Definition

Bacteria, viruses and tonsillitis

When tonsillitis is caused by bacteria (about 15 per cent of all tonsil infections), it is usually a streptococcus bacterium. It is not easy to tell when tonsillitis is caused by bacteria – A doctor may do a throat swab (gently rubbing sterile cotton wool on a stick over the tonsil) and send it for testing.

There are many viruses that can cause tonsillitis. Antibiotics do not help if the tonsillitis is caused by a viral infection.

Tonsillitis can lead to a number of complications, including:

A.) Chronic tonsillitis – Infection of the tonsils which does not clear up. The person may go on feeling unwell and tired

B.) Secondary infections – the infection can spread to the person’s nose, sinuses or ears

C.) Glue ear (otitis media) in children – the adenoids are part of the same group of lymph nodes as tonsils. When the adenoids swell up (usually when the tonsils are also large), they can block the Eustachian tube, which goes from the back of the throat to the middle ear. This is the thin tube that you push air along when you ‘pop’ your ear. If this tube stays blocked most of the time, sticky fluid forms in the middle ear which interferes with hearing. This is called a glue ear.

D.) Quinsy – if the infection spreads into the tissue around the tonsils, an abscess can form in the throat, also known as a peri-tonsillar abscess. This causes severe pain and can interfere with swallowing and even breathing. Antibiotics may help, but sometimes an operation is needed to drain the abscess.

Treatment of tonsillitis usually involves keeping the patient comfortable while the illness runs its course. This supportive care includes bed rest, drinking extra fluids, gargling with warm salt water, and taking pain relievers—usually NSAIDs—to reduce fever. Frozen juice bars and cold fruit drinks can bring some temporary relief of sore throat pain; drinking warm tea or broth can be soothing. If the throat culture shows that S. pyogenes is present, penicillin or other antibiotics will be prescribed. An injection of benzathine or procaine penicillin may be most effective in treating the infection, but it is also painful. If an oral antibiotic is prescribed, it must be taken for the full course of treatment, usually 10-14 days. If the patient has several episodes of severe tonsillitis, the doctor may recommend a tonsillectomy, which is the surgical removal of the tonsils.

Since most attacks of tonsillitis are caused by viruses, most of the treatment is aimed at helping to relieve the symptoms such as pain and fever. Paracetamol can help and the person should rest. Most children with tonsillitis do not feel well and it hurts them to swallow. Try cool drinks (cold drinks can hurt), ice blocks and ice cream. Don’t worry if a child stops eating for a day or two. Usually, they pick up quickly when the infection has gone.

For tonsillitis that is caused by bacteria, antibiotics are prescribed.

If attacks of tonsillitis become frequent and severe, or cause complications, your doctor might suggest an operation, known as tonsillectomy.

Reasons for tonsillectomy can include:

1.) Recurrent bouts of tonsillitis accompanied by pain, discomfort and high temperature (fever).

2.) Chronic tonsillitis that doesn’t clear up with antibiotics.

3.) Frequent ear infections associated with tonsillitis

4.) Breathing difficulties due to enlarged tonsils

5.) Abscesses forming in the throat (peri-tonsillar abscesses or quinsy)

6.) Failure to thrive because of difficulty in swallowing due to frequent infection and enlargement of their tonsils.

Before doing a tonsillectomy, your doctor will give you a complete physical check-up. The tonsil pad has a large blood supply, and special note will be taken whether you have any abnormal bleeding tendencies. Your doctor will check to see if your tonsils are actively inflamed and, if so, will prescribe antibiotics for a few weeks to control the infection before the surgery.

A tonsillectomy is performed under general anaesthesia. The surgeon props open the person’s mouth and clamps their tonsils with special instruments. The glandular tissue is contained inside a skin lining which the surgeon cuts using scalpel, scissors, laser or an electric current (electrocautery). The surgeon then removes the tonsils. Each tonsil pad has a substantial blood supply, so electrocautery is often used to fuse the blood vessels and reduce the risk of haemorrhage.

