TONSILLITIS – HOMOEOPATHIC TREATMENT MODALITY FOR CHILDREN’S

 ABSTRACT 

Tonsillitis is common, especially in children. Tonsillitis is inflammation of the tonsils most commonly caused by viral or bacterial infection. The most common problems affecting the tonsils are recurrent infections (throat or ear) and significant enlargement or obstruction that causes breathing and swallowing problems.  The condition can occur occasionally or recur frequently. This article provides an overview of the aetiology, diagnosis, and appropriate general & homoeopathic management of this disorder.

INTRODUCTION

Tonsils are the two masses seen in the back of the throat, one on either side at the back of the mouth. Tonsils can normally see by opening mouth wide and looking in a mirror. They are the two fleshy lumps that can see at the sides and back of the mouth. Tonsils are made of soft glandular tissue and are part of the immune system. A main function of tonsils is to trap bacteria and viruses (germs) which may breathe in. Antibodies and immune cells in the tonsils help to kill germs and help to prevent throat and lung infections. But sometimes the tonsils themselves become infected. Overwhelmed by bacteria or viruses, they swell and become inflamed, a condition known as tonsillitis.

AETIOLOGY

Most cases of tonsillitis are caused by infection with a common virus, but bacterial infections also may cause tonsillitis. The tonsils actually serve as a filter for bacteria, sometimes certain bacteria, such as group A Streptoccocci, can infiltrate the tonsils and cause tonsillitis. However, viruses such as the Epstein Barr virus typically cause tonsillitis.  Being a child and having close contacts with viral or bacterial-laden persons increase the risk for developing tonsillitis.

A common cause is Streptococcus bacteria. Other common causes include: Adenoviruses, Influenza virus, Epstein-Barr virus, Parainfluenza viruses, Enteroviruses, Herpes simplex virus

CLINICAL MANIFESTATIONS

Being a child and having close contacts with viral or bacterial-laden persons increase the risk for developing tonsillitis.

It is also important to understand that symptoms will be experienced differently for each person. Cases that are caused by bacteria are often followed by skin rash and a flushed face. Tonsillitis that is caused by a virus will develop symptoms that are flu-like such as runny nose or aches and pains throughout the body.

Acute tonsillitis is caused by both bacteria and viruses and will be accompanied by symptoms of ear pain when swallowing, bad breath, and drooling along with sore throat and fever.

Fever, Enlarged, tender glands (lymph nodes) in the neck, A scratchy, muffled or throaty voice, Bad breath, Stomachache, particularly in younger children, Stiff neck, Headache.

In young children who are unable to describe how they feel, signs of tonsillitis may include: Drooling due to difficult or painful swallowing, Refusal to eat, Unusual fussiness.

Viral tonsillitis typically requires no special treatment. Rather, gargling with salt water, drinking warm liquids such as broth or tea is enough.

Inflammation or swelling of the tonsils from frequent or ongoing (chronic) tonsillitis can cause complications such as: Difficulty breathing, Disrupted breathing during sleep (obstructive sleep apnea), Infection that spreads deep into surrounding tissue (tonsillar cellulitis), Infection that results in a collection of pus behind a tonsil (tonsillar abscess)

If tonsillitis caused by group A streptococcus or another strain of streptococcal bacteria isn't treated, or if antibiotic treatment is incomplete, child has an increased risk of rare disorders such as: Rheumatic fever, an inflammatory disorder that affects the heart, joints and other tissues. Post-streptococcal glomerulonephritis, an inflammatory disorder of the kidneys that results in inadequate removal of waste and excess fluids from blood.

Chronic tonsillitis is a persistent infection in the tonsils. Since this infection is repetitive, crypts or pockets can form in the tonsils where bacteria can store. Frequently, small, foul smelling stones (tonsilloliths) are found within these crypts that are made of high quantities of sulfur. These stones cause a symptom of a full throat or a throat that has something caught in the back. A foul breath that is characterized by the smell of rotten eggs (because of the sulfur) is also a symptom of this condition. Other symptoms that can be caused by tonsillitis that are not normally associated with it include snoring and disturbed sleep patterns. These conditions develop as the tonsils enlarge and begin to obstruct other areas of the throat. A person's voice is generally affected by this type of illness and changes in the tone of voice a person normally has.

