Does your little one often breathe through their mouth? It could be swollen adenoids (Adenoiditis)!

Have you ever noticed that your little one often has a runny nose, a stuffy nose, and breathes through his mouth? Sometimes when he sleeps at night, he snores like an old man, right? Some mothers say, "Oh, doctor, my child always has a runny nose and a stuffy nose." Although we think these things are just a common cold, sometimes this can be due to swelling of the glands called adenoids, which is called adenoiditis . Shall we talk about this in more detail?

What exactly are adenoids?

Simply put, these adenoids are two small lymphoid tissue-like glands located behind our little ones' noses, at the top of the throat, or more precisely, behind the nasal cavity. Think of them as sentinels that catch germs that enter our bodies. That is, they are an important part of our children's immune system . These adenoids are there to catch unwanted germs, bacteria, and viruses that enter our bodies from the environment when we breathe and eat, fight them, and protect them from getting sick.

So, what is adenoiditis? Why does it happen?

Now you understand what adenoids are and how important they are. So, these glands that fight germs can sometimes become infected with germs, or they can become inflamed. That's what we medically call adenoiditis . To be precise, this is swelling of the adenoids.

What happens when that happens? These glands swell and become larger. Then the airway that allows breathing through the nose starts to get blocked. It becomes difficult for the child to breathe through their nose, and they start breathing through their mouth . Sometimes, you can even tell a difference when you talk with your nose blocked.

Main causes of swollen adenoids

There can be a number of reasons why these adenoids become swollen. Most often, it starts like this:

1. Viral and bacterial infections: First, a child may have a viral infection, such as a cold, that weakens the upper respiratory tract. Then, a bacterial infection can take over that weakened area. When two such infections occur in a row, the adenoids are more likely to swell.

• Viruses that cause the common cold and flu.
• Bacteria that cause diseases such as bronchitis , ear infections, pneumonia , and throat infections (such as strep throat ).

2. Allergies: Some children may have allergies to things like dust, pollen, and certain foods. These allergies can also cause the adenoids to swell.

3. Acid Reflux: Sometimes, stomach acid can also cause swelling of the adenoids when it comes up into the throat and damages the tissues there. This is a condition called LPR (Laryngopharyngeal Reflux) .

Who is most likely to develop adenoiditis?

This condition called adenoiditis is most common in children between the ages of 3 and 7. Parents know that children of this age are more likely to get colds and fevers. This is because they are about to start going to school and playing with other children. Also, the adenoids are at their largest at this age. So, even a small swelling at such a time can cause a lot of blockage in the nasal passages.

This is very rare in adults. This is because the adenoids usually shrink and become smaller after the age of 7. In most cases, they disappear completely by the time they reach adulthood. However, depending on the amount of tissue remaining, the adenoids in adults can also swell for the reasons mentioned above. Rarely, abnormal growths such as cancer can also cause the adenoids in adults to swell. This is more common in adults.

Important: While it is normal for adenoids to enlarge in young children, it is especially important to be concerned if an adult's adenoids are enlarged.

What symptoms will a child show if they develop this disease?

If your little one has adenoiditis, you may notice one or more of these symptoms:

• Fever develops.
• Breathing through the mouth (especially at night, while sleeping).
• My nose feels stuffy and I have a runny nose all the time.
• Sometimes the airway can be completely blocked (nasal obstruction) .
• Feeling like mucus is coming down the throat, constantly scratching the throat (Postnasal drip) .
• Snoring at night . Sometimes it can feel like you're suffocating.
• Sore throat .
• Breastfed babies may have trouble feeding because their nose is blocked.
• Ear infections can occur frequently.
• When you speak, you may sound like you are speaking through your nose (nasal voice).

What complications can occur if the adenoids problem persists?

This is something to be careful about. If the adenoids are swollen and the airways are constantly blocked, one problem can lead to many more problems.

Imagine, when it becomes difficult to breathe through the nose, the child continues to breathe through the mouth. When breathing through the mouth for such a long time , there is a high chance of cavities forming in the teeth and misaligned bite. Because when the mouth is open, the saliva in the mouth dries up, which is not good for the teeth. Not only that, this can also affect the development of facial bones , and the shape of the face may change slightly.

Difficulty breathing can make it difficult to sleep at night. Sometimes breathing stops for a while and then starts again. We call this 'Obstructive Sleep Apnea' . Then the child has difficulty paying attention during the day, has difficulty concentrating on schoolwork, and this can also affect learning ability. The child may also feel tired all the time.

Another thing is that these swollen adenoids can block the Eustachian tubes, which connect the child's middle ear to the back of the nose. These tubes are responsible for equalizing pressure inside the ear. When these tubes become blocked, they can cause frequent earwaxing, ear infections , and sometimes hearing loss .

How does a doctor accurately diagnose adenoiditis?

