WHAT YOU NEED TO KNOW ABOUT TONSILLITIS?

Tonsillitis is the inflammation of the tonsils. Tonsils are two oval-shaped pads of tissue at the back of the throat. Tonsils act as filters, trapping germs that could otherwise enter your airways and cause infection. They also produce antibodies to fight infection. But sometimes the tonsils themselves become infected. Overwhelmed by bacteria or viruses, they swell and become inflamed, a condition known as tonsillitis.

Tonsillitis is common with children. Most cases of tonsillitis are caused by infection with a common virus, but bacterial infections also may cause tonsillitis. The condition can occur occasionally or recur frequently. 

SYMPTOMS

Tonsillitis most commonly affects children between preschool ages and the mid-teenage years. Common signs and symptoms of tonsillitis include:

• Red, swollen tonsils
• White or yellow coating or patches on the tonsils
• Sore throat
• Difficult or painful swallowing
• Fever
• Enlarged, tender glands (lymph nodes) in the neck
• A scratchy, muffled or throaty voice
• Bad breath
• Stomachache, particularly in younger children
• Stiff neck
• Headache

In children, symptoms may also include:

• Nausea
• Vomiting
• Abdominal pain

WHY DO TONSILS GET INFECTED?

The tonsils are the immune system's first line of defense against bacteria and viruses that enter your mouth. This function may make the tonsils particularly vulnerable to infection and inflammation. However, the tonsil's immune system function declines after puberty — a factor that may account for the rare cases of tonsillitis in adults.

COMPLICATIONS

Inflammation or swelling of the tonsils from frequent or ongoing (chronic) tonsillitis can cause complications such as:

• Difficulty breathing
• Disrupted breathing during sleep
• Infection that spreads deep into surrounding tissue (tonsillar cellulitis)
• Infection that results in a collection of pus behind a tonsil (peritonsillar abscess)

TREATMENT

Treatment for tonsillitis will depend in part on the cause. To determine the cause, your doctor may perform a rapid strep test or throat swab culture. Both tests involve gently swabbing the back of the throat close to the tonsils with a cotton swab. A lab test can detect a bacterial infection. A viral infection will not show on the test, but may be assumed if the test for bacteria is negative

If tests reveal bacteria, treatment will consist of antibiotics to cure the infection. Symptoms will likely improve within two or three days after starting the antibiotic. It is important to take all of the medication your doctor prescribes to make sure the bacteria are gone.

PREVENTION

The germs that cause viral and bacterial tonsillitis are contagious. Therefore, the best prevention is to practice good hygiene. Teach your child to:

• Wash his or her hands thoroughly and frequently, especially after using the toilet and before eating
• Avoid sharing food, drinking glasses, water bottles or utensils
• Replace his or her toothbrush after being diagnosed with tonsillitis

To help your child prevent the spread of a bacterial or viral infection to others:

• Keep your child at home when he or she is ill
• Ask your doctor when it's all right for your child to return to school
• Teach your child to cough or sneeze into a tissue or, when necessary, into his or her elbow
• Teach your child to wash his or her hands after sneezing or coughing

BLACK HAIRY TONGUE

The name black hairy tongue may sound scary, but the condition is harmless. Black hairy tongue is caused by bacteria or fungi in the mouth, which make the tongue, appear black and hairy. It's easily remedied by good oral hygiene.

While it is always alarming to see, a black tongue generally is not a sign of anything serious. You might also notice that your tongue looks slightly hairy. Those are not hairs. These are both signs of a temporary condition that’s sometimes called “black, hairy tongue.”

CAUSES

A black hairy tongue is caused by too much bacteria or yeast growth in the mouth. Your tongue is covered in hundreds of tiny bumps called papillae. Usually, you don’t notice them much. But when dead skin cells start to collect on their tips, they start to look longer and visible.

They are easily stained by bacteria and other substances, these gives your tongue a black, furry appearance.