 

 

MANAGEMENT:

Self-Care Tips

- Turmeric and ginger are powerful anti-inflammatory spices and can easily be integrated into diet or taken in raw form.

- Try gargling with a saline solution of half a teaspoon of salt to one cup of tepid water to remove mucous and reduce swelling. Suck zinc lozenges as zinc helps the immune system.

- Garlic is useful in treating any kind of throat infection, including tonsillitis. An onion and garlic soup are excellent foods to eat during a bout of tonsillitis.

- Cut out all processed and refined foods as well as fast foods. Try to find time to cook wholesome meals, focusing on whole grains, vegetables and proteins such as fish and legumes.

- Take an echinacea and goldenseal tincture. Echinacea boosts the immune system, while goldenseal has antibiotic, anti-catarrhal, anti-infective, anti-inflammatory properties.

- Drink fresh vegetable juice—made from carrots, cucumbers, beets and celery—with a little fresh ginger, which will alkalize our body and is an excellent tonic for tonsillitis.

- Try to omit sugar from regular diet. sugar consumption has also been shown to reduce the body's ability to fight viruses and infection. If you need your sweet fix, take a spoonful of manuka honey, as it is said to have many health benefits, including antiviral, antibacterial and anti-inflammatory properties

- Do not share utensils, drinking glasses, toothbrushes, etc., with anyone who has  tonsillitis or a sore throat.

- Wash your (and your child's) hands frequently.

- Cover your mouth when you cough or sneeze, and teach your children to do the same

Tonsillectomy

A tonsillectomy is a surgical procedure in which the tonsils are removed from either side of the throat. The procedure is performed in response to cases of repeated occurrence of acute tonsillitis or adenoiditis, obstructive sleep apnea, nasal airway obstruction, snoring, or peritonsillar abscess. Sometimes the adenoids are removed at the same time, a procedure called adenoidectomy. Tonsillectomy remains one of the most common surgical procedures in children.

 

HOMOEOPATHIC MANAGEMENT

There is no cure for this tonsillitis in modern medicine expect symptomatic relief. With our homoeopathic remedies we can prevent the tendencies of further attacks in future by developing your own immunity, increase the resistance power, to prevent further complication and getting rid of the complaint permanently without side effects.Homoeopathy treats the person as a whole. It means that homoeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homoeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc.

A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition.

