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Long-term health risks after having adenoids or tonsils removed in childhood

291 points by tankerslay 8y ago

godelmachine 8y ago
When my father was a child, there was a craze in town (India) that tonsils are bad and removing them will only do good. My grandma fell for it, among hordes of other mothers, and got my fathers tonsils removed. My father is a Gen X cohort, and now whenever the pollen season arrives (he is in USA now), he is totally helpless.
- creep 8y ago
  I had my tonsils and adenoids removed due to recurring severe infection. Well, actually, the tonsils were removed due to infection, and my adenoids were an "afterthought" because my dad has a history of sleep apnea. I don't have any allergies, and I definitely don't get sick as often as when I was younger-- during which time I was getting all sorts of infections (ear, kidney, eyes, etc.) recurrently. Anyways. Just another anecdote on the pile.
  - sparrish 8y ago
    My daughter was 3 when they removed her tonsils. Recurring infections and swelling were making it difficult for her to breath. She still has the occasional cold but nothing like before they were removed. They were huge for a tiny 3 year old.
- wil421 8y ago
  I have bad allergies and still have my tonsils. The pollen season in the US can be very different than other places especially in the South. For me it also came with age and my allergies started in my 20s. I’d bet your father is not used to the pollen in his region. Doubt it because of his tonsils.
- madaxe_again 8y ago
  It was the same in the UK in the 80’s - I remember pretty much my entire year at school going for surgery over the course of a year. Despite having had repeated tonsillitis as a kid (and bronchitis at the same time - unheated boarding school with abysmal hygiene and dozens of boys to a room is quite the disease incubator), my mother, a nurse, dug her heels in, and said no. She'd had to deal first-hand with the outcomes of botched tonsillectomies a few times too many. They did my brother seven years later without their permission - and he suffers from severe allergies to this day. I have none. I’ve always been extremely sceptical of “its vestigial” or “that body part is bad for you”. I mean, surely if either were true, selection would have done away with it. If having tonsils were a dysgenic trait, nobody would have them. I can tell you why it remains such persistent practice - it’s a quick and easy surgery in most cases, and it’s billable at a decent rate in most places. A surgeon in the UK can do ten or more in a day, at £3k a pop. You have an endless supply of patients, and parents who’ll consent because after all they had theirs done when they were kids. Play your cards right and you’ll make millions a year.
  - maaark 8y ago
    >They did my brother seven years later without their permission In the UK, in the late 80s or 90s? I'm not saying it didn't happen, but HOW?! Did your family attempt to complain or sue?
    - madaxe_again 8y ago
      Boarding school, loco parentis. Without an explicit intervention from a parent they can do as they please, and they’re under no obligation to inform the parents of anything. I wrote letters home, telling my parents of the day-to-day, my brother did not. https://en.m.wikipedia.org/wiki/In_loco_parentis https://en.m.wikipedia.org/wiki/In_loco_parentis
  - DanBC 8y ago
    > I can tell you why it remains such persistent practice - It's strongly recommended against in the UK now. We do less than 1 operation per 1000 population. > A surgeon in the UK can do ten or more in a day, at £3k a pop. That's not how English surgeons are paid, is it? https://www.nhs.uk/conditions/tonsillitis/ https://www.nhs.uk/conditions/tonsillitis/ > It's very rare that someone needs to have their tonsils taken out. This is usually only the case if you have severe tonsillitis that keeps coming back.
- astura 8y ago
  They probably aren't related; I have my tonsils and also have bad pollen allergies.
yani 8y ago
Tonsils can cause miserable life to suferrers and while they might have negative long term effect, the research does not include the mental issues that recurring tonsils cause.
nsxwolf 8y ago
I seem to recall that a "tonsils out" subplot was commonplace in the American sitcoms of the 60s and 70s, but completely disappeared soon after that. I was born in the late 70s and I don't think I know a single peer who had tonsils or adenoids removed.
- tssva 8y ago
  Having your tonsils out in the 60s and 70s was a much more painful procedure with a longer recovery time so people were more aware when someone had them removed. My daughter had her tonsils and adenoids removed 6 years ago. She had it done on Friday morning and was running around feeling fine on Saturday. No significant pain and she was back to school on Monday. Unless she mentioned it none of her friends knew.
gravelc 8y ago
Is there a causal link between the surgery and the increase in long-term disease risk, or were patients who were more likely to get the surgery (because of more severe symptoms or more frequent occurrence of infections) at greater long-term disease risk (whether they had surgery or not)? Without some functional mechanism, I'd be very wary of these kinds of data analyses.
- mehrdadn 8y ago
  > Without some functional mechanism, I'd be very wary of these kinds of data analyses. Kind of a tangent, but dumb question: wouldn't the sensible default assumption be that messing with your body is likely to be harmful unless proven harmless? Rather than the other way around? So if you're skeptical, shouldn't you be skeptical that it's harmless?
  - robbiep 8y ago
    It has not been until recent times that any form of messing around the body was for any reason other than self preservation or the improvement of quality of life. I am talking post-enlightenment/age of reason medicine here, not dark ages blood letting. And we still get it wrong, and still do things without enough of an evidence base, but when it comes to removal of adenoids, the reason it is done is because in those it is affecting it is having a harmful effect on. Whether that be the formation of peritonsilar abscesses (potentially fatal), difficulty breathing (watching a 6 yo struggle to get air into their lungs due to enormous tonsils is not a sight I enjoy seeing) or just missing large numbers of days of school due to repeated illness, with knock on effects to child wellbeing and performance, there is a firm reason why we do this procedure
    - nailer 8y ago
      Weird to hear tonsilectomies being spoken of in thw present tense. It stopped being routine in Australia in the 80s.
      - robbiep 8y ago
vsizov 8y ago
If you have your tonsils removed you most probably have not a very strong immune system, originally. So it's OK to expect that you're less healthy during the life. I don't think that tonsils removal is causing this, the root of the problem is deeper I think. I have my tonsils removed a year ago when I was 32 because of problems with my joints. They are better now actually. So I would say, you need to remove your tonsils when it's absolutely necessary.
cheschire 8y ago
My daughter's adenoids were removed after their size caused her ear canals to remain closed, which was causing fluid buildup behind her ear and affecting her ability to hear clearly. When a child cannot hear, they cannot learn important nuances to speech. Additionally, prolonged exposure to those fluids, if I understood the ENT doctor correctly, her hearing could have been permanently damaged had we left it. We were also taking intercontinental flights at the time and the closed canal could have caused a rupture, further limiting her hearing. None of these things were associated with an ear infection. We only identified the adenoid issue because she was having trouble hearing and the ENT identified the large adenoids at that point. There was no pain associated with it, and I suspect many parents may not even realize that their kids have this issue. What are the long term speech and hearing risks compared to the long term health risks? I strongly caution anyone against a knee-jerk response to a study like this. It could be another anti-vaccination study all over again.
- headmelted 8y ago