Tonsillitis usually resolves within a few days with rest and supportive care. Treating the symptoms of sore throat and fever will make the patient more comfortable. If fever persists for more than 48 hours, however, or is higher than 102°F, the patient should be seen by a doctor. If antibiotics are prescribed to treat an infection, they should be taken as directed for the complete course of treatment, even if the patient starts to feel better in a few days. Prolonged symptoms may indicate that the patient has other upper respiratory infections, most commonly in the ears or sinuses. An abscess behind the tonsil (a peritonsillar abscess) may also occur. In rare cases, a persistent sore throat may point to more serious conditions, such as rheumatic fever or pneumonia.

The bacteria and viruses that cause tonsillitis are easily spread from person to person. It is not unusual for an entire family or several students in the same classroom to come down with similar symptoms, especially if S. pyogenes is the cause. The risk of transmission can be lowered by avoiding exposure to anyone who already has tonsillitis or a sore throat. Drinking glasses and eating utensils should not be shared and should be washed in hot, soapy water before reuse. Old toothbrushes should be replaced to prevent reinfection. People who are caring for someone with tonsillitis should wash their hands frequently, to prevent spreading the infection to others.

Cancers are often referred to by terms that contain a prefix related to the cell type in which the cancer originated and a suffix such as -sarcoma, -carcinoma, or just -oma. Common prefixes include:

All cancers begin in cells, the body’s basic unit of life. To understand cancer, it’s helpful to know what happens when normal cells become cancer cells.

The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.

However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producingmutationsthat affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called atumor.

(Image from Understanding Cancer Series: Cancer.)

Not all tumors are cancerous; tumors can be benign or malignant.

Some cancers do not form tumors. For example, leukemia is a cancer of the bone marrow and blood.

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Some cancers can be felt or seen through the skin – a lump on the breast or testicle can be an indicator of cancer in those locations. Skin cancer (melanoma) is often noted by a change in a wart or mole on the skin. Some oral cancers present white patches inside the mouth or white spots on the tongue.

Other cancers have symptoms that are less physically apparent. Some brain tumors tend to present symptoms early in the disease as they affect important cognitive functions. Pancreas cancers are usually too small to cause symptoms until they cause pain by pushing against nearby nerves or interfere with liver function to cause a yellowing of the skin and eyes called jaundice. Symptoms also can be created as a tumor grows and pushes against organs and blood vessels. For example, colon cancers lead to symptoms such as constipation, diarrhea, and changes in stool size. Bladder or prostate cancers cause changes in bladder function such as more frequent or infrequent urination.

As cancer cells use the body’s energy and interfere with normal hormone function, it is possible to present symptoms such as fever, fatigue, excessive sweating, anemia, and unexplained weight loss. However, these symptoms are common in several other maladies as well. For example, coughing and hoarseness can point to lung or throat cancer as well as several other conditions.

When cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. Spreading to the lungs may cause coughing and shortness of breath. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and break easily. Symptoms of metastasis ultimately depend on the location to which the cancer has spread.

How cancer spreads–

scientists reported inNature Communications(October 2012 issue) that they havediscovered an important clue as to why cancer cells spread. It has something to do with their adhesion (stickiness) properties. Certain molecular interactions between cells and the scaffolding that holds them in place (extracellular matrix) cause them to become unstuck at the original tumor site, they become dislodged, move on and then reattach themselves at a new site.

The researchers say this discovery is important because cancer mortality is mainly due to metastatic tumors, those that grow from cells that have traveled from their original site to another part of the body. Only 10% of cancer deaths are caused by the primary tumors.

The scientists, from the Massachusetts Institute of Technology, say that finding a way to stop cancer cells from sticking to new sites could interfere with metastatic disease, and halt the growth of secondary tumors.

Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumor is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body.

Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyze your body’s sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer.

After a diagnosis is made, doctors find out how far the cancer has spread and determine the stage of the cancer. The stage determines which choices will be available for treatment and informs prognoses. The most common cancer staging method is called the TNM system. T (1-4) indicates the size and direct extent of the primary tumor, N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes, and M (0-1) indicates whether the cancer has metastasized to other organs in the body. A small tumor that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example.

TNM descriptions then lead to a simpler categorization of stages, from 0 to 4, where lower numbers indicate that the cancer has spread less. While most Stage 1 tumors are curable, most Stage 4 tumors are inoperable or untreatable.

Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and patients often receive a combination of therapies and palliative care. Treatments usually fall into one of the following categories: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or gene therapy.

Reducing inflammation:

Inflammation is a natural response of the body to injury. However, excessive inflammation retards the healing process. Proteolytic enzymes reduce inflammation by neutralizing the biochemicals of inflammation (i.e., bradykinins and pro-inflammatory eicosanoids) to levels at which the synthesis, repair and regeneration of injured tissues can take place.Reducing inflammation can have immediate impact on improved heart health, cancer prevention and recovery, and Alzheimer’s prevention. It also helps speed up recovery from sprains, strains, fractures, bruises, contusions, surgery and arthritis. In one study, football players who suffered from ankle injuries found that proteolytic enzyme supplements accelerated healing and got the players back on the field 50 percent faster than athletes who received placebo tablets.Other trials have shown that supplemental proteolytic enzymes can help reduce inflammation, speed healing of bruises and other tissue injuries (including fractures), and reduce overall recovery time when compared to athletes taking a placebo. And even in patients recovering from facial and various reconstructive surgeries, treatment with proteolytic enzymes significantly reduced swelling, bruising and stiffness compared to placebo groups.

Proteolytic enzymes are the primary tools the body uses to “digest” organic debris in the circulatory and lymph systems. Supplementing merely improves the effectiveness of the process. Dissolving fibrin in the blood, reducing the risk of clots:Certain specialized proteases such as nattokinase are extremely effective at improving the “quality” of blood cells, optimizing the ability of blood to flow through the circulatory system, and reducing the risk of clots. This is extremely important in reducing the risk of stroke. It also makes using proteolytic enzymes during long plane flights a no-brainer, as they minimize the potential of blood clots in the legs.

Maximized immune system: The primary vehicle the immune system uses for destroying invaders is enzymes. Macrophages, for example, literally digest invaders with proteolytic enzymes. Supplementation significantly improves the ability of your immune system to do its job.

Killing of bacteria, viruses, molds and fungi:Bacteria, viruses, molds and fungi are protein/ amino acid-based. Proteolytic enzymes taken between meals literally go into the bloodstream and digest these invaders.

Supplemental proteolytic enzymes clean CICs (circulating immune complexes (CICs), which trigger allergies and autoimmune diseases)out of the body, thereby reducing allergies and autoimmune conditions. In addition, this helps with sinusitis and asthma.

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Scar tissue is made of protein. Proteolytic enzymes can effectively “digest” scar tissue – particularly in the circulatory system.

And finally, a properly designed supplemental proteolytic enzyme formula can helpreduce the symptoms of MS, clean out the lungsand aid in detoxing.

In studies, proteolytic enzymes are believed to have proven to be quite safe, although they can occasionally cause digestive upset and allergic reactions.

*One proteolytic enzyme, pancreatin, may interfere with folate absorption. In addition, the proteolytic enzyme papain might increase the blood-thinning effects of warfarin and possibly other anticoagulants.

*The proteolytic enzyme bromelain might alsocause problems if combined with drugs that thin the blood.In addition,there are concerns that bromelain should not be mixed with sedative drugs.Finally,bromelain may increase blood concentrations of certain antibiotics.

*Sedative drugs: Do not take bromelain, exceptunder a physician’s supervision.