Why You Should At Least Think Twice Before Having Your Tonsils, Adenoids or Appendix Removed

The Immune System is composed of the Lymphatic vessels and organs (Lymph nodes, thymus, spleen, and Tonsils), white blood cells (neutrophils, eosinophils, basophils, lymphocytes, monocytes, ect..), specialized cells residing in various tissue (macrophages, mast cells, ect..), and specialized chemical factors.

Tonsils are made of soft glandular tissue and are part of the immune system. You have two tonsils, one on either side at the back of the mouth. A main function of the Tonsils is to trap bacteria and viruses (germs) which you may breathe in. Antibodies and Immune cells in the Tonsils help to kill germs and to help prevent throat and lung infections. Adenoids are also made of glandular tissue and are part of the immune system. They hang from the upper part of the back of the nasal cavity. Like tonsils, adenoids help to defend the body from infection. They trap bacteria and viruses which you breathe in through your nose. They contain cells and antibodies of the immune system to help prevent throat and lung infections. Long denigrated as vestigial or useless, the Appendix now appears to have a reason to be – as a “safe house” for the beneficial bacteria living in the human gut. The humble organ is a part of the immune system and may help us recover from serious infections.

Prevent Disease – Doctors have been prescribing tonsillectomies for decades for those with  recurrent sore throats. However,  health experts now know that the long-term risks of this procedure are a detriment  to overall immunity and exceed any short-term benefit. Previous research at the  University at Buffalo has shown that removal of tonsils and adenoids results in less fidgeting and other non-exercise                           motor activity which results in weight gain.
In another study involving 300 children aged 2 to 8 advised                           to have their tonsils out, those who avoided surgery had                           fewer annual visits to doctors and lower resulting medical                           costs due to fevers and throat infections.
A new study provides evidence that a critical type of immune cell can   develop in human tonsils. The cells, called T lymphocytes, or T cells,   have been thought to develop only in the thymus, an organ of the immune   system that sits on the heart.
The study, led by researchers at the Ohio State University Comprehensive   Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove   Research Institute (OSUCCC — James), could improve the understanding of   T-cell cancers,  autoimmune diseases and the importance of first line of  immune defence mechanisms such as the tonsils.
The study identified T cells at five distinct stages of development   in the tonsil. These stages, identified using molecular signposts on   the cells, were very similar to the stages of T-cell development in the thymus, although some differences were found as well.
The study also discovered that the cells develop in a particular region of the tonsil, in areas near the fibrous scaffold of the tonsil, a very sensitive and important area for primary immunity.
The findings are published in the Journal of Clinical Investigation.
“We’ve known for a long time that a functional thymus is necessary   to develop a complete repertoire of T-cells, but whether a T-cell   factory existed outside the thymus has been controversial,” says   principal investigator Dr. Michael A. Caligiuri, director of Ohio   State’s Comprehensive Cancer Center and CEO of the James Cancer Hospital   and Solove Research Institute.

Patient.co.ukTonsils

Tonsils are made of soft glandular tissue and are part of the immune system. You have two tonsils, one on either side at the back of the mouth.
Tonsils vary in size from person to person.
A main function of tonsils is to trap bacteria and viruses (germs) which you may breathe in. Antibodies and immune cells in the tonsils help to kill germs and help to prevent throat and lung infections.
You can normally see your tonsils by opening your mouth wide and looking in a mirror. They are the two fleshy lumps that you can see at the sides and back of the mouth.

 
 
 
  “I believe our study answers that question. It is the first report to   describe a comprehensive, stepwise model for T-cell development outside   the thymus.”
It also raises a number of questions. Caligiuri notes that it’s   still unclear whether T-cells that develop in the tonsil also mature   there or whether they leave the tonsil to mature elsewhere. Since the complete implications of this phenomenon for human health and   disease are not entirely known, removing the tonsils should certainly be considered as a very last resort since their could be considerable long-term implications.
 

                    Caligiuri, McClory and their colleagues conducted the study using tonsil   tissue obtained from children undergoing routine tonsillectomy at   Nationwide Children’s Hospital in Columbus, and thymic tissue obtained   from children undergoing thoracic surgery.
Using the molecular features of T-cells as they develop in the thymus,   the researchers identified five populations of maturing T cells in the   tonsils. They found, for example, that the first two of those groups   resembled  cells of the earliest stages of T cells that developed in the   thymus, while cells in the fifth group were similar to nearly mature   T-cells in the thymus.
They also showed that all five of the cell groups had the capacity to   develop into T cells in laboratory tests, and that the first four   populations had the capacity to develop into immune cells called natural   killer cells.
“Overall, our work suggests that the tonsils serve as a T-cell factory,   along with the thymus,” Caligiuri says. “Next, we need to learn what   proportion of T-cells is derived within the tonsil compared with the   thymus.”