Indicated Remedies	Indications
Apis mell	Stinging-burning pain when swallowing; dryness in mouth and throat; red and highly inflamed tonsils; deep ulcers on tonsils and palate, with erysipelatous or Oedematous appearance around ulcers; Oedema glottidis, tenacious mucus in throat; Aggravation heat or hot drinks, Amelioration from cold or cool drinks.
Baryta carb	Liability to quinsy after every cold or suppressed sweat of feet; tonsils tend to suppurate, especially the right; throat feels worse from empty swallowing; pricking sensation when swallowing;
Belladonna	Tonsillitis, worse right side, parts bright-red; worse swallowing liquids; during deglutition sensation as if throat were too narrow and as if nothing would pass properly;.
Ferrum phos	Tonsils swollen and raw, great pain in swallowing; high fever.
Hepar sulph	Chronic tonsillitis, especially when accompanied by hardness of hearing, with sensation like splinter or fishbone in throat when swallowing; sharp, lancinating pains, throbbing, rigors and chills, with stitches in throat, extending to ears, worse when swallowing; cannot bear cold air.
Kali bichrom	Tonsillitis herpetica with membranous exudations, inflammation of uvula and pharynx, foul, yellow tongue, fauces covered with ropy mucus (often mistaken for true diphtheria); Eustachian tubes blocked up; pain shoots from ear down throat.
Kali Mur	Acute and chronic swelling of the tonsils, which are covered with a whitish coating; hawking up cheesy lumps having a disgusting odor and taste.
Lac caninum	Tonsils inflamed, shining and very sore, swollen so as almost to close the throat; suppuration from left to right, or changing from side to side, or both tonsils equally affected; whole posterior portion and throat Oedematous; tonsils enlarged; pricking; cutting pains from empty swallowing; great dryness of tonsils at night; throat sensitive to touch externally; ashy-gray exudation.
Lachesis	Throat purplish, patient very nervous, least touch unbearable; tonsils swollen, left Aggravation with tendency to right; inability to swallow, threatening, suffocation; liquids escape by the nose when swallowing is attempted and are more difficult to swallow than solids;
Lycopodium	Tonsils enlarged, indurated and studded with many small ulcers; swelling and suppuration of tonsils, going from right to left; chronic enlargement of tonsils; Aggravation from cold drinks, and smarting in throat from hot drinks.
Mercurius	Parenchymatous tonsillitis (after Bell.); throbbing pain, tonsils and fauces yellowish-red, often covered with a thin false membrane; tongue pale, flabby and indented by the teeth; pain on deglutition and speaking; pain on empty swallowing;
Mercurius iod. Flav	Hypertrophy of tonsils with enlargement of cervical and salivary glands and inflammation of the mucous membrane of mouth and pharynx, which is succulent and freely secreting; ptyalism; foetor oris; swallowing difficult.
Mercurius iod. Rub	Scalded feeling in throat, dark-red fauces, left tonsil most affected; Extensive implication of submaxillary glands.
Phytolacca	Chills alternating with fever; great weakness; tonsils large, bluish, ulcerated; intense dryness of throat; rough, burning, smarting fauces; pain in throat extends to ears when swallowing; aching in back, neck, head and limbs; ulceration on tonsils and fauces; with grayish-white, sloughs and little or no foetor; cannot hot fluids; great prostration.
Silicea	Deep ulcers, even gangrene; tonsils; swollen, each effort to swallow distorts face; tonsillitis, when the suppurating gland will not head; pricking in throat, as from a pin, causing cough; left side.
Echinacea Angustifolia	Irritation of larynx. Voice husky. Constant clearing of mucus from throat. Sore throat. Frothy mucus, hawks from throat. Tonsils purple or black, gray exudation extending to posterior sinuses and air-passages. Ulcerated sore throat. Mucus in throat with raw sensation. Soreness of throat, worse on left side.
Baptisia Tinctoria	Aphonia. Larynx sore to touch, painful swallowing or speaking. Fauces dark-red, dark, putrid ulcers. Tonsils and soft palate dark red and swollen. Painless sore throat and offensive discharge. Numb inside but sensitive outside. Can swallow liquids only, least solid food gags. Ragged ulcers in the throat. Spasms of gullet. Constriction at cardiac orifice of esophagus. Constrictive feeling in throat causing frequent efforts at swallowing.
Streptococcinum	Adenopathy of the neck. Big, infected, purulent tonsils. Red angina.Persistent pain and redness of the throat. Acute and chronic laryngitis. It is most suitedfor Tonsillectomy recurrence infection.
Tuberculinum	Chronic recurring Tonsillitis and Adenoids <change of weather from damp to cold. Vibrionic preparations like Throat 30, Infection 200 and War 1M also found veryeffective in the treatment of Tonsillitis
Agraphis Nutans	Enlarged tonsils. Throat and ear complaints with tendency to free discharge from mucus membrane. Adenoids enlarged, throat deafness.
Polyporus Pinicola	Throat dry, sore, frequent inclination to swallow. Tonsils much congested and enlarged, frequent efforts to swallow, quite painful
Raphanus	Heat and burning in throat, at times, chiefly in tonsils, with lancinations. Swelling, redness and pain in tonsils, as if raw.
Elaps Coralum	Tonsils swollen so that no passage is visible, deglutition impossible, throat sensitive to Touch
Mancinella	Great swelling and suppuration of tonsils, with danger of suffocation; whistling breathing; Yellowish-white ulcers on tonsils, with violent burning pain; great elongation of uvula; offensive breath.
Teplitz	Pain in throat without redness, on swallowing. Swelling of uvula and tonsils with difficulty in swallowing. Swelling of cervical glands.
Ustilago	Frequent attack of tonsillitis. Tonsils are congested and enlarged. The left tonsils is esp. affected. It looks large and dusky. There is intense pain on swallowing, lancinating pain extents from the tonsils to ear. The throat is dry and there is feeling of lump, behind the larynx which make the swallow constantly.

