Day of tonsillectomy

Overview

A tonsillectomy is surgery to remove your tonsils – the two small glands at the back of your throat. On the day of your tonsillectomy, you will go to the hospital, have the surgery under general anaesthetic (you are fully asleep), and then begin your recovery. Most people go home the same day, but some stay overnight for observation.

Tonsillectomy is a common surgery, especially in children. Thousands of procedures are done each year across the UK and worldwide.

It is most often done in children who have frequent sore throats or tonsillitis. Adults may also have this surgery, for reasons such as breathing problems during sleep or recurrent infections that do not get better with other treatments.

Symptoms

Common symptoms

• After surgery, you will have a sore throat that may last for 1 to 2 weeks.
• Pain when swallowing is normal and can be helped by pain relief prescribed by your doctor or nurse.
• Some people feel ear pain – this is a normal sensation because the nerves in your throat connect to your ears.

Symptoms in children

• Children may be more fussy or irritable than usual.
• They may refuse to eat or drink because swallowing hurts.
• A low fever is common and usually not a cause for concern, but you should still let the medical team know.

Symptoms in older adults

• Older adults may have more intense pain and a longer recovery time.
• They are more likely to be kept in hospital overnight to make sure they are stable.
• Dehydration is a bigger risk – drinking enough fluids is very important.

Causes

Main causes

• Tonsillectomy is done to treat recurrent tonsillitis (frequent, severe throat infections) that do not get better with antibiotics.
• It may also be recommended for sleep-disordered breathing, such as obstructive sleep apnoea, where enlarged tonsils block the airway during sleep.
• Less common reasons include a peritonsillar abscess (a collection of pus near the tonsil that keeps coming back) or suspicion of cancer.

Risk factors

• Children and adults who have had 7 or more episodes of tonsillitis in one year, or 5 episodes per year for 2 years, are more likely to be offered surgery.
• Anyone with very large tonsils that cause breathing or swallowing problems may be at higher risk.
• Smoking and exposure to secondhand smoke can increase the risk of throat infections.

When to see a doctor

See a doctor urgently if:

• If you have signs of a bleed after surgery (bright red blood in saliva, vomiting blood, or bleeding from the nose or mouth), call your emergency services immediately.
• If you have difficulty breathing, severe pain not controlled by pain relief, or cannot swallow any fluids for more than 12 hours, seek urgent medical care.

Book a routine appointment if:

• Before surgery, you will have a pre‑operative assessment to make sure you are fit for the anaesthetic. Attend all scheduled appointments.
• If you develop a fever, cough, or cold in the days before your surgery, tell your surgical team – they may need to reschedule the operation.

Diagnosis

The decision for tonsillectomy is usually based on your medical history, how many episodes of tonsillitis you have had, and whether your symptoms affect your daily life. Your doctor may also examine your throat and, if needed, refer you to an ear, nose, and throat (ENT) specialist.

Tests that may be done

• A throat swab may be taken to check for bacteria if tonsillitis is suspected.
• If sleep apnoea is a concern, a sleep study (polysomnography) may be arranged.
• In rare cases where there is a lump or other unusual finding, a biopsy (taking a tiny sample of tissue) might be done.

What to expect at your appointment

Before the day of surgery, you will have a pre‑operative visit to check your general health, discuss any medicines you take, and go over what will happen on the day. You will be told when to stop eating and drinking (usually 6 hours before surgery) and what time to arrive at the hospital.

Treatment

A tonsillectomy is a surgical treatment to remove the tonsils. It is done under general anaesthetic, meaning you are completely asleep and feel no pain during the procedure. On the day of surgery, you will arrive at the hospital, have the operation, spend some time in a recovery area, and then either go home or stay overnight depending on your situation.

Self-care at home

• Rest for at least a week – take time off work or school as advised.
• Drink plenty of cool, non‑acidic fluids like water, still drinks, or milk. Avoid very hot drinks and acidic juices (like orange juice) because they can sting.
• Eat soft, easy‑to‑swallow foods – ice cream, yoghurt, mashed potatoes, soup, and jelly are good choices. Avoid hard, sharp, or spicy foods for 7 to 10 days.
• Use over‑the‑counter pain relief as recommended by your doctor or pharmacist. Do not use aspirin products unless your doctor says it is safe – they can increase bleeding risk.
• Do not blow your nose, cough hard, or strain on the toilet for at least a week to avoid causing a bleed.

Medical treatments

Pain relief after surgery is very important. You may be given prescription painkillers (such as paracetamol or ibuprofen, or stronger medicines) to take regularly for the first few days. Sometimes your surgeon will also give you anti‑nausea medicine or antibiotics if needed. Always follow the dose instructions your healthcare team provides. Do not take any medicines that you have not discussed with your doctor.

When is surgery considered?

Tonsillectomy is typically recommended only when other treatments have not worked, or when the problem is severe enough to affect health or quality of life. Common reasons include frequent, severe tonsillitis, obstructive sleep apnoea, or an abscess that keeps returning. Your ENT specialist will discuss whether surgery is right for you.

Living with this condition

On the day of your tonsillectomy, you will spend a few hours in the hospital after surgery. You will be monitored for any bleeding, pain, or difficulty breathing. Once you are stable, you can go home with a friend or family member. You should have someone stay with you for the first 24 hours in case of an emergency. Follow your discharge instructions carefully.

Lifestyle tips

• Plan to rest at home for at least 7 days. Avoid heavy lifting, vigorous exercise, and sports for 2 weeks or until your doctor says it is safe.
• Keep your throat moist by drinking little and often. Using a humidifier can also help.
• Avoid smoking and secondhand smoke – they irritate the throat and delay healing.

Diet and exercise

Start with cool, soft foods and liquids. Slowly reintroduce more solid foods as your pain allows. Do not eat anything hard, crunchy, or spicy until your doctor says it is safe. Light activity like walking around the house is fine, but avoid running, jumping, or heavy lifting until your throat feels better – usually at least 1 to 2 weeks.

Mental health and emotional wellbeing

It is normal to feel anxious, frustrated, or restless during recovery. Pain and trouble eating can be upsetting, especially for children. Talk to your family, friends, or your healthcare team about how you are feeling. Most people feel much better after the first week.

Prevention

Tonsillectomy is not something you can prevent – it is a treatment for existing problems. However, good hygiene like washing hands regularly and avoiding close contact with people who have a sore throat may help reduce the number of infections you get.

Vaccines

There is no vaccine specifically to prevent tonsillitis, but staying up to date with routine vaccinations (like the flu vaccine and pneumococcal vaccine) can help prevent some respiratory infections.

Screening programmes

There is no routine screening for tonsil problems. Your doctor will only recommend tonsillectomy after evaluating your symptoms and medical history.

Complications

If left untreated

• If the underlying condition (e.g., recurrent tonsillitis or obstructed breathing) is not treated, it can lead to more frequent infections, missed school or work, and in severe cases, complications like spread of infection to the neck or blood.

Long-term outlook

For most people, the outlook after a tonsillectomy is very good. The surgery usually resolves the problem it was intended to treat – whether that is fewer throat infections or better breathing at night. Recovery can be uncomfortable for a week or two, but nearly all people heal without serious issues. Your healthcare team will guide you through the process and be available if you have any worries.

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