Chronic angina: treatment, causes of development, symptoms
The content of the article:
- The reasons for the development of pathology
- Symptoms of chronic tonsillitis
- Diagnostics
- How to treat chronic sore throat
- Video
Chronic angina has a high prevalence among all age groups. In a child, the role of the palatine tonsils as a lymphoepithelial organ that performs a protective function is more pronounced than in adults.
To distinguish chronic tonsillitis from other forms of pathology, you need to see a doctor
The approach to the treatment of chronic tonsillitis should be complex, since the pathology causes persistent disorders of microbiocenosis and immunity, contributing to frequent exacerbations of inflammation, as well as the development of severe complications.
In order to understand how to get rid of this disease, it is necessary to determine what it is.
Chronic tonsillitis, or chronic tonsillitis, is a common infectious-allergic disease with the predominant localization of a persistent chronic inflammatory process in the tonsils.
The reasons for the development of pathology
The etiological factor in the development of chronic tonsillitis is various pathogens: bacteria, viruses and fungi. The most common cause of the disease is group A beta-hemolytic streptococcus, Staphylococcus aureus, Haemophilus influenzae, pneumococci, anaerobes, adenoviruses, herpes virus and others.
The causative agent of the disease can be bacteria, viruses and fungi
The disease can develop after a sore throat or imperceptibly, masking by frequent ARVI (acute respiratory viral infections), stomatitis.
With untimely treatment of acute tonsillitis, the inflammatory process does not undergo a complete reverse development and turns into a chronic form. Infection from chronic foci is possible: carious teeth, chronic inflammatory diseases of the nose, pharynx.
Also, the occurrence of pathology may be associated with the activation of the non-pathogenic flora of the upper respiratory tract in violation of the protective and adaptive mechanisms of the body.
Chronic inflammation of the tonsils contributes to the suppression of nonspecific factors of the body's natural resistance, disruption of the humoral and cellular links of immunity.
The increased antigenic load causes the hyperproduction of class E immunoglobulins (IgE), which causes the infectious-allergic pathogenesis of chronic tonsillitis.
Provoking factors, such as general or local hypothermia, smoking, concomitant infectious and somatic diseases, contribute to the growth of bacteria in the lacunae of the tonsils and exacerbation of inflammation.
Morphologically, in chronic inflammation, there is a change in the epithelial cover, crypts of the tonsils, parenchyma and surrounding tissue. In the walls of the crypts, massive infiltration by lymphocytes and plasma cells is observed, as well as epithelial rejection. In the lumen of the lacunae, liquid purulent contents from leukocytes, epithelium, and food particles can accumulate.
Reparative replacement of the tonsil parenchyma with connective tissue gradually occurs. Closed foci are formed, where pus can accumulate or a pathogenic microorganism can be constantly present. In the deep sections of the lacunae in chronic tonsillitis, there is usually no large polymorphism of the flora, when, as on the surface of the tonsils, more than 30 combinations of various forms of microbes have been identified.
In the paratonsillar tissue and the tonsil capsule, connective tissue proliferates.
Symptoms of chronic tonsillitis
The disease can manifest itself with the following symptoms:
- minor pain and sore throat;
- discomfort when swallowing or talking;
- bad breath;
- subfebrile body temperature (37.1–38.0 ° C);
- general weakness, fatigue, irritability;
- an increase and slight soreness of regional lymph nodes;
- periodic exacerbations of angina.
Diagnostics
When choosing the tactics of managing patients with chronic tonsillitis at the diagnostic stage, it is necessary not only to correctly diagnose, but also to determine the stages or forms of the disease, which reflect the pathogenetic and clinical aspects and are taken into account when prescribing treatment:
- simple form or initial stage;
- toxic-allergic form I;
- toxic-allergic form II.
