The tonsils are lumps on each side at the back of the throat, whereas the adenoids are glands further up in the throat and behind the nose. They form part of the immune system.

The tonsils and adenoids are the body’s first line of defense against illness-causing microbes that enter through the mouth or nose.

A 2020 literature review explains that the tonsils and adenoids are responsible for activating white blood cells. These cells help the body fight infections.

Sometimes, the tonsils and adenoids become enlarged, often due to a viral or bacterial infection. This common occurrence can cause snoring, breathing difficulties, and frequent colds.

If antimicrobial drugs do not resolve an infection, a doctor may need to remove the glands surgically. If there is no infection, doctors may recommend steroid nasal sprays.

Keep reading to learn more about tonsils and adenoids, including their functions, common health issues, and treatment options.

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Adenoids and tonsils are structures in the lymphatic (lymph) system, which is part of the immune system.

The tonsils, also known as the palatine tonsils, are two round lumps on the right and left sides of the back of the throat. The adenoids, or pharyngeal tonsils, are glands high in the throat and behind the nose.

Although tonsils are visible when the mouth is open wide, doctors can only view adenoids using an angled mirror or a camera in the nose.

In most people, the tonsils and adenoids decrease in size after the age of 9 years. During a person’s teenage years, they further reduce in size.

These components of the immune system are responsible for filtering bacteria and viruses from the air. In doing so, they can protect against infections. The tonsils and adenoids serve most of their purpose in early childhood.

They aid in developing two types of white blood cells: B cells and T cells. Due to their role in development, a lack of tonsils, adenoids, or both later in life will not make a person immunocompromised.

A common issue with tonsils and adenoids is their enlargement.

Doctors do not know why tonsils and adenoids increase in size, but it is often a normal part of childhood. Other symptoms, such as a sore throat, painful swallowing, and fever, sometimes accompany the enlargement.

One common condition affecting the tonsils and adenoids is tonsillitis, which is the inflammation of the tonsils.

Possible signs and symptoms of enlarged tonsils or adenoids include:

  • pauses in breathing during sleep
  • snoring
  • strained breathing
  • mainly breathing through the mouth
  • frequent colds
  • trouble swallowing
  • restless sleep, bedwetting, and waking frequently
  • unusual sleeping positions, such as having the head bent backward

The symptoms of tonsillitis include:

  • fever
  • reddish color of tonsils
  • swelling
  • a sore throat, which sometimes comes with ear pain
  • a yellow or white coating on the tonsils
  • painful or uncomfortable swallowing
  • slight voice change due to swelling
  • swollen lymph nodes
  • bad breath

Although other symptoms can accompany enlarged tonsils and adenoids, many children do not have any. However, research shows that approximately 2% have breathing pauses during sleep and 7% snore.

The symptoms that a person experiences will depend partly on whether the tonsils or adenoids have become enlarged. Enlarged tonsils can cause pauses in breathing during sleep, and enlarged adenoids affect a person’s ability to breathe through the nose.

Over time, enlarged tonsils can result in:

Additionally, the possible effects of enlarged adenoids include:

Doctors generally treat tonsillitis before considering surgical removal.

They may prescribe antibiotics for someone with a bacterial infection and antivirals if a viral infection is the cause. Alternatively, they may recommend a steroid nasal spray that shrinks the adenoids, making it easier to breathe.

As with any surgery, the removal of the tonsils or adenoids carries risks. Therefore, doctors usually recommend waiting for the symptoms to improve before moving forward with one of these procedures.

There are also criteria for the number of episodes of tonsillitis, strep throat, or both that a person has before they become a candidate for removal. According to the Paradise criteria, a person must have had at least seven episodes in the past year.

Doctors may choose to perform:

  • a partial or total tonsillectomy, which is the removal of the tonsils
  • an adenoidectomy, which is the removal of the adenoids
  • both a tonsillectomy and an adenoidectomy

After surgery, many children experience improved breathing, better sleep, and less snoring.

Children should avoid physically strenuous activities for 2–3 weeks after surgery. Although guidance on what they should eat or drink differs, they should prioritize consuming plenty of fluids.

As the healing process takes 2–3 weeks, the wound can start bleeding again after returning home. When this happens, blood will come out of the nose or mouth. Parents or caregivers should look for signs of bleeding in children and seek medical care if they notice any.

Tonsils and adenoids are structures in the throat. As part of the immune system, they help the body fight infections.

One of the most common conditions affecting them is enlargement. Although it does not produce many symptoms in children, it causes snoring in 7% of cases and nighttime breathing problems in 2%.

When symptoms occur, doctors may first prescribe antimicrobials for infections or steroid nasal sprays to shrink enlarged adenoids. If medications do not resolve the issue, surgery may be necessary.