  Reading stories like yours does make me wonder if the bigger issue here is variance in standards of care. Clearly you've been advised, based on your specific circumstances, of why it would be in your daughter's best interests to have this surgery done (there's no sarcasm here - it's great that so much consideration has gone into it and clearly it's been the right thing to do in your case). It does seem like based on my own anecdotal experience, and from other comments in the thread, as if "tonsils out" is an automatically triggered decision in much of the world for certain ailments in cases where it may or may not be appropriate or warranted. For the record, I hate even being anywhere near the fence on an issue like this, as I'm very much pro-vaccination (for example) and my position on this comes across as anti-science which I'm anything but.
b34r 8y ago
I’ve begged my doctor to remove my tonsils and they refuse due to studies like this. I get tonsil stones every single month and at least one severe case of tonsilitis per year (usually closer to 3-4.) Anyone have strategies that worked to convince their GP to allow them to be removed? At this point I’m considering just paying out of pocket to get it done.
- NegativeLatency 8y ago
  Get a second opinion?
- nradov 8y ago
  This sort of thing is just a matter of doctor shopping. Keep asking different doctors until you get an answer you like.
- graeme 8y ago
  You probably know this, but note that removal doesn't necessarily end the stones. Had mine removed as a kid. Then had a peritonsular abcess around age 20. Then had tonsil stones for a few years. After a change in diet (no wheat, little packaged food) they stopped. Can't be sure of the exact cause. Also, I've heard waterpik devices can help.
- wellboy 8y ago
  You can do a tonsillotimoy instead of a tonsillectomy. It's a much less invasive surgery and they only burn down your tonsils bit by bit and you can leave the next day.
- wil421 8y ago
  Have you tried using a water pick? I recently discovered there was such a thing as tonsil stones.
- eip 8y ago
  It's pretty simple to remove tonsil stones. Just get a lighted tongue depressor and a tonsil stone tool. Think of it as another maintenance task. Like brushing your teeth.
pmoriarty 8y ago
I can't find it now, but two or three months ago I read a story in the news about a teenage girl who bled to death after her surgeon accidentally cut in to her aorta during her tonsilectomy. The saddest thing was that it was a slow, completely preventable death, and that the doctors did not take her symptoms at all seriously, despite her coughing up copious amounts of blood, telling her and her mother that it was all perfectly normal. Very sad story.
barking 8y ago
This does not tie in with my experience as someone who had those removed at age 6. This winter for example, everyone in our household had nasty chest infections except me.
- zaarn 8y ago
  Anecdotal data is not a good source of medical advice.
  - tomohawk 8y ago
    When treating a patient, using the results of a study is a good starting point, but it may really have nothing to do with treating the specific patient. The patient may fall outside of the distribution of normal occurrences, as indicated by the study. They may be an outlier. This is one reason why medicine is challenging - you're not treating a population, you're treating a patient. If you are the patient, you want the doctor who is guided by science, but also not blinded by "well, the studies say to do X, but that's not working. I guess there's nothing I can do for you". In my case, I had my tonsils removed as an adult and it is one of the best medical decisions I've ever made. Prior, I had all kinds of health problems. They are now gone, and while I used to get sick a few times a year to the extent of missing work, that no longer happens.
    - zaarn 8y ago
      While I generally agree, treating a patient is also not as simple. For example, I never had my tonsils removed and in the past 5 years I have not been sick a single time. Plus, this doesn't invalidate the study itself, as the results merely lay out a chance, the probability that you will suffer long term effects. People can smoke cigarettes their entire life and never get lung cancer or they smoke once and get a diagnosis for lung cancer next year.
  - sv12l 8y ago
    It think their entire study is based on the collection of such 'anecdotes'.
blackhaz 8y ago
Thank you so much for posting this. Really, THANK YOU, kind stranger. Here in the Czech Republic we're always forced by doctors to do AE/TE to our son despite being mildly affected by strep as we are fighting PANDAS. The latest research converges on that AE/TE is not effective, and that we're doing the right thing by not doing the operation. It looks like doctors even in the most advanced medical institutions are blindly following old books here and still recommend to take the tonsils out at every occasion and eat bags of antibiotics "just for any case." The level of medicine here is so abysmal (except, probably, surgery) that we now have to rely mostly on our own heads and collect the latest research. Thank you.
- headmelted 8y ago
  You're right to be cautious and fact check everything you're told. I apologise if my response becomes overly ranty. This isn't to scare you, just to encourage you that you're doing the right thing by taking such an active role in your child's care. I have views on this that would seem to most people to be seriously conflicted. I'm militantly pro-science, and I argue constantly in the face of anti-science and pseudo-scientific bullshit anywhere I hear it. It makes me no fun at all at parties, and even some family members groan whenever someone brings up "alternative views" to the scientific consensus on much of anything as they know I'm about to start lecturing, whether it's climate change, vaccination, flat earth (<- seriously) or most of anything else. On the other hand, my personal experiences of how medical science is applied locally by doctors and surgeons has made me entirely disillusioned with their whole industry, and I never trust anything I'm told without confirming it for myself. To explain, I'm based in Northern Ireland, and a debate has gone on for a long time as to whether our National Health Service (NHS) is struggling or in trouble. In reality, it has already imploded. This isn't hyperbole. Here's an exact quote from the BBC: "Northern Ireland has some of the worst performance figures in the UK. During the Christmas period, the number of patients seen in four hours in A&E departments dropped to 63%. Exactly the same proportion started their cancer treatment within 62 days, according to the latest statistics, while the numbers waiting longer than they should for a routine operation have almost doubled in the past four years." This hits home for me really hard. In the last six years my extended family has experienced: - Two missed cancer diagnoses. - A potentially serious (and time-sensitive) diagnosis requiring specialist follow up that was missed on two seperate occasions. - Delayed treatments for potentially life-threatening cancer of over 100% of the recommended waiting period. Our local hospital has become known as a place more likely to kill you than help you, due to how abysmal the standard of care is. Here's a link from a couple of months ago: https://www.irishnews.com/news/2018/03/15/news/pensioner-dies-in-chaotic-a-e-department-1278554/ https://www.irishnews.com/news/2018/03/15/news/pensioner-die... Life threatening emergencies that arrive by ambulance are often left unattended for over four hours (this is recorded in the public record thanks to open data laws). I sincerely hope the circumstances in the Czech Republic are better and that the doctors are much less overworked and much more capable of helping you, my intention here is just to give you encouragement that you're right in not just assuming that your child's in safe hands without you being involved.
amazert 8y ago
Thanks for this post. I have tonsil problem from years but i am always afraid to get that removed from my body. The general treatment which i do when feel problem is hot water gargle.
headmelted 8y ago