 

CONCLUSION

In a significant number of children, homoeopathic treatment can help to prevent recurrence of frequent tonsillitis, thus helping children avoid tonsillectomy. The treatment of enlarged tonsils with homoeopathy has two stages in cases of long standing. Acute inflammation needs to be treated with a different set of medicines and its recurrence to be treated once the acute stage is over. Deep-acting medicines are required to treat the constitution and bring about lasting relief. It is true that this method takes a longer time, but it is also the best one because not only the tonsils are cured but also the patient.

RETHINKING SINUSITIS TREATMENT – ROLE OF HOMOEOPATHY WITH EXPERIENCE

 ABSTRACT 

Sinuses are air filled spaces in the skull that communicate with the nose, situated within the bones between eyes, behind cheekbones, and in forehead. They make mucus, which keeps the inside of nose moist. Sinusitis is a condition in which the cavities around the nasal passages become inflamed. An infection in the nose and upper respiratory tract can spread to the sinuses. Sinuses can get acutely infected during an episode of cold or many times they remain chronically infected due to repeated colds or non clearance of infection. This article provides an overview of the aetiology, diagnosis, and appropriate general & homoeopathic management of this disorder.

 

INTRODUCTION

Sinusitis is an inflammation of the paranasal sinuses. The inflammation could be caused by a virus, bacteria, or fungus. The infection may also be the result of an allergic or autoimmune reaction – when the immune system attacks healthy cells. Chronic sinusitis is generally accepted to be a common illness incurring considerable costs, despite limited epidemiological data. It is defined as an inflammation of the nasal mucosa and paranasal sinuses for at least 12 weeks which may cause nasal blockage or congestion, mucous discharge, facial pain or pressure, and/or impaired smell. Polyps, which may or may not be present are increasingly recognized as part of the sinusitis pathology.

 

AETIOLOGY

The sinuses are air-filled spaces in the skull. They are located behind the forehead, nasal bones, cheeks, and eyes. Healthy sinuses contain no bacteria or other germs. Most of the time, mucus is able to drain out and air is able to flow through the sinuses. Sinus infections or sinusitis may be caused by anything that interferes with airflow into the sinuses and the drainage of mucus out of the sinuses.

When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.

Sinusitis can occur from one of these conditions:

· Small hairs (cilia) in the sinuses fail to properly move mucus out. This may be due to some medical conditions.

· Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.

· A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.

 

RISK FACTORS

· Tumors or growths also can block the sinuses if they are near the sinus opening

· Dehydration, disease, drying medications, and lack of sufficient humidity can cause sinusitis or sinus infection. The drainage of mucous from the sinuses can also be impaired by thickening of the mucous secretions, by a decrease in hydration (water content) of the mucous brought on by disease (for example, cystic fibrosis), drying medications (antihistamines), and lack of sufficient humidity in the air.

· Stagnated mucus provides an environment for bacteria, viruses, and in some circumstances, (for example, AIDS or immunodepression people) fungus, to grow within the sinus cavities.

· tissue irritants such as nasal sprays, cocaine, and cigarette smoke

 

CLASSIFICATION

Sinusitis may be classified in several ways, based on its duration (acute, subacute, or chronic) and the type of inflammation (either infectious or noninfectious). The term rhinosinusitis is used to imply that both the nose and sinuses are involved and is becoming the preferred term over sinusitis.

