Tonsil problems (tonsillitis and tonsil stones)

Tonsil problems relate to pain and issues with the tonsils, a pair of oval-shaped tissue masses which sit on each side of the throat (at the back). Problems typically relate to tonsillitis (make this a link to below), which is when the tonsils become inflamed and swollen due to an infection caused by a virus or a bacteria.

Other very common tonsil problems include; 

Thankfully tonsil cancer is very rare but you should seek an urgent review from an ENT surgeon should you notice one tonsil being larger than the other or any growth on the tonsil. Please visit this page for further important information about this

Symptoms of tonsilitis (infected tonsils)

Symptoms of tonsilitis (infected tonsils)

The most common symptoms are:

  • Sore throat
  • Red, swollen tonsils
  • Yellow coating on the tonsils 
  • Difficulty swallowing 
  • Swelling of the glands (lymph nodes) in the neck
  • Pain or stiffness in the neck

Other symptoms include:

  • Bad breath
  • Fever
  • Aching stomach
  • Headache
  • Voice change or “throaty” voice

Sometimes the infection can develop into an abscess (fluid or pus collection) behind the tonsil called a quinsy. This condition is extremely painful and will result in great difficulty in opening the mouth.

Other symptoms include:

  • Refusal to eat
  • Fussiness with food
  • Irritability
  • High temperature
  • Drooling

Causes of tonsilitis

Causes of tonsilitis

The majority of tonsil problems – or tonsillitis – are caused when the patient is suffering from a common throat virus.

However, they can also be caused by bacterial infections. The tonsils are particularly prone to infection, as they are your body’s first line of defence against more serious diseases.

After early childhood, the function of the tonsils becomes largely redundant, meaning that problems such as tonsillitis in adults are less common but still can be troublesome for some. Tonsil problems are, therefore, much more common in children.

Glandular fever (infectious mononucleosis)

This is also called the kissing disease. It is typically seen in young adults and is a result of a throat infection caused by a virus called Ebstein Barr. This causes:

  • Severe sore throat
  • Fever
  • Severe painful gland swelling the neck
  • Severe and long lasting fatigue even after the infection has subsided
  • Swelling of the spleen and liver

Glandular fever is contagious so it is important you don’t share drinks etc while recovering.

Treatment options for tonsil problems

The treatment for tonsil problems depends on the cause

Whether through viral or bacterial infection. In order to determine treatment, it is imperative to first get diagnosed so that you can establish the cause.
Treatment for tonsil problems consists mainly of care at home. Most cases will subside naturally and can be aided by encouraging rest and proper sleep. It is also important that the patient drinks adequate liquids, ideally soothing drinks such as warm water with honey or lemon or cold drinks with ice. 

Natural remedies such as gargling with salt water can also help; make sure the water is warm, and use around half a teaspoon of salt with eight ounces of water. You can also take over the counter lozenges, paracetamol or ibuprofen.

If the problem doesn’t get better with the treatment outlined above you may be prescribed antibiotics. In the majority of cases, this should clear up the problem. If you cannot eat and drink or develop an abscess behind the tonsil (quinsy) you may need to be admitted hospital for antibiotics, anti-inflammatories and pain killers through a drip.

Surgery for tonsil infections which keep happening (recurrent tonsilitis)

If you get recurring tonsil infections which are impacting upon your life you should consider having the tonsils removed (tonsillectomy) (make this a link to tonsillectomy page). This is a straightforward operation which takes around 30-40minutes.



More details about the procedure, risks and recovery can be found on the ENT LDN tonsillectomy page (make this a link to tonsillectomy page).

Mr Lakhani offers coblation tonsil surgery (a vapourisation technique which leads to less pain after surgery) in certain cases and can discuss this further with you.


Tonsil Stones (tonsiloliths)

Tonsil Stones (tonsiloliths)

The tonsils have small holes and gaps in them which can catch small bits of food. Bacteria or fungus within the mouth and throat act on this stuck food and create a paste which hardens to form small firm stones.

Features of tonsil stones

  • Firm yellow/white stones which smell bad
  • Often come back
  • Can be multiple and occur on both sides
  • Cause of bad breath
  • Lead to throat irritation 

How can you self-treat tonsil stones?

  • Regular cleaning with gargles or a water pick – This can keep the food debris from collecting within the tonsil holes.
  • Remove the stones with a Q tip or cotton bud – Gently pressing around the tonsil stones can cause them to dislodge.

Yes. Having your tonsils removed permanently cures this condition. There are risks with having the tonsils removed so Mr Lakhani will carefully assess the risks and benefits in your case.

Mr Lakhani would usually use the coblation technique to remove the tonsils for tonsil stones as it results in a much lower pain level after surgery.

Get in Touch

Julia Brighton

9 Harley Street
London W1G 9QY


020 7760 7561
020 7760 7222

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