Only barely related but I have a personal story about this! I had my tonsils removed at eleven years old. I didn't know why then, and I still don't now. I suffer quite a bit now from allergies (I'm not sure how related to this it is, and I guess I've no way of knowing really). I remember being really scared, and the surgeon playfully telling me that I'd be fine, I'd be asleep through the whole thing and would wake up back on the ward (with ice cream!) and barely even know it was over. I was told that I should count to ten while they issue the anaesthetic. I was unconcious by seven. The next thing I remember is waking up really disorientated, in a different room, and could only see blurred grey shapes. I've never been in such pain before or since. I shut my eyes and bit down hard into the white hospital pillow while screaming. An unfamiliar voice shouted angrily at me that I wasn't supposed to be awake yet. I opened my eyes as the pillow felt wet only to realise that it had turned completely red. It felt like someone had cut my throat out. My mother (having been advised that I'd be asleep for hours) had gone to get a coffee and was completely unaware that any of this had happened. For reasons that were never explained, the nurse wouldn't take me out of the room and my mum wasn't informed until a couple of hours later when I was wheeled back out onto the ward. I had to stay in hospital for another two days as a result of what went wrong (haven't a clue to this day what that was exactly), and was bloody terrified. Anyway, long story short is that when the bleeding eventually stopped I finally got some ice cream. It was warm, it tasted bad, and it was entirely not worth it. In summary, surgery could well be correct for you and/or your child if a competent professional has analysed and considered your case and health outcomes, but I don't recommend that anyone allow themselves or their children to be mutilated without any explanation at all in exchange for sweet treats.
- chunkyslink 8y ago
  I'm really sorry you had to experience this.
  - headmelted 8y ago
    I appreciate that. It really was atrocious ice cream.
- iamforreal 8y ago
aviv 8y ago
In 20 years HN will have a front page top post about the long term health risks of male circumcision. Sometimes it take time for common sense to become.. common.
- roesel 8y ago
  And those are?
  - workaccount34 8y ago
    Mutilated genitals
    - roesel 8y ago
      I dont know if that qualifies for a “long term health risk”.
      - workaccount34 8y ago
        We aren't lizards. We can't magically grow back lost portions of out body.
        tom_ 8y ago
        Right, but if you survive the procedure, are the side-effects going to kill you, or leave you more likely to contract diseases, and so on? That's more the question. And the answer appears to be no. Plenty of reasons why it's a bad idea, just not this one...
mhandley 8y ago
I had my adenoids and tonsils removed as a kid in the early 1970s. Had bad allergies all the way into my thirties, but I have no way of telling if they were the reason I needed to have my adenoids removed in the first place. However, I simply grew out of my allergies in my late 30s. These days I rarely get sick, despite living in London and travelling on public transport all the time. And when everyone else in my family has a terrible sore throat, I never have a problem, so that's definitely a plus side for me right now. I'd be really interested in whether there's a downside heading into old age, but I've not seen any data on that.
bariswheel 8y ago
I've had my tonsils removed at age 6, no allergies at all. My appetite increased quite a bit they tell me, but my parents were in their twenties back then, who knows. Anyway, wanted to throw in my data point in here.
forthispurpose 8y ago
this practice (along with getting appendix removed when not necessary) seems like some distant relative of bloodletting.
calewis 8y ago
You have to pay to have them removed in the UK now, it's no longer free on the NHS, unless you suffer from 3x serious infections in a one year period. I suffer from frequent sore throughs, infections and even tonsillitis. My Auntie, who is a doctor, strongly advised me not having them removed. Which at the time is not what I wanted to hear but it seems, unsurprisingly, was great advice.
giljabeab 8y ago
I had frequent tonsil infections as a kid and was given the option to have them out but declined. Now I have two very small and pitted tonsils due to frequent infections which asides from the odd tonsil stone don’t bother me at all. I don’t get hay fever or any allergies. Think I made the right decision
zbowling 8y ago
Could there be a correlation between people needing to get their tonsils out and their higher rate of infection from some other factor and not necessarily as a result of the tonsils getting removed?
- stareatgoats 8y ago
  > "cases were no less healthy than controls presurgery in the first 9 years of life" Looks like they addressed that (heading: Testing for Biases in General Health Before Surgery)
Angostura 8y ago
Just to add to the anecdotes in here. I had my tonsils removed at about the age of three and never suffered any particular consequences.
- pacomerh 8y ago
  Same here, I had them removed at the same age and never had an issue related to allergies or anything serious.
- varjag 8y ago
  Had adenoids removed, and suffer from runny nose and (fortunately relatively mild) allergies all my life. Never occurred to me before it could be related.
- keypress 8y ago
  For perspective. I had horrible health that plagued me until I was about 20. Whether that's got anything to do with the butchering, I have no idea.
axilmar 8y ago
In my generation, 100% of us had our tonslis/adenoids removed as children, but we have no significant differences in health issues whatsoever.
manmal 8y ago
My son had adenoids removed last year because his hearing was VERY bad because of some kind of mucus blockage. Doctors explained to us that he would hear perfectly without the adenoids, because inner ear measurements were very good. So during the OP they cut away the adenoids, and made a hole into each eardrum, so fluids could exit. After the OP his hearing was so good that he told us not to scream at him when we barely whispered - for 2 weeks. As soon as the holes in the eardrums healed up, the blockage developed again and his hearing was exactly the same as before the OP. We tried alternative treatments for a year, strange juices with corticosteroids and stuff (which worked well for his hearing, but he couldn't really sleep while on them), near-infrared radiation through the nose (our favorite so far, but does not work that well because adenoids are too far in)... so he's soon have his second OP where they will likely remove adenoids again (they regrow sometimes) and insert little tubes into his eardrums such that fluids can regularly exit the ears. Distant relatives of mine have the same issue, but worse (delayed speech development due to near-deafness), and for them the OP worked for 1,5 years and now its positive effects are going away; perhaps requiring another OP. I'm not thrilled about all this. BTW here is advice a very expensive doc gave me regarding hearing and speech development: If your kid understands what you are saying while you whisper from a distance of ~1 meter, then her speech development should not be negatively affected, or not that much.
- darkerside 8y ago
  Sorry to hear you're going through this. I can't imagine how frustrating it must be. Are you concerned about side effects from all these interventions? Do you have a hypothetical point at which you would simply choose to accept your child's hearing impairment?
  - manmal 8y ago
    I'm trying to be a stoic, and I will deliberately try to accept anything that I cannot influence in this very moment. Approaching medial issues, I think that the only thing you have to accept (until your death) is that your previous attempts at improving have failed; so as long my son's hearing is not good, I'll keep on looking for things to try out. There are time and cost constraints of course; sometimes I go for weeks without researching anything to improve the situation. But the motivation to do something returns naturally when he's in pain again, or is misbehaving very badly because of this.
ponderatul 8y ago