To make a diagnosis, a number of studies are carried out, including a clinical and biochemical blood test
First, the doctor collects a detailed anamnesis during the consultation, analyzes the complaints, conducts an examination, if necessary - pharyngoscopy, sends the contents of the lacunae or the secreted from the surface of the tonsils for bacteriological examination. According to the indications, additional consultation of related specialists, a clinical blood test, a general urinalysis, a biochemical blood test, an ECG (electrocardiography), an X-ray examination and other diagnostic methods are required.
The simple form of pathology is characterized mainly by local symptoms:
- hyperemia of the palatine arches;
- reshaping and thickening of the anterior and posterior arches;
- determination of purulent-caseous plugs or liquid pus in the lacunae of the tonsils.
Purulent yellow follicles are visible under the mucous membrane. Fusion with arms is possible.
In the photo taken during pharyngoscopy, you can clearly see the changes inherent in chronic inflammation of the palatine tonsils.
Separate groups of regional lymph nodes are enlarged and painful on palpation. With a simple form of exacerbation, inflammation does not occur often.
For toxic-allergic form I, periodic sore throats are characteristic, there is hyperemia and swelling of the palatine arches, an increase in the palatine tonsils, subfebrile body temperature. In connection with intoxication, general weakness, malaise, fatigue, periodic pain in the joints appear.
During the period of exacerbation, pain occurs in the heart, but without objective abnormalities on the ECG.
Toxic-allergic form II is characterized by more pronounced signs of form I and the presence of diseases associated with chronic tonsillitis. Functional disorders of cardiac activity are recorded on the ECG, pain in the heart and rhythm disturbances are noted both during angina and outside exacerbation.
In toxic-allergic form II, prolonged low-grade fever is observed. In the clinical analysis of blood, biochemical analysis and general analysis of urine, functional disorders in the kidneys, liver, vascular system and joints are determined.
With chronic inflammation, the development of tonsil abscess is possible
Local and general diseases associated with chronic inflammation of the tonsils develop:
- paratonsillar abscess;
- pharyngitis;
- parapharyngitis;
- acute and chronic tonsillogenic sepsis;
- infectious arthritis;
- rheumatism;
- acquired heart defects;
- diseases of the urinary system and prostate gland (glomerulonephritis, pyelonephritis, cystitis, prostatitis);
- diseases of the thyroid gland;
- damage to the meninges.
How to treat chronic sore throat
Treatment should be based on the clinical course of the disease. Also, when choosing a therapy, the doctor takes into account the general condition, the presence of concomitant pathologies.
Conservative treatment is indicated for a simple form of chronic tonsillitis and for toxic-allergic form I without exacerbation. Patients with toxic-allergic form II need tonsillectomy (removal of tonsils).
With angina of toxic-allergic form II, tonsillectomy is prescribed
During an exacerbation, antibacterial drugs are used. With a banal gram-positive flora, semisynthetic broad-spectrum penicillins (Amoxicillin, Amoxiclav), I generation cephalosporins (Cefazolin, Cephalexin), macrolides (Erythromycin, Rovamycin) are prescribed.
Due to the risk of complications due to the incorrect selection of the antibiotic, as well as the prevalence of resistant flora, the selection of an antibacterial drug should be carried out only by a doctor.
In an acute inflammatory process with a high body temperature, anti-inflammatory drugs (Paracetamol) are used.
Local therapy plays an important role. Rinsing the throat and washing the lacunae of the tonsils is carried out with antiseptic solutions (Chlorhexidine, Octenisept), saline, and also an ionic copper-silver solution, which is prepared using an ionizer.
Antiseptics are also presented in the form of sucking tablets (Hexaliz, Septolete). Local immunomodulators (Ribomunil) are also prescribed.
Folk remedies can be used at home in conjunction with the main therapy, so that inflammation passes faster during an exacerbation. But first you need to consult with a specialist.
Video
We offer for viewing a video on the topic of the article.
Alina Ervasova Obstetrician-gynecologist, consultant About the author
Education: First Moscow State Medical University. THEM. Sechenov.
Work experience: 4 years of work in private practice.
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