingernails.

It helps digestion, strengthens the spleen and stomach, and relieves constipation. It is combined with the scraping technique to eliminate accumulated food.

Consolidate tonsils after swelling is reduced: After recovery from tonsillitis, boil water with honeysuckle and raw licorice to make juice and drink it. Raw licorice has the function of sweetness, warmth, antipyretic and detoxification, and regulates the spleen and stomach. If the child coughs and has phlegm at this time, , add orange red, so that the evil spirits in the body will go out.