Let me provide you an alternative perspective worth considering. Depending on the seriousness of your condition, having adenoids can result in having problems breathing normally( aka through the nose). Now obviously breathing is very important for your organism, and it will find ways to adapt, and you will find yourself breathing through your mouth. Breathing through the mouth will encourage the development of a long face, cus tongue is not in its natural position, at the top of the palate. Your posture will change since having the mouth open is not the default position of the body for long periods of time. You might find your neck lunging forward. And these are just second and third order effects for not being to breathe properly during early childhood. Jaws might not develop properly, teeth as well. And that is all the effects I know about. Yes, I've had both my adenoids and tonsils removed, in the end. Not early enough though.
- doktrin 8y ago
  I had my tonsils removed when I was 19 because of sleep apnea. Even after reading this piece I'm reasonably confident, though not certain, that it was a net-positive.
- jdcarter 8y ago
  My daughter couldn't breathe easily when she was young--when sleeping you could literally hear her breathing from a room or two away. Like having Darth Vader sleeping in the next room. After tonsil/adenoidectomy at about 3 years old she could finally breathe properly and her sleep become much better. It made a HUGE difference to her quality of life.
ToFab123 8y ago
It was amazing to have the tonsils removed as a kid. For a couple of days we were only allowed to eat ice-cream :)
joshgel 8y ago
Like everything in life and medicine, it is all risk-benefit analysis. I'm underwhelmed by the absolute risk reduction for most of these findings. Most people get some sort of upper respiratory infection, is increasing URIs rate from say 65% to 70% clinically meaningful? Sure its statistically significant here given the large sample size, but I'm not sure it helps us know what will happen. But if a child is suffering now, and we have the chance to help, what should we do with this data? I'm definitely against unnecessary surgery, especially in children. I just don't think this pushes my definition of necessary very much.
ousta 8y ago
Would love similar study on circumcision...
Proven 8y ago
Can I sue the government?
jbronn 8y ago
Since everyone is joining in with anecdotes, I’ll share mine. During second grade I had strep at least four consecutive times. One of those times I developed an ear infection with pain so intense my parents took me to the emergency room. On doctor’s orders, I had my tonsils removed. While the procedure was not pleasant (I had severe nausea from the anesthesia), the effects were immediate and permanent. In nearly three decades since I’ve yet to develop strep again.
vanderZwan 8y ago
I had my tonsils removed last year (so at age 33) due to having a peritonsillar abscess multiple times in a couple of years - which implies that the first time I was infected it likely became a "chronic" risk. So far no allergies, so I hope my immune system is already "properly trained" from before or something. Anyway, if anyone ever needs to have their tonsils removed for health reasons: only drink isotonic water[0] when you're thirsty. For some reason my surgeon forgot to tell me that, but I discovered this on my own by accident. After the surgery I felt very dehydrated, so made some ORS at home. To my surprise, drinking it did not hurt at all, even though drinking plain water earlier had felt like getting thousands of paper-cuts in an open wound. I was eating regular food within a week (it took a bit longer to fully heal up of course), and didn't even need to use the heavy duty painkillers that I was prescribed (only over-the-counter painkillers for sleeping, really). I suspect that instead of being a pain-killer, drinking isowater avoided the irritation that caused the pain in the first place, which means I also avoided inflammation and healed up faster than expected due to that. [0] Take this recipe for home-made rehydration solution and tweak to your liking http://rehydrate.org/solutions/homemade.htm http://rehydrate.org/solutions/homemade.htm
azinman2 8y ago
I wonder if it’s really the other way around — people who tend to get infections often have this surgery because, well, they often get infections?
JTbane 8y ago
Interesting that however advanced medical science is, we still don't know about everything the lymphatic system does.
fromMars 8y ago
I am skeptical of the findings. I imagine that people who get their Tonsils and Adenoids removed are probably more predisposed to allergies to begin with. My brother got both removed when he was 10 as he was suffering from ear infections and other problems, I didn't. Now as an adult, my allergies are worse and I get sore throats more frequently with more irritating symptoms. Allergies are also common in my family. So my experience is that this surgery can have a very positive effect on one's quality of life.
- cryptonector 8y ago
  From the abstract: > Increases in long-term absolute disease risks were considerably larger than changes in risk for the disorders these surgeries aim to treat. Presumably specifics are discussed in the paper. They followed 1.2 million children. Perhaps they were able to get an apples-to-apples comparison of children with similar issues and who did and did not get these surgeries.
xpto123 8y ago
Too late, my 3 kids had the adenoids removed. Anything that i should look out for?
Dolores12 8y ago
What if enlarged tonsils/adenoids is a allergic response of immune system? These people are prone to allergic reactions in first place. Correct way of testing this hypothesis would be to cancel OP to 50% of control group and compare long-term health risks after 30 years.
gormz 8y ago
I used to get a lot of throat infections when I was a kid and had the discussion with my doctor to whether I should get my tonsils removed. My doctor was heavily opposed. recently, I've been having allergies and more throat issues and wished I would have got them taken out. Pretty glad I didn't now.
aladoc99 8y ago
I have to point out the obvious confounder here. The kids who get their tonsils and adenoids out are the ones with recurrent respiratory infections to begin with. Really the only way to control for this is to randomize kids to surgery or not and then follow for 20 years or more. This in contrast is an observational study, albeit with a very large number of subjects. They said they tried to control for confounding factors, but it's hard to see how effective that can be after the fact.
verulito 8y ago
Mine were removed when I was 2 because they were huge! Like all surgery, it comes with risks and tradeoffs. It's great that we have a better idea of what the risks are now but that's not a reason not to do the surgery. Let's not forget that it's still a well tolerated procedure that confers some benefit to the right patients. We're not removing them for fun. What benefit is that? Large tonsils occlude the airway, causing sleep breathing disruptions. The impact of those disruptions isn't visible but we know it is very harmful, particularly to children since they're still developing. We can avoid those developmental problems by removing the tonsils. I don't want to go into it here in too much detail but "developmental problems" is not a small thing, we're talking about structural changes to the skull, learning difficulties, behavior problems, etc. An open question is how bad does the occlusion need to be before it justifies removing the tonsils. I don't know the answer to that question. I'd say bad. And that happens increasingly often because large tonsils have a strong correlation with allergies to begin with. Chronic infections are more a complication of the original problem, not the cause of it. And that's not even touching the damage these infections can do to the sinus cavities.
n4kana 8y ago
I had my tonsils out at around age 8 due to chronic ear infections. I don't know how bad it was before the operation, but my respiratory health has been abysmal since the operation. I've recently begun to wonder if oral probiotics could be a missing part of the equation. Tonsils literally have "crypts" - the quality of your oral bacteria must play a huge role in how they function. http://www.blisk12.com/what-is-blis-k12/ http://www.blisk12.com/what-is-blis-k12/