Adenoids

Adenoids are also made of glandular tissue and are part of the immune system. They hang from the upper part of the back of the nasal cavity.
Adenoids get bigger after you are born but usually stop growing between the ages of three and seven years.
You cannot see your adenoids. If needed, a doctor can look at the adenoids either by using a light and a small mirror held at the back of the mouth, or by using a small flexible telescope. Occasionally, an X-ray is done to determine the size of the adenoids.
Like tonsils, adenoids help to defend the body from infection. They trap bacteria and viruses which you breathe in through your nose. They contain cells and antibodies of the immune system to help prevent throat and lung infections.
Although tonsils and adenoids may help to prevent infection, they are not considered to be very important. The body has other means of preventing infection and fighting off bacteria and viruses. In fact, the adenoids tend to shrink after early childhood, and by the teenage years they often almost disappear completely. Generally, you can have your tonsils and adenoids removed without increasing your risk of infection.

Some problems associated with tonsils

Tonsillitis

Tonsillitis is an infection of the tonsils. A sore throat is the common symptom. In addition, you may also have a cough, fever, headache, feel sick, feel tired, find swallowing painful, and have swollen neck glands. Pus may appear as white spots on the enlarged tonsils. Symptoms typically get worse over 2-3 days and then gradually go, usually within a week. Most cases of tonsillitis are caused by viruses, some are caused by bacteria. See separate leaflet called ‘Tonsillitis’ for more details.

Infectious mononucleosis (glandular fever)

Infectious mononucleosis is caused by a virus (the Epstein-Barr virus). It tends to cause a severe bout of tonsillitis in addition to other symptoms. See separate leaflet called ‘Glandular Fever’ for more details.

Quinsy

This is also known as peritonsillar abscess. An abscess is a collection of pus. Quinsy is an uncommon condition where an abscess develops next to a tonsil due to a bacterial infection. It usually develops just on one side. It may follow a tonsillitis or develop without a preceding tonsillitis. The tonsil on the affected side may be swollen or look normal, but is pushed towards the midline as pus forms and the abscess next to the tonsil gets bigger and bigger. Quinsy is very painful and can make you feel very unwell. It is treated with antibiotics, but also the pus often needs to be drained with a small operation.

Cancer of the tonsil

This is a rare cancer. It is more common in smokers and those who drink a lot of alcohol.

Do I need my tonsils taken out?

You may be advised to have your tonsils removed in certain situations. In particular:

  • If you have frequent and severe bouts of tonsillitis. This usually means:
    • Seven or more episodes of tonsillitis in the preceding year, or
    • Five or more such episodes in each of the preceding two years, or
    • Three or more such episodes in each of the preceding three years. And …
    • The bouts of tonsillitis affect normal functioning. For example, they are severe enough to make you need time off from work or from school.

    The adenoids may also be removed at the same time for this reason. Throat infections are not totally prevented if the tonsils are removed. However, there is a good chance that their number and severity will be reduced. Also, the risk of developing quinsy is reduced. Many people say they generally feel better in themselves after having their tonsils removed if they previously had frequent bouts of tonsillitis.

  • If you have large tonsils that are partially obstructing your airway, this may be a contributing factor to a condition called obstructive sleep apnoea syndrome. See separate leaflet called ‘Sleep Apnoea’.
  • If you develop cancer of the tonsil.

Some problems associated with adenoids

Swollen or enlarged adenoids are common in children. Causes include:

  • Infections with viruses or bacteria. Once an infection clears, the swelling often goes down but sometimes the adenoids remain enlarged.
  • Allergies.
  • Often there is no apparent cause.

What are the symptoms of swollen, enlarged adenoids?

Swollen adenoids may not cause any symptoms or problems. However, symptoms may develop in some cases, especially if the adenoids become very large. Possible symptoms include the following:

  • Breathing through the nose may be noisy or rattly. This may get worse and cause difficulty breathing through the nose. The child then mainly mouth breathes.
  • A constantly runny nose.
  • Snoring at night. In severe cases sleep may be disrupted by the blocked nose and there is difficulty with breathing.
  • Swollen adenoids may block the entrance of the Eustachian tube. This is the tube that goes from the back of the nose to the middle ear. It normally allows air to get into the middle ear. If this tube is blocked it may contribute to the formation of glue ear (fluid in the middle ear). See separate leaflet called ‘Glue Ear’.