· Acute sinus infection (acute sinusitis or acute bacterial rhinosinusitis) usually lasts less than 3-5 days.

· Subacute sinus infection lasts one to three months.

· Chronic sinus infection is greater than three months. Chronic sinusitis may be further sub-classified into chronic sinusitis with or without nasal polyps, or allergic fungal sinusitis.

· Recurrent sinusitis has several sinusitis attacks every year.

· Infected sinusitis usually is caused by an uncomplicated virus infection. Less frequently, bacterial growth causes sinus infection and fungal sinus infection is very infrequent. Subacute and chronic forms of a sinus infection usually are the result of incomplete treatment of an acute sinus infection.

· Non infectious sinusitis is caused by irritants and allergic conditions and follows the same general timeline for acute, subacute, and chronic as infectious sinusitis.

 

CLINICAL MANIFESTATIONS

There are many signs and symptoms of sinusitis and sinus infections. The following is a summary of predominant ones that may occur. Most patients have several signs and symptoms at the same time. Others may have some symptoms that are intermittent; most do not have all symptoms at once. The signs and symptoms of a sinus infection or sinusitis include the following:

· Headache,  Facial tenderness and/or swelling, Pressure or pain due to mucus pressing on sinus tissue or inflammation of sinuses.

· Fever, Postnasal drip, Sore throat , Cough,  Tooth pain, Ear pain and Eye pain caused by pressure on surrounding nerves and tissues

· Fatigue,  Bad breath, Itching/sneezing and Ulceration.

· Multiple chronic (over one to three months) symptoms usually are a sign of subacute or chronic sinusitis

 

INVESTIGATIONS

Diagnostic methods may include:

medical history

physical examination

Plain X-ray studies of the sinuses may be misleading and procedures such as CT and MRI scans, which are much more sensitive in their ability to diagnose a sinus infection, are so expensive

Occasionally, nasal secretions are examined for secreted cells that may help differentiate between infectious and allergic sinusitis.

PREVENTION

There are many things you can do to reduce your chance of developing sinusitis or to relieve early sinusitis symptoms. One of the most important is to promote drainage and keep nasal passages clear. Here are some suggestions:

Bathe nasal passages daily. Run water gently into the nasal passages to help clear excess mucus and moisten membranes. Good times to do it are in the morning and at night, During the day, use nasal saline spray to moisten nasal passages.

Drink lots of water. Good hydration helps keep the mucus thin and loose. Have a bottle of water at  desk at work or put a glass near the kitchen sink to remind to drink water throughout the day.

Inhale steam. Linger in a hot shower. Or bring water to a boil and pour it into a pan; place a towel over  head, and carefully bend over the pan to inhale the steam. To avoid burns, keep distance at first and move in gradually to a comfortable zone.

Avoid dry environments. A humidifier in home and at work place can help prevent nasal passages from drying out. Keep humidifiers clean and free of bacteria and mold.

Sleep with head elevated. Mucus pools in sinuses at night when head is down, so have head propped up with pillows or a wedge during sleep.

Be nice to nose. Blow nose gently, one nostril at a time. Forceful blowing can irritate the nasal passages and propel bacteria-laden mucus back up into your sinuses.

Eat foods with antibacterial properties - To fight the virus, add antibacterial foods like garlic, ginger, and onions to meals.

Try drinking ginger tea. Add raw honey for an extra boost. Honey is packed with antioxidants and has antibacterial and antifungal properties.

MANAGEMENT

Home Managements

 

Nasal irrigation - One of the simplest, cheapest, and most effective ways to prevent and treat sinus problems is nasal irrigation. Using a homemade solution, can often relieve sinusitis symptoms, reduce reliance on nasal sprays and antibiotics, and improve quality of life. At least once a day, follow these steps:

Stir ½ teaspoon of non-iodized salt and ½ teaspoon of baking soda into 2 cups of lukewarm distilled or previously boiled water (as recommended by the American Academy of Otolaryngology).

Fill a small bulb syringe or Neti-Pot with the saltwater solution.