291 points by tankerslay 8y ago

When my father was a child, there was a craze in town (India) that tonsils are bad and removing them will only do good. My grandma fell for it, among hordes of other mothers, and got my fathers tonsils removed. My father is a Gen X cohort, and now whenever the pollen season arrives (he is in USA now), he is totally helpless.

creep 8y ago
I had my tonsils and adenoids removed due to recurring severe infection. Well, actually, the tonsils were removed due to infection, and my adenoids were an "afterthought" because my dad has a history of sleep apnea. I don't have any allergies, and I definitely don't get sick as often as when I was younger-- during which time I was getting all sorts of infections (ear, kidney, eyes, etc.) recurrently. Anyways. Just another anecdote on the pile.
- sparrish 8y ago
  My daughter was 3 when they removed her tonsils. Recurring infections and swelling were making it difficult for her to breath. She still has the occasional cold but nothing like before they were removed. They were huge for a tiny 3 year old.
wil421 8y ago
I have bad allergies and still have my tonsils. The pollen season in the US can be very different than other places especially in the South. For me it also came with age and my allergies started in my 20s. I’d bet your father is not used to the pollen in his region. Doubt it because of his tonsils.
madaxe_again 8y ago
It was the same in the UK in the 80’s - I remember pretty much my entire year at school going for surgery over the course of a year. Despite having had repeated tonsillitis as a kid (and bronchitis at the same time - unheated boarding school with abysmal hygiene and dozens of boys to a room is quite the disease incubator), my mother, a nurse, dug her heels in, and said no. She'd had to deal first-hand with the outcomes of botched tonsillectomies a few times too many. They did my brother seven years later without their permission - and he suffers from severe allergies to this day. I have none. I’ve always been extremely sceptical of “its vestigial” or “that body part is bad for you”. I mean, surely if either were true, selection would have done away with it. If having tonsils were a dysgenic trait, nobody would have them. I can tell you why it remains such persistent practice - it’s a quick and easy surgery in most cases, and it’s billable at a decent rate in most places. A surgeon in the UK can do ten or more in a day, at £3k a pop. You have an endless supply of patients, and parents who’ll consent because after all they had theirs done when they were kids. Play your cards right and you’ll make millions a year.
- maaark 8y ago
  >They did my brother seven years later without their permission In the UK, in the late 80s or 90s? I'm not saying it didn't happen, but HOW?! Did your family attempt to complain or sue?
  - madaxe_again 8y ago
    Boarding school, loco parentis. Without an explicit intervention from a parent they can do as they please, and they’re under no obligation to inform the parents of anything. I wrote letters home, telling my parents of the day-to-day, my brother did not. https://en.m.wikipedia.org/wiki/In_loco_parentis https://en.m.wikipedia.org/wiki/In_loco_parentis
- DanBC 8y ago
  > I can tell you why it remains such persistent practice - It's strongly recommended against in the UK now. We do less than 1 operation per 1000 population. > A surgeon in the UK can do ten or more in a day, at £3k a pop. That's not how English surgeons are paid, is it? https://www.nhs.uk/conditions/tonsillitis/ https://www.nhs.uk/conditions/tonsillitis/ > It's very rare that someone needs to have their tonsils taken out. This is usually only the case if you have severe tonsillitis that keeps coming back.
astura 8y ago
They probably aren't related; I have my tonsils and also have bad pollen allergies.

yani 8y ago

Tonsils can cause miserable life to suferrers and while they might have negative long term effect, the research does not include the mental issues that recurring tonsils cause.

nsxwolf 8y ago

I seem to recall that a "tonsils out" subplot was commonplace in the American sitcoms of the 60s and 70s, but completely disappeared soon after that. I was born in the late 70s and I don't think I know a single peer who had tonsils or adenoids removed.

tssva 8y ago
Having your tonsils out in the 60s and 70s was a much more painful procedure with a longer recovery time so people were more aware when someone had them removed. My daughter had her tonsils and adenoids removed 6 years ago. She had it done on Friday morning and was running around feeling fine on Saturday. No significant pain and she was back to school on Monday. Unless she mentioned it none of her friends knew.

gravelc 8y ago

Is there a causal link between the surgery and the increase in long-term disease risk, or were patients who were more likely to get the surgery (because of more severe symptoms or more frequent occurrence of infections) at greater long-term disease risk (whether they had surgery or not)? Without some functional mechanism, I'd be very wary of these kinds of data analyses.

mehrdadn 8y ago
> Without some functional mechanism, I'd be very wary of these kinds of data analyses. Kind of a tangent, but dumb question: wouldn't the sensible default assumption be that messing with your body is likely to be harmful unless proven harmless? Rather than the other way around? So if you're skeptical, shouldn't you be skeptical that it's harmless?
- robbiep 8y ago
  It has not been until recent times that any form of messing around the body was for any reason other than self preservation or the improvement of quality of life. I am talking post-enlightenment/age of reason medicine here, not dark ages blood letting. And we still get it wrong, and still do things without enough of an evidence base, but when it comes to removal of adenoids, the reason it is done is because in those it is affecting it is having a harmful effect on. Whether that be the formation of peritonsilar abscesses (potentially fatal), difficulty breathing (watching a 6 yo struggle to get air into their lungs due to enormous tonsils is not a sight I enjoy seeing) or just missing large numbers of days of school due to repeated illness, with knock on effects to child wellbeing and performance, there is a firm reason why we do this procedure
  - nailer 8y ago
    Weird to hear tonsilectomies being spoken of in thw present tense. It stopped being routine in Australia in the 80s.
    - robbiep 8y ago

vsizov 8y ago

If you have your tonsils removed you most probably have not a very strong immune system, originally. So it's OK to expect that you're less healthy during the life. I don't think that tonsils removal is causing this, the root of the problem is deeper I think. I have my tonsils removed a year ago when I was 32 because of problems with my joints. They are better now actually. So I would say, you need to remove your tonsils when it's absolutely necessary.

cheschire 8y ago

My daughter's adenoids were removed after their size caused her ear canals to remain closed, which was causing fluid buildup behind her ear and affecting her ability to hear clearly. When a child cannot hear, they cannot learn important nuances to speech. Additionally, prolonged exposure to those fluids, if I understood the ENT doctor correctly, her hearing could have been permanently damaged had we left it. We were also taking intercontinental flights at the time and the closed canal could have caused a rupture, further limiting her hearing. None of these things were associated with an ear infection. We only identified the adenoid issue because she was having trouble hearing and the ENT identified the large adenoids at that point. There was no pain associated with it, and I suspect many parents may not even realize that their kids have this issue. What are the long term speech and hearing risks compared to the long term health risks? I strongly caution anyone against a knee-jerk response to a study like this. It could be another anti-vaccination study all over again.