What is the treatment for enlarged adenoids?

In most cases no treatment is needed. Often the symptoms are mild but may flare up during a cold or throat infection. Adenoids normally gradually shrink in later childhood and usually almost disappear by the teenage years. So symptoms tend to clear in time.
If symptoms are severe then a doctor may consider removing the adenoids. For example, if a child regularly has difficulty sleeping or disrupted nights’ sleep due to a blocked nose. Also, some children with glue ear may benefit from removing the adenoids.

A note about removing the tonsils and / or adenoids

Several years ago, operations to remove tonsils and adenoids were very common. These operations are done less commonly these days and the main indications for them being advised are discussed above. As with all operations, there is a risk involved with surgery.
For example, possible complications of surgery include infection and severe bleeding from the sites where the tonsils or adenoids were removed, and anaesthetic reactions. Also, after adenoids are removed, there is a small risk that speech may become nasal. That is, a child may sound as if they are speaking through their nose. This is because after the adenoids are removed, the gap between the soft palate (the back part of the palate) and the roof of the mouth may not close properly as it should do when we talk. If this occurs, it may only be temporary. However, in a small number of cases speech therapy is needed, or even an operation to narrow the gap.
Therefore, before you have, or your child has, an operation it is useful to discuss with the surgeon the benefits versus the risks of the operation.

APPENDIX

Appendix Isn’t Useless At All: It’s A Safe House For Good Bacteria and Could Save Your Life

ScienceDaily – Long denigrated as vestigial or useless, the appendix now appears to have a reason to be – as a “safe house” for the beneficial bacteria living in the human gut.

William Parker, Ph.D. is one of a team of scientists to discover that the appendix has a function — protecting beneficial bacteria. (Credit: Duke University Medical Center)

Drawing upon a series of observations and experiments, Duke University Medical Center investigators postulate that the beneficial bacteria in the appendix that aid digestion can ride out a bout of diarrhea that completely evacuates the intestines and emerge afterwards to repopulate the gut. Read More

Rob Dunn, Scientificamerican.comThe humble organ may help us recover from serious infections
You may have heard that the appendix is a relic of our past, like the hind leg bones of a whale. Bill Parker, a professor of surgery at the Duke University School of Medicine, heard that, too; he just disagrees. Parker thinks the appendix serves as a “nature reserve” for beneficial bacteria in our gut. When we get a severe gut infection such as cholera (which happened often during much of our history and is common in many regions even today), the bene­ficial bacteria in our gut are depleted. The appendix allows them to be re­stored. In essence, Parker sees the appendix as a sanctuary for our tiny mutualist friends, a place where there is always room at the inn.
Parker’s hypothesis, which he and collaborators first published in 2007 in the Journal of Theoretical Biology, is a fundamentally new idea about how an organ in our body works. A paper published last December provides new data to back up the theory.
James Grendell, chief of the division of gastroenterology, hepatology and nutrition at Winthrop University-Hospital on Long Island, and his team studied 254 patients with a history of gut infections caused by the bacterium Clostridium difficile. C. difficile, known as C. diff among the medical in-crowd, is a deadly pathogen often encountered in hospitals, particularly when patients must be treated by prolonged courses of antibiotics. C. diff does not appear to compete well with the native biota of patients’ guts, but when the native biota are depleted (as is the case after several courses of antibiotics), C. diff can grow quickly and take over. If Parker’s idea is right, individuals without an appendix should be more likely to have a recurrence of C. diff than those with one.
And that is precisely what Grendell’s group found: patients without an appendix were more than twice as likely to have a recurrence of C. difficile. Recurrence in individuals with their appendix intact occurred in 18 percent of cases. Recurrence in those without their appendix occurred in 45 percent of cases.
Where does this leave us? In your body is an organ that appears to be helping out the bacteria in your life so they can, in turn, help keep you alive. More tests, even true experiments, need to be done before we can be sure. Until then, doctors will keep cutting out infected appendixes. When they do, when they hold them up, they hold up a symbol – a somewhat gross, pinky finger – size symbol – both of our complex relationship with other species and of how little we know.

ALSO SEE: New research shows drug treatment can replace tonsillectomy

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Comments

  1. Thanks for putting all of this together, I agree that there are better, natural methods other than surgery that restore the health of the system. We do need all of our body parts!!

  2. Kay DeFreese says:

    I had my appendix out when I was 12. Had no choice in the matter. It was almost to the point of rupturing. I could have died had it not been taken out.

  3. Everyone loves it when folks come together and share views. Great site, keep it up!

  4. Very good blog post. I definitely love this website. Keep writing!

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