Tonsillitis and Sore Throat: Symptoms, Home Care and Treatment

A scratchy throat that makes every swallow painful, a child who refuses food, a fever that arrives in the evening. Sore throat is among the most common reasons for a visit to the clinic, especially when the weather changes. In many cases the culprit is the tonsils, two small glands at the back of your throat that help fight infection but sometimes get infected themselves. That is called tonsillitis.

What causes a sore throat and tonsillitis?

• Viruses cause most cases, including the common cold and flu. These get better by themselves and do not need antibiotics.
• Bacteria, most often Streptococcus (strep throat), cause a smaller share. These may need an antibiotic prescribed by a doctor.
• Dry air, smoke, shisha, dust and pollution irritate the throat.
• Allergies and postnasal drip, as in sinusitis.
• Acid reflux can cause a chronic sore throat, often worse in the morning.
• Shouting, singing, and drinking very cold drinks, which do not directly cause infection but can aggravate the throat.

Symptoms of tonsillitis

• Painful swallowing and a sore throat
• Red, swollen tonsils, sometimes with white or yellow patches
• Fever, chills and tiredness
• Tender lumps in the neck
• Bad breath, a muffled voice, or ear pain
• In young children: drooling, refusing food, irritability and stomach ache

Viral or bacterial? Why it matters

Cough, runny nose, hoarseness and red eyes point towards a virus. A sudden severe sore throat with fever, white patches on the tonsils, tender neck glands and no cough points towards strep throat. A throat swab or rapid test can tell the difference. This matters because antibiotics do nothing for viral infections, and taking them unnecessarily adds to antibiotic resistance, a growing problem in Pakistan. When a doctor does prescribe an antibiotic, finishing the full course matters, since untreated strep can rarely lead to rheumatic fever and heart valve damage.

Home care that actually helps

• Rest and plenty of fluids. Warm water, soups, tea with honey (not for babies under one year) and lukewarm drinks soothe the throat.
• Gargle with warm salt water a few times a day. Children old enough to gargle without swallowing can do this too.
• Soft foods such as khichdi, yoghurt, porridge and mashed fruit are easier to swallow.
• Throat lozenges or sprays can ease the pain in adults and older children.
• Paracetamol or ibuprofen as advised for pain and fever.
• Avoid smoking, shisha and dusty places. A humidifier or a bowl of steam may help dry air.
• Stay home from school or work while you have a fever, and use a separate cup and towel.

When are tonsils removed?

Surgery (tonsillectomy) is considered when someone has many severe episodes in a year, repeated abscesses, or tonsils so big they cause breathing trouble or sleep apnoea. It is not needed for the occasional sore throat, and most children grow out of frequent tonsillitis.

When to see a doctor straight away

• Difficulty breathing or swallowing saliva, or drooling
• A very sore throat on one side with a swollen, pushed-over tonsil, which could be an abscess
• Fever lasting more than two to three days or a very high fever
• Sore throat lasting more than a week
• Stiff neck, a rash, or joint pain after a sore throat
• A child who is very sleepy, limp or refusing all fluids
• Blood in saliva or a lump in the neck that does not go away

Prevention

• Wash hands often and avoid sharing cups, spoons and toothbrushes.
• Replace your toothbrush after a throat infection.
• Avoid close contact with people who have a sore throat.
• Do not smoke, and keep away from second-hand smoke.

Key takeaways

• Most sore throats and tonsillitis are viral and clear in about a week with rest, fluids and simple pain relief.
• Antibiotics help only bacterial infections, and only when prescribed. Do not buy them on your own.
• Difficulty breathing, drooling, or a one-sided swollen tonsil need urgent care.

Related products on Medimart

• Benzydamine: a spray or gargle that eases a sore throat
• Paracetamol: for pain and fever, used as directed on the label
• Amoxicillin and azithromycin: antibiotics, which are supplied only on a prescription and only when a doctor finds a bacterial cause

Browse throat infection products on Medimart, with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription and should be taken only as advised by your doctor.

This guide is for general information and does not replace advice from a doctor.