headmelted 8y ago
Reading stories like yours does make me wonder if the bigger issue here is variance in standards of care. Clearly you've been advised, based on your specific circumstances, of why it would be in your daughter's best interests to have this surgery done (there's no sarcasm here - it's great that so much consideration has gone into it and clearly it's been the right thing to do in your case). It does seem like based on my own anecdotal experience, and from other comments in the thread, as if "tonsils out" is an automatically triggered decision in much of the world for certain ailments in cases where it may or may not be appropriate or warranted. For the record, I hate even being anywhere near the fence on an issue like this, as I'm very much pro-vaccination (for example) and my position on this comes across as anti-science which I'm anything but.

b34r 8y ago

I’ve begged my doctor to remove my tonsils and they refuse due to studies like this. I get tonsil stones every single month and at least one severe case of tonsilitis per year (usually closer to 3-4.) Anyone have strategies that worked to convince their GP to allow them to be removed? At this point I’m considering just paying out of pocket to get it done.

NegativeLatency 8y ago
Get a second opinion?
nradov 8y ago
This sort of thing is just a matter of doctor shopping. Keep asking different doctors until you get an answer you like.
graeme 8y ago
You probably know this, but note that removal doesn't necessarily end the stones. Had mine removed as a kid. Then had a peritonsular abcess around age 20. Then had tonsil stones for a few years. After a change in diet (no wheat, little packaged food) they stopped. Can't be sure of the exact cause. Also, I've heard waterpik devices can help.
wellboy 8y ago
You can do a tonsillotimoy instead of a tonsillectomy. It's a much less invasive surgery and they only burn down your tonsils bit by bit and you can leave the next day.
wil421 8y ago
Have you tried using a water pick? I recently discovered there was such a thing as tonsil stones.
eip 8y ago
It's pretty simple to remove tonsil stones. Just get a lighted tongue depressor and a tonsil stone tool. Think of it as another maintenance task. Like brushing your teeth.

pmoriarty 8y ago

I can't find it now, but two or three months ago I read a story in the news about a teenage girl who bled to death after her surgeon accidentally cut in to her aorta during her tonsilectomy. The saddest thing was that it was a slow, completely preventable death, and that the doctors did not take her symptoms at all seriously, despite her coughing up copious amounts of blood, telling her and her mother that it was all perfectly normal. Very sad story.

barking 8y ago

This does not tie in with my experience as someone who had those removed at age 6. This winter for example, everyone in our household had nasty chest infections except me.

zaarn 8y ago
Anecdotal data is not a good source of medical advice.
- tomohawk 8y ago
  When treating a patient, using the results of a study is a good starting point, but it may really have nothing to do with treating the specific patient. The patient may fall outside of the distribution of normal occurrences, as indicated by the study. They may be an outlier. This is one reason why medicine is challenging - you're not treating a population, you're treating a patient. If you are the patient, you want the doctor who is guided by science, but also not blinded by "well, the studies say to do X, but that's not working. I guess there's nothing I can do for you". In my case, I had my tonsils removed as an adult and it is one of the best medical decisions I've ever made. Prior, I had all kinds of health problems. They are now gone, and while I used to get sick a few times a year to the extent of missing work, that no longer happens.
  - zaarn 8y ago
    While I generally agree, treating a patient is also not as simple. For example, I never had my tonsils removed and in the past 5 years I have not been sick a single time. Plus, this doesn't invalidate the study itself, as the results merely lay out a chance, the probability that you will suffer long term effects. People can smoke cigarettes their entire life and never get lung cancer or they smoke once and get a diagnosis for lung cancer next year.
- sv12l 8y ago
  It think their entire study is based on the collection of such 'anecdotes'.

blackhaz 8y ago

Thank you so much for posting this. Really, THANK YOU, kind stranger. Here in the Czech Republic we're always forced by doctors to do AE/TE to our son despite being mildly affected by strep as we are fighting PANDAS. The latest research converges on that AE/TE is not effective, and that we're doing the right thing by not doing the operation. It looks like doctors even in the most advanced medical institutions are blindly following old books here and still recommend to take the tonsils out at every occasion and eat bags of antibiotics "just for any case." The level of medicine here is so abysmal (except, probably, surgery) that we now have to rely mostly on our own heads and collect the latest research. Thank you.

headmelted 8y ago
You're right to be cautious and fact check everything you're told. I apologise if my response becomes overly ranty. This isn't to scare you, just to encourage you that you're doing the right thing by taking such an active role in your child's care. I have views on this that would seem to most people to be seriously conflicted. I'm militantly pro-science, and I argue constantly in the face of anti-science and pseudo-scientific bullshit anywhere I hear it. It makes me no fun at all at parties, and even some family members groan whenever someone brings up "alternative views" to the scientific consensus on much of anything as they know I'm about to start lecturing, whether it's climate change, vaccination, flat earth (<- seriously) or most of anything else. On the other hand, my personal experiences of how medical science is applied locally by doctors and surgeons has made me entirely disillusioned with their whole industry, and I never trust anything I'm told without confirming it for myself. To explain, I'm based in Northern Ireland, and a debate has gone on for a long time as to whether our National Health Service (NHS) is struggling or in trouble. In reality, it has already imploded. This isn't hyperbole. Here's an exact quote from the BBC: "Northern Ireland has some of the worst performance figures in the UK. During the Christmas period, the number of patients seen in four hours in A&E departments dropped to 63%. Exactly the same proportion started their cancer treatment within 62 days, according to the latest statistics, while the numbers waiting longer than they should for a routine operation have almost doubled in the past four years." This hits home for me really hard. In the last six years my extended family has experienced: - Two missed cancer diagnoses. - A potentially serious (and time-sensitive) diagnosis requiring specialist follow up that was missed on two seperate occasions. - Delayed treatments for potentially life-threatening cancer of over 100% of the recommended waiting period. Our local hospital has become known as a place more likely to kill you than help you, due to how abysmal the standard of care is. Here's a link from a couple of months ago: https://www.irishnews.com/news/2018/03/15/news/pensioner-dies-in-chaotic-a-e-department-1278554/ https://www.irishnews.com/news/2018/03/15/news/pensioner-die... Life threatening emergencies that arrive by ambulance are often left unattended for over four hours (this is recorded in the public record thanks to open data laws). I sincerely hope the circumstances in the Czech Republic are better and that the doctors are much less overworked and much more capable of helping you, my intention here is just to give you encouragement that you're right in not just assuming that your child's in safe hands without you being involved.

amazert 8y ago

Thanks for this post. I have tonsil problem from years but i am always afraid to get that removed from my body. The general treatment which i do when feel problem is hot water gargle.

