Adenoids and Tonsils: Immune Health in Kids and Adults

Your tonsils are found at the back of your throat. If you open your mouth, look into the mirror, and say “ah,” you will see your left and right tonsils. You also have two other tonsils at the base of the tongue called the lingual tonsils.

Your adenoids are behind your nose, high up in the throat. This collection of adenoids and tonsils is sometimes called Waldeyer’s ring. 

A healthcare provider might recommend tonsil and adenoid removal if they become enlarged and inflamed, making breathing or swallowing difficult, or if you have multiple throat infections yearly. Tonsil and adenoid removal surgery (T&A) is often done during childhood, but it can also be performed on adults.

This article will examine how tonsils and adenoids help with immune function, signs of enlargement, remedies for swelling, and how the removal procedure works.

Adenoids, Tonsils, and Immune Health

Your adenoids and tonsils are part of your lymphatic system. They play an essential role in keeping you healthy and safe from germs. Because of their positioning, they help prevent bacteria and other foreign substances that might make you sick from entering through your nose and mouth. 

But what happens if you have your adenoids and tonsils removed? Does it leave you vulnerable to infection?

Your throat has a backup system of sorts, a collection of cells that act to defend your body from invading germs when the adenoids and tonsils have been removed. However, some research suggests that removing the adenoids and tonsils may still affect immune health.

Female Lymphatic System

One 2019 longitudinal study (a study that follows individuals over a period of time) involving 40 children under 3 years old found that children showed a significant decrease in antibodies (immune proteins) one month after surgery. However, there didn’t seem to be a negative effect on the immune system’s function.

A review of 18 studies found asthma improved in children after removing the adenoids. How the removal of the tonsils or adenoids in childhood may affect allergies and respiratory health later in life is a much-studied topic of research, and controversies remain. One study found an increased risk of asthma (but not allergies) in people who had these operations at an early age.

Signs and Causes of Enlargement

Your tonsils and adenoids can become swollen and inflamed because of viral or bacterial infections. Swollen and inflamed tonsils (tonsillitis) are more common in children age 2 and older, but they can also become enlarged in adults. 

When your tonsils or adenoids are infected and swollen, you may experience:

• Sore throat
• Visible redness or swelling in the tonsils
• Noticeable red or white patches on the tonsils
• Problems swallowing and painful swallowing
• Swollen lymph nodes in your neck
• Bad breath
• Fever
  

Children may also experience symptoms due to tonsils and adenoids that are enlarged but not infected. Signs of enlargement may include:

• Chronic nasal issues like runny nose, nasal blockage
• Regular mouth breathing
• Snoring
• Trouble sleeping 
• Chronic ear infections or ear pain
  
• Chronic upper respiratory infections
• Jaw alignment issues
• Chronic sleep apnea (breathing repeatedly stops during sleep)
  

Because enlarged adenoids can make it hard to breathe through the nose, chronic mouth breathing may also cause:

• Dryness around the mouth
• Dry, chapped lips
• Runny nose
  

Home Remedies

Swollen tonsils and adenoids often occur because of viruses for which there’s no treatment. The illness will usually go away on its own with rest and time. A healthcare provider will likely prescribe antibiotics for a bacterial infection, such as strep throat.

Whether your swollen tonsils and adenoids are the result of a bacterial or viral infection, you can try the following at-home strategies to manage symptoms and discomfort:

• Stay hydrated.
• Temporarily change your diet and avoid foods that irritate your throat.
• Drink hot or cold things to help with throat pain.
• Try using a humidifier or take steamy showers.
• Use lozenges that can help numb the throat. 
• Take over-the-counter (OTC) anti-inflammatories such as Advil (ibuprofen) to help relieve pain and swelling. Talk to a healthcare provider about what is appropriate for children.
• Try a saltwater gargle.
  

For enlarged tonsils, a healthcare provider might suggest a wait-and-see approach. In some children, the enlargement may not cause problems.

T&A Removal Procedure 

A healthcare provider may recommend a tonsillectomy and/or adenoidectomy for a child or adult who continues to experience tonsil and/or adenoid swelling that blocks the airways, makes breathing uncomfortable, or causes problems with swallowing. Your provider may also recommend it if you get multiple throat infections yearly.

In children, these operations are usually performed at the same time, with the child going home the same day. A general anesthetic is given, so the patient is unconscious throughout the procedure. The removal is done through the mouth. There are no external incisions.

The procedure often takes less than 30 minutes to perform. The child is then monitored for recovery before being released to be taken home. Some children may need to stay overnight if they are under age 3 or have a serious sleep problem. Adults may require an overnight stay if they have a complex medical condition.

These procedures are usually routine and free of complications. The child can return to school or child care once they can eat and drink normally and are getting good sleep. Many children recover fully within one to two weeks. Risks include bleeding, complications from anesthesia, and infection.

Adult recovery from a tonsillectomy can take longer and may require staying home from work or school for 10 days.

Summary

Your tonsils and adenoids play an important role in keeping you healthy. They block germs and other foreign substances from entering your body. Sometimes, though, they can get infected and swollen. Having enlarged tonsils and adenoids is another potential problem that can affect breathing and sleep. 

A healthcare provider may recommend surgery for chronic swelling and enlargement of the tonsils and adenoids. 

A Word From Verywell 

A healthcare provider can help you weigh the pros and cons of tonsil or adenoid surgery for yourself or your child. While enlarged adenoids and tonsils can cause problems, some healthcare providers may recommend a wait-and-see approach. It's also important to discuss potential complications and what to expect during recovery.