Adenoiditis

Adenoiditis is inflammation (swelling) of your child’s adenoid glands. Adenoids are behind your child’s nose, in the back of their nasal cavity. A part of your child’s immune system, they trap and fight germs that can make your child sick.

But just because adenoids are germ-fighters doesn’t mean they can’t become irritated or infected. When they do, they become inflamed. They can enlarge to the point that they block your child’s nasal passages, making it harder for them to breathe through their nose.

Common cold symptoms like a sore throat or runny nose are signs of adenoiditis. They let you know that your child needs extra attention and care to heal and feel better.

Symptoms of adenoiditis

Symptoms of adenoiditis include:

• Fever
• Mouth breathing
• Nasal congestion
• Nasal obstruction
• Postnasal drip
• Runny nose
• Snoring
• Sore throat
• Trouble feeding (infants)

Adenoiditis causes

The most common cause of acute (short-term) adenoiditis follows a pattern. First, your child gets an upper respiratory infection from a virus. The infection leaves them vulnerable to a bacterial infection that follows. The infections cause inflammation in your child’s adenoid glands.

But back-to-back infections aren’t the only cause. Adenoiditis causes include:

• Viruses, including the ones that cause colds and the flu
• Bacteria, including the ones that cause bronchitis, ear infections, pneumonia and strep throat
• Stomach acid backflowing into your child’s throat and causing irritation (as is the case with a form of acid reflux called LPR)
• Allergies that irritate your child’s throat

Adenoiditis is less common in adults, but it can happen. It’s rare because adenoid tissue usually shrinks starting around age 7. Your adenoids are mostly gone by adulthood.

But your adenoids can swell for all the reasons above, depending on how much tissue remains. Enlarged adenoids can also happen in response to abnormal growths, including cancer. This is more likely to happen in adults.

Risk factors

Adenoiditis is most common in children from ages 3 to 7. As most parents and caregivers know, kids in this age range get lots of upper respiratory infections.

Also, adenoids reach their peak size during these years. This means that inflammation in your child’s adenoids can block more of their nasal passages than if these glands were smaller.

How to lower your risk

The best way to lower your child’s risk of adenoiditis is to take steps to prevent them from getting sick. Teaching good hygiene and making sure they’re eating nutritious foods helps. It’s also a good idea to keep them away from secondhand smoke.

Complications of this condition

Complications can happen when enlarged, swollen adenoids block your child’s airway. When this happens, one complication can lead to another.

For example, a blocked airway makes it difficult for your child to breathe through their nose. To get enough air, your child may breathe through their mouth. Long-term mouth breathing increases your child’s risk of cavities and a misaligned bite. It can also affect how the bones develop in their face.

Difficulty breathing can cause obstructive sleep apnea, which prevents your child from getting enough sleep. This can keep them from focusing during the day. Over time, it can impact their ability to learn.

Enlarged adenoids can also block your child’s eustachian tubes. These tubes connect your child’s ears to the back of their nose. They relieve air pressure in your child’s ears. Blocked eustachian tubes can lead to frequent ear infections and even hearing loss.

How doctors diagnose this condition

Your child’s pediatrician will diagnose adenoiditis by asking about their symptoms. Your child may need several tests to learn what’s causing adenoiditis:

• A physical exam. Their provider may use a small mirror, like the kind dentists use, to check for swollen adenoids.
• Endoscopy. Their provider may use a thin, flexible tube with a light and camera at the end to see your child’s adenoids up close. This procedure is called a nasal endoscopy.
• Fluid sample tests. Their provider may test for bacteria. A common test called a throat culture involves swabbing the back of your child’s throat to test for the bacteria that cause strep throat.
• Allergy tests. Your child may need allergy testing if their provider thinks an allergic reaction is causing inflamed adenoids.

How is adenoiditis treated?

Adenoiditis related to a virus usually goes away once your child’s body fights the infection. They may not need treatment.

Other times, providers treat inflamed adenoids by addressing what’s causing the swelling. Your child may need:

• Antibiotics to treat bacterial infections (common ones include amoxicillin and penicillin)
• Antihistamines or nasal steroid sprays (like Flonase®) to calm an allergic response
• Nasal irrigation to flush out allergens or germs that may be causing issues
• Medicines to fight acid reflux, like proton pump inhibitors (PPIs) and H2 blockers

Surgery

For long-term adenoiditis that doesn’t get better with medicine, your child may need surgery. Surgery to remove adenoids is called an adenoidectomy. A specialist called an otolaryngologist (ear, nose and throat doctor) performs this procedure.

It’s normal to feel unsure about removing a part of your child’s immune system. But there’s no need to worry. Not having adenoids won’t make your child more likely to get infections. Instead, the other parts of your child’s immune system will just work harder to protect them from germs.

Recovery time

Adenoiditis gets better once the cause is addressed. It usually takes about a week for viruses to clear. Most children start to feel better within a few days after starting antibiotics. But you should make sure your child takes all of their medicine.

Children who get their adenoids removed usually need at least a week of recovery time at home.

When should I see my child’s healthcare provider?

Reach out to your child’s pediatrician if their symptoms aren’t improving within two days of starting an antibiotic. Let them know if your child is developing new or worsening symptoms. Contact their provider if your child has a fever that isn’t improving with fever-reducing medicines, too.

What can I expect if my child has this condition?

Many children get swollen adenoids when they get sick. But most colds and the flu get better with time. Some causes — like bacterial infections, acid reflux and allergies — get better with medicine. But if your child does need surgery, rest assured that this is a common procedure with excellent results.

A child can be perfectly healthy without their adenoids.

Is there anything I can do to help my child feel better?

Caring for a child with adenoiditis requires giving them lots of attention and love. To help them feel better, make sure they’re getting enough fluids and rest. There are several sore throat remedies you can try if their throat hurts.

It’s especially important to pay close attention to how they’re feeling. Check in often to ask how they’re doing. This reassures them. And it provides you with the information you need to give helpful updates to their pediatrician.