headmelted 8y ago

Only barely related but I have a personal story about this! I had my tonsils removed at eleven years old. I didn't know why then, and I still don't now. I suffer quite a bit now from allergies (I'm not sure how related to this it is, and I guess I've no way of knowing really). I remember being really scared, and the surgeon playfully telling me that I'd be fine, I'd be asleep through the whole thing and would wake up back on the ward (with ice cream!) and barely even know it was over. I was told that I should count to ten while they issue the anaesthetic. I was unconcious by seven. The next thing I remember is waking up really disorientated, in a different room, and could only see blurred grey shapes. I've never been in such pain before or since. I shut my eyes and bit down hard into the white hospital pillow while screaming. An unfamiliar voice shouted angrily at me that I wasn't supposed to be awake yet. I opened my eyes as the pillow felt wet only to realise that it had turned completely red. It felt like someone had cut my throat out. My mother (having been advised that I'd be asleep for hours) had gone to get a coffee and was completely unaware that any of this had happened. For reasons that were never explained, the nurse wouldn't take me out of the room and my mum wasn't informed until a couple of hours later when I was wheeled back out onto the ward. I had to stay in hospital for another two days as a result of what went wrong (haven't a clue to this day what that was exactly), and was bloody terrified. Anyway, long story short is that when the bleeding eventually stopped I finally got some ice cream. It was warm, it tasted bad, and it was entirely not worth it. In summary, surgery could well be correct for you and/or your child if a competent professional has analysed and considered your case and health outcomes, but I don't recommend that anyone allow themselves or their children to be mutilated without any explanation at all in exchange for sweet treats.

chunkyslink 8y ago
I'm really sorry you had to experience this.
- headmelted 8y ago
  I appreciate that. It really was atrocious ice cream.
iamforreal 8y ago

aviv 8y ago

In 20 years HN will have a front page top post about the long term health risks of male circumcision. Sometimes it take time for common sense to become.. common.

roesel 8y ago
And those are?
- workaccount34 8y ago
  Mutilated genitals
  - roesel 8y ago
    I dont know if that qualifies for a “long term health risk”.
    - workaccount34 8y ago
      We aren't lizards. We can't magically grow back lost portions of out body.
      - tom_ 8y ago
        Right, but if you survive the procedure, are the side-effects going to kill you, or leave you more likely to contract diseases, and so on? That's more the question. And the answer appears to be no. Plenty of reasons why it's a bad idea, just not this one...

mhandley 8y ago

I had my adenoids and tonsils removed as a kid in the early 1970s. Had bad allergies all the way into my thirties, but I have no way of telling if they were the reason I needed to have my adenoids removed in the first place. However, I simply grew out of my allergies in my late 30s. These days I rarely get sick, despite living in London and travelling on public transport all the time. And when everyone else in my family has a terrible sore throat, I never have a problem, so that's definitely a plus side for me right now. I'd be really interested in whether there's a downside heading into old age, but I've not seen any data on that.

bariswheel 8y ago

I've had my tonsils removed at age 6, no allergies at all. My appetite increased quite a bit they tell me, but my parents were in their twenties back then, who knows. Anyway, wanted to throw in my data point in here.

forthispurpose 8y ago

this practice (along with getting appendix removed when not necessary) seems like some distant relative of bloodletting.

calewis 8y ago

You have to pay to have them removed in the UK now, it's no longer free on the NHS, unless you suffer from 3x serious infections in a one year period. I suffer from frequent sore throughs, infections and even tonsillitis. My Auntie, who is a doctor, strongly advised me not having them removed. Which at the time is not what I wanted to hear but it seems, unsurprisingly, was great advice.

giljabeab 8y ago

I had frequent tonsil infections as a kid and was given the option to have them out but declined. Now I have two very small and pitted tonsils due to frequent infections which asides from the odd tonsil stone don’t bother me at all. I don’t get hay fever or any allergies. Think I made the right decision

zbowling 8y ago

Could there be a correlation between people needing to get their tonsils out and their higher rate of infection from some other factor and not necessarily as a result of the tonsils getting removed?

stareatgoats 8y ago
> "cases were no less healthy than controls presurgery in the first 9 years of life" Looks like they addressed that (heading: Testing for Biases in General Health Before Surgery)

Angostura 8y ago

Just to add to the anecdotes in here. I had my tonsils removed at about the age of three and never suffered any particular consequences.

pacomerh 8y ago
Same here, I had them removed at the same age and never had an issue related to allergies or anything serious.
varjag 8y ago
Had adenoids removed, and suffer from runny nose and (fortunately relatively mild) allergies all my life. Never occurred to me before it could be related.
keypress 8y ago
For perspective. I had horrible health that plagued me until I was about 20. Whether that's got anything to do with the butchering, I have no idea.

axilmar 8y ago

In my generation, 100% of us had our tonslis/adenoids removed as children, but we have no significant differences in health issues whatsoever.

manmal 8y ago

My son had adenoids removed last year because his hearing was VERY bad because of some kind of mucus blockage. Doctors explained to us that he would hear perfectly without the adenoids, because inner ear measurements were very good. So during the OP they cut away the adenoids, and made a hole into each eardrum, so fluids could exit. After the OP his hearing was so good that he told us not to scream at him when we barely whispered - for 2 weeks. As soon as the holes in the eardrums healed up, the blockage developed again and his hearing was exactly the same as before the OP. We tried alternative treatments for a year, strange juices with corticosteroids and stuff (which worked well for his hearing, but he couldn't really sleep while on them), near-infrared radiation through the nose (our favorite so far, but does not work that well because adenoids are too far in)... so he's soon have his second OP where they will likely remove adenoids again (they regrow sometimes) and insert little tubes into his eardrums such that fluids can regularly exit the ears. Distant relatives of mine have the same issue, but worse (delayed speech development due to near-deafness), and for them the OP worked for 1,5 years and now its positive effects are going away; perhaps requiring another OP. I'm not thrilled about all this. BTW here is advice a very expensive doc gave me regarding hearing and speech development: If your kid understands what you are saying while you whisper from a distance of ~1 meter, then her speech development should not be negatively affected, or not that much.

darkerside 8y ago
Sorry to hear you're going through this. I can't imagine how frustrating it must be. Are you concerned about side effects from all these interventions? Do you have a hypothetical point at which you would simply choose to accept your child's hearing impairment?
- manmal 8y ago
  I'm trying to be a stoic, and I will deliberately try to accept anything that I cannot influence in this very moment. Approaching medial issues, I think that the only thing you have to accept (until your death) is that your previous attempts at improving have failed; so as long my son's hearing is not good, I'll keep on looking for things to try out. There are time and cost constraints of course; sometimes I go for weeks without researching anything to improve the situation. But the motivation to do something returns naturally when he's in pain again, or is misbehaving very badly because of this.