When you take your little one to the doctor, they will first ask you about the symptoms. They will ask you a lot of questions, such as how long the symptoms have been present, how they feel at night, and how they eat and drink. Then, they may do a few tests to find out if you have adenoiditis and what is causing it:

• Physical exam: Sometimes the doctor will insert a small mirror (like the ones dentists use) down the throat to check for swollen adenoids. However, this can be difficult to see accurately, especially in young children.
• Endoscopy: This is often the best way to see adenoids. This involves carefully inserting a thin, flexible tube with a camera and light at the end (also called a nasal endoscopy ) through your nose and looking closely at the adenoids. This allows you to see exactly how swollen they are, how big they are, and how blocked the nasal passages are. This can be a little uncomfortable, but it is not very painful.
• Testing a pus/fluid sample: A throat swab (called a throat culture ) can be taken to see if there are bacteria in it, especially the bacteria that cause strep throat .
• Allergy tests: If the doctor thinks that the cause of the swelling is an allergy, he may also conduct tests related to that.

Sometimes an X-ray may be taken to see the size of the adenoids.

What are the treatments for this? Is it something to be afraid of?

The treatment for adenoiditis depends on the cause.

Most of the time, when adenoids become swollen due to a virus, the child's immune system fights it off and heals in a few days or a week. It doesn't require any special treatment. All you need to do is take some medicine for fever and body aches, get plenty of rest, and drink plenty of fluids.

However, if it is due to another cause, the swelling will decrease when that cause is treated. For example:

• If the doctor confirms that it is a bacterial infection, he will prescribe antibiotics . Amoxicillin and Penicillin are the most popular antibiotics that are commonly prescribed. These medications should be taken exactly as prescribed, for the exact number of days. It is not a good idea to stop taking them halfway.
• If it is due to an allergy, your doctor may prescribe antihistamines or a nasal steroid spray, such as Flonase® .
• Nasal irrigation with saline nasal wash helps to flush out allergens or germs and also helps to reduce nasal congestion.
• If you have acid reflux, your doctor may prescribe medication, such as proton pump inhibitors (PPIs) or H2 blockers .

What if medication doesn't work? Do I need to have surgery (Adenoidectomy)?

Sometimes, despite medication, the swelling of the adenoids may persist. Or, if you have frequent adenoiditis, which causes frequent earwaxing, or difficulty breathing at night (Obstructive Sleep Apnea), your doctor may recommend surgery , called an adenoidectomy . This involves surgically removing the swollen adenoids. This operation is performed by an ear, nose, and throat specialist (Otolaryngologist - ENT doctor) .

Now you may be thinking, 'Oh, will removing part of the immune system make my child more likely to get sick?' Don't worry . That won't happen. In fact, the adenoids are just one small part of the immune system. Removing them won't make your child more likely to get sick. The rest of the immune system (such as the tonsils and lymph nodes) will work better and protect your child from germs. In fact, removing the swollen, often-ill adenoids may actually make your child less likely to get sick.

What happens after the adenoids operation? Is the little one okay?

Adenoiditis will get better quickly if the cause is treated. If it is a virus, it will get better in about a week. The child will start feeling better within a few days of starting antibiotics. However, all the medicines prescribed by the doctor should be given exactly and on time. Do not stop halfway just because you feel a little better.

If you have an operation to remove the adenoids (Adenoidectomy), it is usually done in the same day and you can go home (day surgery). For a few days after the operation, your throat may be a little sore, and you may feel a little uncomfortable when eating. The doctor will give you painkillers for this. You usually need to rest at home for at least a week. After that, the child can go to school and play normally. Many children feel great relief after this operation, and things like breathing through the nose and sleeping are much better.

How to take care of your baby at home? When should you see a doctor?

When caring for a child with adenoiditis, you need to be very loving and attentive . To help them feel better, give them plenty of fluids (like water, soup, fruit juice) and get plenty of rest. If they have a sore throat, there are several home remedies you can try, such as giving them a little honey and gargling with salt water (if your child can handle it).

The most important thing is to always check in on how your child is feeling. Always ask, 'How are you, son/daughter?' That will help them feel better. You can also tell the doctor exactly what you need to tell him/her.

In these cases, you should definitely see a doctor:

• If symptoms do not improve or fever does not subside after two days of starting antibiotics.
• If the child develops new symptoms, or if existing symptoms worsen (e.g., increased breathing rate, bluish lips).
• If the fever persists despite being given fever-reducing medicine.
• If the child is having a lot of difficulty breathing.
• If they refuse to eat or drink, or if they vomit.

So, let's remember the most important things, shall we?

Many children get swollen adenoids when they get sick. But most colds and flus get better over time. Some causes – bacterial infections, stomach acid problems, allergies – can be treated with medication. But if your child needs surgery, remember that it is a very common and successful procedure. A child can be healthy without adenoids.

Many parents don't think of the medical term 'adenoiditis' when they see their child's symptoms. Instead, swollen adenoids can look like a cold or the flu. Over time, they can look like recurring ear infections. But more important than knowing the medical term is knowing when to see a doctor. Most children get better with time. But if symptoms last more than a week, or are severe, call a doctor. They can help your child get better quickly. Wishing your little one a speedy recovery!

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