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(Ilya Andriyanov/Getty Images/Hemera)
(Ilya Andriyanov/Getty Images/Hemera)

Will removing my son's tonsils end his sore throats? Add to ...

QUESTION: My son has constant sore throats. Should we consider having his tonsils removed?

ANSWER: It is important to discover the underlying cause of these constant sore throats.

The most serious cause is an infection with a bacteria, called group A betahemolytic streptococcus (GABS). This type of bacterial infection is less common than viral infections such as a cold.

There is only one way to confirm a GABS infection, sometimes called “strep throat.” The doctor must perform a throat swab which is sent to a lab where it is cultured for analysis. In other words, a physician can’t simply look at a child’s throat as to make a diagnosis.

Confirmed cases are treated with antibiotics. If GABS is left untreated or undiagnosed it may lead to complications such as rheumatic fever or post-streptococcal glomerulonephritis, a serious kidney infection.

Ear, nose and throat experts recently published a position paper on when it is appropriate to remove tonsils: If a child has more than seven episodes of GABS a year, then a tonsillectomy is appropriate; if there are five infections a year for two years in a row; or if there are three infections a year for three years in a row.

Tonsillectomies now are the second most common surgical procedure after the placement of tubes for recurrent middle ear infections. In the earlier part of the 20th-century tonsillectomies were the No. 1 reason for surgery in childhood.

Mouth-breathing due to enlarged tonsils or allergies can lead to sore throats. Usually these children don’t have a history of unusually frequent viral or bacterial infections. If they also suffer from sleep disordered breathing (where they may pause to breathe during their sleep) then a surgeon will consider doing a tonsillectomy – especially if there are related problems such as lack of concentration at school, fatigue, anxiety and chronic headaches.

Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Peter Nieman.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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