Dear Doctor,

My throat is itchy and the tonsils normally get swollen, especially when I jog. What could be the problem and how can I overcome it?

Hamza

Dear Hamza,

You have not specified for how long you have been having this problem. Does it occur with cold weather or changing season or it is not related to the weather? Is there associated fever, headache, itching and throat pain while swallowing?

Tonsillitis is inflammation of the tissues present in the back of throat. It can be due to allergy or infection. One may develop tonsillitis due to allergy and there may be secondary infection over it, adding to the sickness.

One can be allergic to something present in the atmosphere like dust, pollens, fungal spores or insect droppings.

It can be something applied over the body or something eaten. When seasons are changing, there can be an increase in concentration of potential allergens (allergy causing substances) in the atmosphere, causing a sore throat.

Majority of these cases are due to viral infection and subside in about a week without treatment. Here the tonsils may just be inflamed with some pain and discomfort. Bacterial infections cause more severe and dramatic symptoms like headache, high fever, malaise. Pockets of pus may form over the tonsils. Rarely one can have fungal infection of the tonsils. This results in itching and curd like white patches, or red or black patches (depending on type of infecting fungus). People with reduced immunity like those with diabetes or HIV/AIDS are more prone to fungal infections.

At times a dry throat caused due to cold breeze can also cause irritation of the tonsils resulting in discomfort. In mild cases there may be only itching and some discomfort, whereas severe cases manifest as throat pain, difficulty in speaking.

Diagnosis of tonsillitis is easily done clinically. Treatment consists of drugs to reduce pain and fever. Anti inflammatory drugs are used to reduce the inflammation. Antibiotics and anti fungal drugs are used to treat the underlying infection, if present. Allergy causing substances can be detected by allergy tests, which are not easy.

Not all allergens can be identified by allergy tests.

Drinking warm water helps to avoid dryness of throat as well as reduce pain and discomfort of inflamed tonsils. Herbal treatments like using ginger tea, basil decoctions are also useful.

In your case the problem could be due to allergy. Try covering the mouth and nose while jogging in the morning. Try wearing warm clothes if weather is cold.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital