Adenoiditis
Adenoiditis is an inflammation of the adenoids, a group of tissues located in the upper part of the mouth and behind the nose. Under normal circumstances, together with the tonsils, they function to catch germs that pass through the nose or mouth by producing antibodies to help the body fight infection.
The examination is performed with the aid of a flashlight because adenoids are very difficult to see. Inflammation of the adenoids is usually caused by infection and results in difficulty breathing and recurrent respiratory infections. Although adenoiditis can occur in adults, in most cases adenoiditis occurs more often in children.
Symptoms of Adenoiditis
Adenoiditis usually causes blockage of the airways, so the complaints generally experienced are:
- Difficulty breathing, including when speaking.
- Snoring while sleeping.
- There is pain or dryness in the throat due to swelling and frequent breathing through the mouth.
- Symptoms of infection, such as fever and runny nose.
- There is enlargement of the lymph nodes in the neck.
- Presence of ear pain or hearing loss.
- Restless sleep.
- Breathe more through your mouth than your nose.
- Bad breath or dry, chapped lips due to breathing through the mouth.
- Difficulty swallowing.
- The speaking voice sounds nasal.
- Continuous runny nose.
- Often catch a cold.
Adenoiditis Risk Factors
Certain risk factors may make a person susceptible to infection of the adenoid tissue. These may include:
- Recurrent infections in the throat, neck, or head.
- Tonsil infection.
- Contact with viruses, germs, and bacteria in the air.
Children are more susceptible to adenoiditis. This is because the adenoids shrink during childhood. By the time they reach late adolescence, the adenoids are generally gone.
Causes of Adenoiditis
The cause of adenoiditis is a bacterial or viral infection. Viruses that cause adenoiditis include adenovirus, Epstein-Barr, and rhinovirus. Meanwhile, the bacteria that often cause adenoiditis are Streptococcus bacteria.
Some preschoolers and teens have naturally large adenoids. However, adenoids can become enlarged due to infection with viruses or bacteria that cause strep throat. Exposure to infections or bacteria can occur in daycare or school.
In addition, allergies, irritation, and gastroesophageal reflux (GERD) can also cause adenoiditis. When enlarged, adenoids can block the nose, the eustachian tubes that connect the back of the throat to the ears.
Usually, adenoids can return to normal size after the cause is resolved. However, in children who are frequently or chronically infected, adenoiditis sometimes persists.
Diagnosis Adenoiditis
Diagnosis of adenoiditis is carried out by an ENT (Ear, Nose, and Throat) specialist to examine the location of the inflammation accurately.
The doctor will make a diagnosis in several ways, namely:
- Physical examination, to determine the location of the infection in the body. The doctor may also ask about the medical history of the sufferer and family members.
- Laboratory tests, to determine the cause of adenoiditis. These may include a rapid stress test (taking a sample of fluid from the back of the throat and tonsils), a throat culture (when the condition does not improve despite medication), and allergy testing (if adenoiditis is suspected to be due to an allergic reaction).
- Radiological examinations, such as X-rays and CT scans to find the source of infection in the sinuses.
Adenoiditis Treatment
Medically, adenoiditis is categorized as rhinosinusitis or pharyngitis. That is why doctors often treat adenoiditis by following the guidelines for treating rhinosinusitis and pharyngitis.
If your doctor suspects that the cause of adenoiditis is a common cold or a common bacterial infection, then treatment does not require antibiotics. Usually, uncomplicated upper respiratory viral infections can resolve within five to seven days.
1. Antibiotics
If symptoms persist and the cause is pointed to unusual bacteria, then the doctor will prescribe antibiotics. Effective bacterial treatment should show improvement in symptoms within 48-72 hours. In the meantime, treatment needs to be carried out for ten days, because shorter treatment duration can result in relapse and cause antibiotic resistance.
2. Allergy treatment
If adenoiditis is caused by environmental allergies, your doctor will prescribe nasal steroid sprays, oral steroids, oral antihistamines, or some combination to see if symptoms improve.
The use of saline sprays and nasal cleansers can also be used as treatment in this case.
3. GERD Treatment
Adenoiditis caused by GERD can be managed by modifying lifestyle and diet. Sufferers can also use H2 blockers or proton pump inhibitors to relieve symptoms.
4. Adenoidectomy
If there is no improvement in symptoms after undergoing the above treatment, the sufferer may need to be referred to an otolaryngologist for further evaluation.
In addition, there is a possibility that sufferers will need to undergo a surgical procedure called adenoidectomy.
Prevention of Adenoiditis
Adenoiditis can be prevented by a healthy lifestyle and maintaining endurance by exercising regularly. Choose healthy and hygienic foods, and drink enough water. The average daily water requirement for adults is 2 liters and can be more if doing heavy activities. Also try to get enough sleep and see a doctor immediately if you experience medical complaints.
Complications of Adenoiditis
Sufferers may experience a number of complications due to adenoiditis. Complications can cause chronic or severe inflammation of the adenoid tissue that spreads to other locations in the head and neck.
Some complications that may occur are:
- Ear infections. Adenoids are located next to the Eustachian tube, which is the tube that allows fluid to drain from the ear. As adenoiditis progresses, the inflammation can block the opening of the tube that leads to the middle ear. This can lead to infections and difficulty hearing.
- Glue ear (middle ear infection). This complication occurs when mucus builds up and blocks the middle ear. This usually begins as a blockage of the eustachian tube which can affect hearing.
- Sinusitis. The sinus cavities can fill with fluid and become infected. The sinuses are hollow areas in the bones of the face around the eyes and nose that contain air sacs.
- Chest infection. The condition is pneumonia or bronchitis, which occurs when the adenoids become severely infected by a virus or bacteria. The infection can spread to the lungs, bronchioles, and other structures in the respiratory system.
- Vomiting. The sufferer may swallow a lot of pus while sleeping, which may be vomited in the morning.