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What Are Some Reasons Why the Tonsils May Become Swollen?

Tonsils, part of the human body's lymphatic system, assist in with the immune response. Found in the back of the throat, these glands may enlarge, leading to snoring and sleep apnea, recurring sore throats, bad breath and difficulty swallowing. Treatment options exist, from tonsil removal to avoiding irritants to antibiotics. Swollen tonsils may be caused by a number of medical conditions, including gastroesophageal reflux disease, smoking and tonsillitis.

Gastroesophageal Reflux Disease

A study presented at the 2007 American Academy of Otolaryngology—Head and Neck Surgery Foundation Annual Meeting reveals a connection between gastroesophageal reflux disease, also known as GERD, and enlarged tonsils 3. According to, GERD occurs when stomach acid and bile flows from the stomach back into the esophagus, which irritates the lining of the esophagus.


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Reaction to allergens and irritants, including cigarette smoke, may cause the tonsils to swell. A tonsillectomy and radiation may be recommended for smaller tumors; neck dissection and jaw bone resection combined with radiation may be needed for larger tonsils.


Tonsillitis, an infection of the tonsils, usually occurs as a result of viral and bacterial infections, according to 1. The most common cause is Streptococcus pyogenes, the bacteria responsible for strep throat. Aside from red, swollen tonsils, symptoms of tonsillitis include:

  • sore throat
  • white or yellow patches visible on the tonsils
  • painful swallowing
  • enlarged lymph nodes in the neck
  • stiff neck
  • bad breath
  • headache

Physicians prescribe antibiotics to clear up the infection; however, recurring and chronic tonsillitis may require surgery to remove the tonsils permanently.