Tonsillectomy: Diet, Recovery, and Pain

Tonsillitis and Tonsillectomy

What is Tonsillitis?

Tonsillitis refers to inflammation of the tonsils. This condition is usually the result of a viral infection but can also be caused by bacteria. Fortunately, in most cases, the inflammation remains localized, and tonsillitis heals within one to two weeks without treatment, eliminating bothersome symptoms such as sore throat and difficulty swallowing. Treat your throat infection with ease: Generally, the fever disappears within a week and may even subside before the neck pain manifests. In more severe cases, medication and/or pain relief are recommended, and surgery (tonsillectomy) may sometimes be necessary. If you suffer from a bacterial infection, antibiotics are your best option. Penicillins, such as amoxicillin and ampicillin, are commonly used. Even if you feel healed, it is essential to complete the antibiotic treatment under your doctor's supervision. Stopping treatment too early could cause the infection to reappear. Properly dosed, paracetamol can effectively reduce pain. It may be helpful to take it before a meal to make swallowing easier. Children with tonsillitis often refuse to eat due to pain, and paracetamol can help them.

Tonsillectomy

In the past, tonsillectomy was a frequent option for patients suffering from recurrent tonsillitis. Today, this operation is limited to patients who do not respond to less invasive treatments. When it comes to tonsillectomy, most of the patients concerned are carefully selected children who are monitored for several months before deciding on the operation. In fact, some people have noticed that their symptoms, caused by frequent bouts of tonsillitis during childhood, improve considerably in adulthood even without surgery. Moreover, the procedure to remove the tonsils is generally performed on an outpatient basis. The child is therefore admitted to the hospital and, barring complications, can go home after the operation, after a period of observation.

Treatment of Tonsilloliths

Tonsilloliths refer to a white or yellowish concretion of solid matter that forms in the tonsillar crypts. Tonsilloliths can be removed by the patient using different methods. Although difficult to perform due to the gag reflex, brushing with a toothbrush can remove superficial tonsilloliths. Another effective method for removing tonsilloliths is to apply pressure with a clean finger against the back of the tonsil, upwards. The pressure pushes the stones out. To improve the procedure, it is recommended to use an oral analgesic to reduce nausea, which will facilitate the procedure. In terms of treatments, the most invasive option is the surgical removal of the tonsillolith by curettage or total tonsillectomy. Longer-term treatment is achieved by laser ablation. Under local anesthesia, a carbon dioxide laser vaporizes and removes the surface of the tonsil, smoothing the edges of the crypts and flattening them so that they can no longer easily retain foreign bodies from which tonsillitis forms.

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When Should Tonsils Be Removed?

Tonsillectomy surgery is only performed in rare and selected cases, generally when:

• Medical therapies have been ineffective;
• Tonsillitis recurs frequently;
• The infection tends to spread to large parts of the mouth, larynx, and pharynx;
• A severe abscess forms;
• Tonsillitis is so severe that it prevents normal breathing and/or eating;

In pediatric patients, surgery is recommended in case of several recurrences:

• 7 or more severe throat infections in one year;
• 5 or more severe throat infections in one year, for 2 consecutive years;
• 3 or more severe throat infections in one year, for 3 consecutive years.

While these rules are general, they are not always applicable in all situations.

What are the Risks of Tonsillectomy?

Although it is not a complex and very invasive procedure, it is important to note that tonsillectomy carries risks, like any surgical intervention:

• Allergic reaction to general anesthesia
• Intraoperative bleeding;
• Postoperative bleeding;
• Infection;
• Damage to nearby structures;

To avoid potential complications and promote good recovery, experts recommend the use of intramuscular injections of phytonadione (vitamin K) at a concentration of 10 mg/ml, cyanocobalamine (vitamin B12) at 2 mg, and calcium folinate at 0.9 mg in adults, to be taken in the two weeks before and after the procedure. These injections aim to prevent the risk of bleeding and promote good healing.

Recovery After a Tonsillectomy

How Long Does Recovery Take After a Tonsillectomy?

The healing process after a tonsillectomy can be unpleasant due to pain when swallowing, which can last for several weeks. On average, light activities can be resumed after 7 to 12 days, while more strenuous activities, such as sports or swimming, may require up to 3 to 4 weeks of recovery.

What to Eat After a Tonsillectomy?

To ensure a healthy recovery, it is crucial to follow a diet based on liquid or soft foods while avoiding hot foods. Don't lock yourself into a monotonous routine of broths, soups, vegetable purees, and creams. Revive your appetite with tasty choices such as ricotta, mozzarella (easily mashed with a fork!), cold cuts like cooked ham, chicken, or turkey. Just be sure to use a knife and fork to make these foods easier to eat. Feel free to experiment to find appetizing and practical options that meet your health needs. Biscuits can be eaten after being crushed in (warm) milk or tea. Bread crusts and pizzas are to be avoided at all costs.

General Advice to Follow in Case of Tonsillitis or Tonsillectomy

In case of tonsillitis or tonsillectomy, it is recommended to:

• Drink plenty of fluids (water and lukewarm fruit juice, no fizzy drinks or alcohol);
• Eat soups and broths;
• Eat fruit or vegetable smoothies, rich in vitamins and minerals;
• Gargle with water and baking soda;
• Keep a sore throat lozenge in your mouth;
• Humidify the environment;
• Avoid smoking;
• Avoid environments rich in smoke or smog;
• Speak as little as possible;
• Avoid the sun and heat sources such as radiators, ovens, and hair dryers;
• If coughing, use a handkerchief to avoid contaminating others;

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