Lean over bathroom or kitchen sink, insert the tip of the syringe just inside one nostril, and gently squeeze the bulb. The water will run back out the nostril (or possibly the opposite nostril) and into the sink. Use at least one full bulb of solution.

Repeat the procedure in the other nostril. (If the salt solution stings nose, use less salt.)

Thoroughly rinse (with distilled or cooled boiled water) and dry the bulb syringe after each use.

 In 2012, the FDA issued a warning about the use of Neti-Pots. The FDA cautions people not to use untreated tap water for rinsing, as contaminated tap water rinses lead to two deaths.

Bacterial and fungal sinus infections usually require antibacterial or antifungal therapy so home treatments without them are often not successful.

Eucalyptus oil can help open up the sinuses and get rid of mucus. One study Trusted Source has found that the main ingredient in eucalyptus oil, cineole, helped people with acute sinusitis recover faster.

Ease facial pain with warm compresses - Applying moist, warm heat may help soothe sinus pain. Place warm, damp towels around your nose, cheeks, and eyes to ease facial pain. This will also help clear the nasal passages from the outside.

HOMOEOPATHIC MANAGEMENT

There is no cure for this chronic sinusitis in modern medicine expect symptomatic relief. If the attacks are recurrent it can lead to middle ear infections ,inflammation of the voice box (Pharygnitis) prolonged stagnation of mucus in the sinus lead to abscess formation which can lead to inflammation of brain structures a critical condition.

With our homoeopathic remedies we can prevent the tendencies of further attacks in future by developing your own immunity, increase the resistance power, to prevent further complication and getting rid of the complaint permanently without side effects.

Homoeopathic prescribing accounts for concomitant symptoms in addition to the predominant pathology, therefore the same main diagnosis may be treated with different remedies in different patients ('individualisation'). The prescribed drugs ('remedies') are under constant debate. They are produced by alternating steps of diluting and agitating a starting substance ('potentiating').Homoeopathy has an excellent scope as it can improve your quality of life –reduce your discomfort   improve your concentration in work hence increase your work output during the acute attacks of sinusitis and also prevent chronicity. By reducing the intensity and frequency of the attacks it can prevent complications of sinusitis and surgery. Some frequently used homoeopathy medicines in sinusitis are Kali-Bichromicum, Thuja, Hydraitis, Lycopodium, Mercury, Pulsatilla, Silicea, Arsenic, Medorrhinum.

 

Indicated Remedies	Indications
Belladonna	Throbbing pains in the front part of the head that come on suddenly and tend to leave suddenly only to return are characteristic of children who need this medicine.
Sulphur	Rarely indicated at the beginning of a sinusitis condition. Children begin sneezing and then develop sinusitis from the least exposure to cold air. Their nasal discharge is thick and yellow. The nostrils become very sore from the acrid discharge, and their nasal passages become sensitive to cold air.
Kali bich	The distinguishing feature of children with sinusitis who need this medicine is that they have a thick, stringy nasal discharge. They have extreme pain at the root of the nose that is better by applying pressure there. The bones and scalp feel sore. Dizziness and nausea when rising from sitting and the severe pain may lead to dimmed vision.
Mercurius	These children feel as though their head was in a vise. The pains are worse in open air, from sleeping, and after eating and drinking. The pains are also aggravated by extremes of hot and cold temperature. The scalp and the nose become very sensitive to the touch. Their teeth feel long and painful, and they may salivate excessively.

 

CONCLUSION

 Patients with sinusitis treated with 'classical' homeopathy showed marked health and quality of life improvementsThe natural Homoeopathic mode of treatment aims at rebuilding the body’s immunity to Sinusitis. The Homeopathic treatment for sinusitis can completely cure the chronicity and recurrence of Sinusitis. Chronic Sinusitis stands the best chance of being cured by Homeopathy. The Homoeopathic treatment of sinusitis is far superior as it does not resort to any strong medicines or antibiotics. The homoeopathic medicine for sinusitis is mild and has the additional benefit that it does not cause any side effect at all.