ponderatul 8y ago

Let me provide you an alternative perspective worth considering. Depending on the seriousness of your condition, having adenoids can result in having problems breathing normally( aka through the nose). Now obviously breathing is very important for your organism, and it will find ways to adapt, and you will find yourself breathing through your mouth. Breathing through the mouth will encourage the development of a long face, cus tongue is not in its natural position, at the top of the palate. Your posture will change since having the mouth open is not the default position of the body for long periods of time. You might find your neck lunging forward. And these are just second and third order effects for not being to breathe properly during early childhood. Jaws might not develop properly, teeth as well. And that is all the effects I know about. Yes, I've had both my adenoids and tonsils removed, in the end. Not early enough though.

doktrin 8y ago
I had my tonsils removed when I was 19 because of sleep apnea. Even after reading this piece I'm reasonably confident, though not certain, that it was a net-positive.
jdcarter 8y ago
My daughter couldn't breathe easily when she was young--when sleeping you could literally hear her breathing from a room or two away. Like having Darth Vader sleeping in the next room. After tonsil/adenoidectomy at about 3 years old she could finally breathe properly and her sleep become much better. It made a HUGE difference to her quality of life.

ToFab123 8y ago

It was amazing to have the tonsils removed as a kid. For a couple of days we were only allowed to eat ice-cream :)

joshgel 8y ago

Like everything in life and medicine, it is all risk-benefit analysis. I'm underwhelmed by the absolute risk reduction for most of these findings. Most people get some sort of upper respiratory infection, is increasing URIs rate from say 65% to 70% clinically meaningful? Sure its statistically significant here given the large sample size, but I'm not sure it helps us know what will happen. But if a child is suffering now, and we have the chance to help, what should we do with this data? I'm definitely against unnecessary surgery, especially in children. I just don't think this pushes my definition of necessary very much.

ousta 8y ago

Would love similar study on circumcision...

Proven 8y ago

Can I sue the government?

jbronn 8y ago

Since everyone is joining in with anecdotes, I’ll share mine. During second grade I had strep at least four consecutive times. One of those times I developed an ear infection with pain so intense my parents took me to the emergency room. On doctor’s orders, I had my tonsils removed. While the procedure was not pleasant (I had severe nausea from the anesthesia), the effects were immediate and permanent. In nearly three decades since I’ve yet to develop strep again.

vanderZwan 8y ago

I had my tonsils removed last year (so at age 33) due to having a peritonsillar abscess multiple times in a couple of years - which implies that the first time I was infected it likely became a "chronic" risk. So far no allergies, so I hope my immune system is already "properly trained" from before or something. Anyway, if anyone ever needs to have their tonsils removed for health reasons: only drink isotonic water[0] when you're thirsty. For some reason my surgeon forgot to tell me that, but I discovered this on my own by accident. After the surgery I felt very dehydrated, so made some ORS at home. To my surprise, drinking it did not hurt at all, even though drinking plain water earlier had felt like getting thousands of paper-cuts in an open wound. I was eating regular food within a week (it took a bit longer to fully heal up of course), and didn't even need to use the heavy duty painkillers that I was prescribed (only over-the-counter painkillers for sleeping, really). I suspect that instead of being a pain-killer, drinking isowater avoided the irritation that caused the pain in the first place, which means I also avoided inflammation and healed up faster than expected due to that. [0] Take this recipe for home-made rehydration solution and tweak to your liking http://rehydrate.org/solutions/homemade.htm http://rehydrate.org/solutions/homemade.htm

azinman2 8y ago

I wonder if it’s really the other way around — people who tend to get infections often have this surgery because, well, they often get infections?

JTbane 8y ago

Interesting that however advanced medical science is, we still don't know about everything the lymphatic system does.

fromMars 8y ago

I am skeptical of the findings. I imagine that people who get their Tonsils and Adenoids removed are probably more predisposed to allergies to begin with. My brother got both removed when he was 10 as he was suffering from ear infections and other problems, I didn't. Now as an adult, my allergies are worse and I get sore throats more frequently with more irritating symptoms. Allergies are also common in my family. So my experience is that this surgery can have a very positive effect on one's quality of life.

cryptonector 8y ago
From the abstract: > Increases in long-term absolute disease risks were considerably larger than changes in risk for the disorders these surgeries aim to treat. Presumably specifics are discussed in the paper. They followed 1.2 million children. Perhaps they were able to get an apples-to-apples comparison of children with similar issues and who did and did not get these surgeries.

xpto123 8y ago

Too late, my 3 kids had the adenoids removed. Anything that i should look out for?

Dolores12 8y ago

What if enlarged tonsils/adenoids is a allergic response of immune system? These people are prone to allergic reactions in first place. Correct way of testing this hypothesis would be to cancel OP to 50% of control group and compare long-term health risks after 30 years.

gormz 8y ago

I used to get a lot of throat infections when I was a kid and had the discussion with my doctor to whether I should get my tonsils removed. My doctor was heavily opposed. recently, I've been having allergies and more throat issues and wished I would have got them taken out. Pretty glad I didn't now.

aladoc99 8y ago

I have to point out the obvious confounder here. The kids who get their tonsils and adenoids out are the ones with recurrent respiratory infections to begin with. Really the only way to control for this is to randomize kids to surgery or not and then follow for 20 years or more. This in contrast is an observational study, albeit with a very large number of subjects. They said they tried to control for confounding factors, but it's hard to see how effective that can be after the fact.

verulito 8y ago

Mine were removed when I was 2 because they were huge! Like all surgery, it comes with risks and tradeoffs. It's great that we have a better idea of what the risks are now but that's not a reason not to do the surgery. Let's not forget that it's still a well tolerated procedure that confers some benefit to the right patients. We're not removing them for fun. What benefit is that? Large tonsils occlude the airway, causing sleep breathing disruptions. The impact of those disruptions isn't visible but we know it is very harmful, particularly to children since they're still developing. We can avoid those developmental problems by removing the tonsils. I don't want to go into it here in too much detail but "developmental problems" is not a small thing, we're talking about structural changes to the skull, learning difficulties, behavior problems, etc. An open question is how bad does the occlusion need to be before it justifies removing the tonsils. I don't know the answer to that question. I'd say bad. And that happens increasingly often because large tonsils have a strong correlation with allergies to begin with. Chronic infections are more a complication of the original problem, not the cause of it. And that's not even touching the damage these infections can do to the sinus cavities.

n4kana 8y ago

I had my tonsils out at around age 8 due to chronic ear infections. I don't know how bad it was before the operation, but my respiratory health has been abysmal since the operation. I've recently begun to wonder if oral probiotics could be a missing part of the equation. Tonsils literally have "crypts" - the quality of your oral bacteria must play a huge role in how they function. http://www.blisk12.com/what-is-blis-k12/ http://www.blisk12.com/what-is-blis-k12/