Doc, why does my daughter have recurring tonsillitis?

Dr Flo,
My daughter, who is almost seven years old, has had recurring tonsillitis since she was a child. The only treatment she has been on is antibiotics. What might be the problem and what is the cure?
Mark

Dear Mark,
Tonsils are lymph nodes found on both sides of the throat. They are part of the body’s defence mechanism, helping to prevent infections.

The tonsils can themselves become infected by bacteria, viruses or other organisms, and this is called tonsillitis. It is a common infection in childhood due to exposure to germs and also because the infection can be easily transmitted through cough, sneezing and touching contaminated surfaces. 

If there is tonsillitis five to seven times in one year, or at least five times in each of the previous two years, or at least three times in each of the previous three years, then it is recurrent tonsillitis.

This can happen because there is a biofilm of resistant bacteria on the surface of the tonsils or because genetics make the body’s immune system have a weaker response to the bacteria causing tonsillitis.

The only permanent solution to this is removal of the tonsils. This should be done after consultation with an ENT (ear, nose, throat) specialist. To prevent infections, avoid anyone who has tonsillitis or a throat infection, maintain good hygiene (washing hands regularly and cleaning surfaces) and take the appropriate medication when unwell to prevent spreading the infection

Dr Flo,
I do not know what is causing rectal bleeding. I have endometriosis but I do not think this is the cause. I have had two colonoscopies that did not show any abnormalities. I only have rectal bleeding during my menstrual cycle. 
Rose

Dear Rose,
The most likely cause of cyclical rectal bleeding is endometriosis. In endometriosis, there is functional endometrial tissue found outside the uterus.

About five per cent of those with endometriosis may have deeply infiltrative endometriosis. This is where the endometrial tissue is found deep within the tissue or organ. In the gastrointestinal tract, this more commonly happens in the muscular layer of the rectum or in the lower part of the large intestines (sigmoid colon).

What is visible on the mucosal surface of the intestines may not be very obvious. It may be as small as a pin point. Biopsy samples taken during colonoscopy sometimes may also not give a specific diagnosis.

Colonoscopies, however, are very useful for checking for other potential causes of rectal bleeding. Other modalities to check for the endometriosis include rectal and/or endoscopic ultrasound, MRI scan or CT scan. Because gastrointestinal endometriosis can be difficult to find, sometimes no conclusion can be drawn from any of these tests and surgery is done to physically check for, and treat the lesion, if possible.

Dr Flo,
Why is it necessary to remove the thyroid gland when there is a problem? Is there no alternative to such drastic surgery? 
Daniel

Dear Daniel,
When thyroid surgery is done, either part or the whole of the thyroid gland may be removed. Surgery may be done to remove thyroid cancer or due to multiple growths on the thyroid gland that are suspected to be a sign of cancer.

Surgery may also be done if the thyroid gland is enlarged, and especially if it is causing problems with breathing or swallowing. Surgery may also be done to remove an overactive thyroid that is producing too much thyroxine and there is poor response to treatment, and using radioactive iodine is not an option for the patient.

In all these cases, surgery is done as the best option for the patient at that time. If other options of treatment are available, these are usually explored before surgery.

Dr Flo,
Scientists say our lifestyle is a determining factor in contracting some cancers. They also warn about our diet. Please shed light on this.
Alnashir Walji

Dear Alnashir,
Getting cancer is usually a result of many factors coming together. In a majority of the cases, there is no specific cause.

Some factors that have been linked to development of cancers include genetics, obesity, physical inactivity, alcohol intake and smoking.

Obesity on its own is a risk factor for several cancers including breast, ovarian, endometrial, colon, rectal, esophageal, stomach, pancreatic, thyroid, liver, kidney, meningioma and multiple myeloma.

This means that having a healthy diet (whole grains, fruits and vegetables, plant proteins, low-fat meats and chicken and fish) and exercising to maintain a healthy weight can reduce this risk.

Alcohol consumption and cigarette smoking are also risk factors for a number of cancers. Another lifestyle choice is sexual behaviour since some sexually transmitted infections have been associated with increased cancer risk such as HIV, HPV, some types of the herpes virus and CMV (cytomegalovirus).

While cancer cannot be prevented completely, keeping our bodies in the best possible health reduces the risk and gives them a better fighting chance.

Send your medical questions to [email protected] for free expert advice

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