All about tonsils: When to keep them, when to remove them

Learn all about the tonsils, how they can be affected by conditions like tonsillitis, when tonsils should be kept and when they should be removed – and more – in this informative article.

What are tonsils and what do they do?

Tonsils are small masses of tissue located at the back of the throat, forming part of the immune system. They act as the body's first line of defence against inhaled or ingested pathogens, helping to filter bacteria and viruses and producing antibodies to fight infections. Despite their role in protecting the body, tonsils can sometimes become more of a problem than a benefit, particularly when they become infected or cause chronic issues.

When should you keep your tonsils?

For most people, tonsils function normally without causing any issues. If you experience occasional sore throats or minor throat infections, there's no need to consider removal. Tonsils can be left in place if:

• Infections are infrequent: If you only suffer from occasional sore throats or mild infections, your tonsils are likely still doing their job effectively.
• No breathing or swallowing difficulties: If your tonsils aren't obstructing your airway or making it difficult to swallow, there may be no need for removal.
• Mild or no symptoms: If your tonsils cause little to no discomfort and don’t interfere with daily life, keeping them is usually recommended.

When is tonsil removal necessary?

Tonsil removal, or tonsillectomy, is generally considered when the tonsils become problematic and interfere with your health or quality of life. Some of the most common reasons for removal include:

• Chronic tonsillitis: If you suffer from frequent or recurring infections, such as tonsillitis (inflammation of the tonsils), that don’t respond well to antibiotics, removal might be necessary.
• Sleep apnoea or breathing issues: Enlarged tonsils can obstruct the airway, leading to sleep apnoea, snoring, or difficulty breathing, particularly in children.
• Difficulty swallowing: In some cases, large or swollen tonsils can make it hard to swallow, leading to discomfort when eating or drinking.
• Abscess or pus-filled pockets (quinsy): Severe infections can lead to the formation of abscesses around the tonsils, which can cause extreme pain and may require removal.

What happens during a tonsillectomy?

A tonsillectomy is a relatively straightforward procedure performed under general anaesthesia. The surgeon removes the tonsils through the mouth, and the recovery typically takes one to two weeks. During this time, patients may experience a sore throat, difficulty swallowing and mild discomfort. Rest, hydration and soft foods are recommended to aid recovery.

When to speak to a doctor

If you or your child experience frequent throat infections, trouble breathing, or persistent discomfort related to the tonsils, it's important to consult a doctor. They can assess whether removal is necessary and help you make an informed decision about the best treatment option.

Tonsils can be important for immune function, but in some cases, removing them is the best way to avoid recurrent infections and other health complications.