Experts aren’t sure why the tongue sometimes stops shedding dead skin cells, but it may be related to:

• Poor oral hygiene. Dead skin cells are more likely to accumulate on the tongue if not regularly brushed.
• Low saliva production. Saliva helps you swallow dead skin cells. When you don’t produce enough saliva, these dead skin cells can hang around on your tongue.
• Liquid diet. Eating solid foods helps to scrape dead skin cells off your tongue. If you take more of liquid diet, it may slow removal of dead skin cells.
• Medication side effects. Some medications causes dry mouth effects as a side effect. This inversely will aid accumulation of dead skins in the mouth/tongue.

Normally, the papillae are pinkish-white. But as they grow, pigments from food, drinks, and possibly the bacteria or yeast themselves get caught in the papillae, dyeing the tongue a color. Most often that color is black, hence the name. But the tongue can also turn brown, yellow, green, or a variety of other colors.

WHY IT TURNS BLACK

Contributing factors include:

• Antibiotics. Antibiotics kill both good and bad bacteria in your body. This can affect the delicate balance of bacteria in your mouth, allowing certain yeasts and bacteria to thrive.
• Tobacco. Whether you are smoking or chewing it, tobacco is one of the biggest risk factors for black tongue. Tobacco easily stains the elongated papillae on your tongue.
• Drinking coffee or tea. Coffee and tea can also easily stain elongated papillae, especially if you drink a lot of either of them.
• Some mouthwashes. Certain harsh mouthwashes that contain oxidizing agents, such as peroxide, can affect the balance of bacteria in your mouth.
• Bismuth subsalicylate (Pepto-Bismol). Bismuth subsalicylate is a common ingredient in some over-the-counter gastrointestinal medications. When it reacts with traces of sulfur in your mouth, it can stain your tongue, making it appear black.
• Low Saliva. Not producing enough saliva increases the chances of dead cell clinging to the papillae
• Poor Oral Hygiene

SYMPTOMS

Other than the discoloration of the tongue, most people with black hairy tongue don't have any symptoms or feel any discomfort. The exception is when there is too much growth of the yeast Candida albicans, which can cause a burning sensation on the tongue. This burning sensation is called glossopyrosis.

Some people complain of a tickling feeling in the back of the roof of the mouth, a metallic taste in their mouth, or nausea. In more severe cases, the condition may lead to a gagging feeling. Sometimes, food getting caught inside the extra-long papillae can cause bad breath.

TREATMENT

A black tongue usually doesn’t require much treatment. In most cases, regularly brushing your tongue with a toothbrush should help to remove dead skin cells and stains within a few days.

If you suspect that a medication or prescribed liquid diet is causing your black tongue, make an appointment with your doctor. They might be able to adjust your dosage or prescribe an antifungal or antibacterial medication to help manage yeast or bacteria in your mouth.

For stubborn elongated papillae, a doctor can remove them using carbon dioxide laser burning or electrodessication, which simultaneously cuts and seals the papillae.

However, you can usually take care of the condition yourself:

• Brush your tongue. Brush your tongue twice a day to help manually remove dead skin cells and bacteria.
• Use a tongue scrapper. Using a tongue scraper every time you brush your teeth will help keep skin cells from accumulating on your papillae.
• Brush after eating. Brushing your teeth and tongue after every meal will help keep food debris and bacteria from getting trapped in the papillae.
• Brush after drinking. Brushing after drinking coffee, tea, and alcohol will help prevent staining.
• Stop using tobacco products. Quitting smoking or chewing tobacco.
• Floss before bed. Flossing your teeth at least once per day will prevent food debris and plaque from building up in your mouth.
• Schedule a cleaning. Getting a cleaning at your dentist’s office will help you maintain good oral health.
• Drink plenty of water. This will help keep your mouth hydrated, which allows you to swallow dead skin cells.
• Chew gum. Chewing a sugar-free gum, or a gum designed for people with dry mouth, will help you produce more saliva to wash down dead skin cells. As you chew, the gum also helps to dislodge trapped skin cells.
• Eat a healthy diet. A diet full of fruits, vegetables, lean proteins, and whole grains will help you maintain a healthy balance of bacteria in your mouth.

FIRST TRIMESTER PREGNANCY EXPECTATIONS

The first trimester begins on the first day of your last period and lasts until the end of week 12. A lot happens during these first three months. The fertilized egg rapidly divides into layers of cells and implants in the wall of your womb where it carries on growing. These layers of cells become an embryo, which is what the baby is called at this stage. During this trimester, your baby grows faster than at any other time. By six weeks, a heartbeat can usually be heard and by the end of week 12, your baby's bones, muscles and all the organs of the body have formed. At this point, your baby looks like a tiny human being and is now called a fetus. He or she will even be practicing swallowing.

The first trimester of pregnancy is marked by an invisible transformation.  Hormones trigger your body to begin nourishing the baby even before tests and a physical exam can confirm the pregnancy.

Knowing what physical and emotional changes to expect during the first trimester can help you face the months ahead with confidence.

THE BODY

The first sign of pregnancy is a missed period. You should expect several other physical changes in the coming weeks, including:

• Tender, swollen breasts. After conception, hormonal changes might make your breasts sensitive or sore. The discomfort will likely decrease with time as your body adjusts to hormonal changes.
• Nausea with or without vomiting. Morning sickness, which can strike at any time of the day or night, often begins one month after you become pregnant. This might be due to rising hormone levels. To help relieve nausea, avoid having an empty stomach. Eat slowly and in small amounts every one to two hours. Eat low fatty foods. Avoid foods or smells that make your nausea worse. Drink plenty of fluids. Foods containing ginger might help.
• Increased urination. You might experience frequent urination than usual. The amount of blood in your body increases during pregnancy, causing your kidneys to process extra fluid that ends up in your bladder.
• Fatigue. During early pregnancy, levels of the hormone progesterone soar — which can put you to sleep. Rest as much as you can. A healthy diet and exercise might help boost your energy.
• Food dislike. When you're pregnant, you might become more sensitive to certain odors and your sense of taste might change. Like most other symptoms of pregnancy, food preferences can be chalked up to hormonal changes.
• Constipation. High levels of the hormone progesterone can slow the movement of food through the digestive system, causing constipation. Iron supplements can add to the problem. To relieve constipation, include plenty of fiber in your diet and drink lots of fluids, especially water and prune or other fruit juices. Regular physical activity also helps

EMOTIONS

Pregnancy might leave you feeling delighted, anxious, exhilarated and exhausted — sometimes all at once. Even if you're thrilled about being pregnant, a new baby adds emotional stress to your life.

It is natural to get worried about your baby's health, adjustment to parenthood and the financial demands of raising a child. One who is working might get worried about balancing the demands of family and career. One might also experience mood swings, tiredness etc. All these are normal. Take care of yourself, look for one who understands you for words of encouragement. If your mood changes become severe or intense, consult your health care provider for support.

PRENATAL CARE

Whether you choose a family doctor, obstetrician, nurse-midwife or other pregnancy specialist, your health care provider will treat, educate and reassure you throughout your pregnancy.

Your first visit will focus on assessing your overall health, identifying any risk factors and determining your baby's gestational age. Your health care provider will ask detailed questions about your health history. Be honest. If you're uncomfortable discussing your health history in front of your partner, schedule a private consultation. Also expect to learn about first trimester screening for chromosomal abnormalities, including prenatal cell-free DNA screening.

After the first visit, you'll probably be asked to schedule checkups every four weeks. During these appointments, discuss any concerns or fears you might have about pregnancy, childbirth or life with a newborn. Remember, no question is silly or unimportant — and the answers can help you take care of yourself and your baby.