What to know about enlarged adenoids

Children
Enlarged adenoids are common in children. The adenoids can become enlarged due to an infection or may be enlarged from birth.

The adenoids are glands that sit behind the nose above the roof of the mouth. When they grow large, they can cause snoring and breathing problems.

This article will describe the function of the adenoids, what causes them to become enlarged, and how to identify enlarged adenoids. We also look at various treatment options.

What are the adenoids?

unwell little boy being comforted by mother
An infection can cause adenoids to become enlarged.

The adenoids are glands that sit above the roof of the mouth and the tonsils. They are part of the immune system.

These glands help trap germs that enter the nose or the mouth, in an effort to prevent infections.

The size of the adenoids increases until a child is 6 years old, then they slowly shrink. The adenoids usually disappear by the time a person is 16. Enlarged adenoids are rare in adults.


Causes

Most of the time, the adenoids become enlarged when the body is trying to fight off infection. They can remain enlarged, even after the infection is gone.

Some children have enlarged adenoids from birth. Allergies can also cause this enlargement.

Although it is rare, adults’ adenoids can become enlarged, due to a chronic infection or allergy, pollution, or smoking. Even less common is enlarged adenoids resulting from a cancerous tumor.


Symptoms

People cannot see the adenoids by looking into the mouth, so it is not possible to tell if they are enlarged by sight.

A doctor can look at the adenoids using a special mirror or lighted camera on the end of a flexible tube.

The signs and symptoms of enlarged adenoids include:

  • snoring
  • pauses in breathing during sleep
  • strained or noisy breathing
  • restless sleep
  • breathing more through the mouth than the nose
  • bad breath or dry, cracked lips resulting from mouth breathing
  • difficulty swallowinga nasal-sounding speaking voice
  • a persistent runny nose
  • frequent ear infections
  • frequent colds
  • swollen glands in the neck
  • sleeping in an unusual position, with the head back and the knees to the chest while the person is lying on their front


Diagnosis

doctor examining young girls throat
A doctor will need to examine the back of the throat.

A doctor may refer the child to a doctor who specializes in ear, nose, and throat disorders. This type of doctor can be called an ENT specialist.

The doctor will take a history of the child’s symptoms and perform a physical exam that includes the back of the throat.

The doctor may use a tool that consists of a camera on the end of a lighted scope to look at the adenoids. They insert the scope through the nose.

Also, they may recommend a blood test to look for infection.

If the child has symptoms of a sleep disturbance, the doctor might recommend a sleep study. This can help indicate whether the symptoms relate to difficulties breathing during sleep or sleep apnea, which sometimes occurs with enlarged adenoids.

Risk factors

Risk factors for enlarged adenoids include:

  • frequent infections in the head, throat, or ears
  • tonsil infections
  • having enlarged tonsils

Because the adenoids usually shrink by adulthood, children are the most susceptible to this enlargement.


Treatment and remedies

In some people, enlarged adenoids do not require treatment, and the doctor will recommend a watchful waiting approach.

Otherwise, the best treatment depends on the child’s age and how large their adenoids are.

The doctor may prescribe antibiotics when a bacterial infection is responsible for the enlargement.

A prescription steroid nasal spray may be able to decrease the size of the adenoids.

Eating healthful foods, getting enough sleep, and drinking plenty of water can keep the immune system functioning well and help reduce the risk of enlarged adenoids. Also, good hygiene can help prevent infections.

In some cases, children need their adenoids removed.

Adenoidectomy

smiling little girl in hospital bed
A child may require an adenoidectomy if they have frequent infections.

An adenoidectomy is a simple surgery that is generally low-risk. The doctor may decide that surgery to remove the adenoids is appropriate if the child experiences:

  • recurrent infections of the adenoids, resulting in frequent sinus or ear infections
  • infections that do not go away with antibiotics
  • breathing problems, especially those that interfere with sleep

If the child has been experiencing problems with their tonsils, the doctor may decide to remove the tonsils at the same time. This is called an adenotonsillectomy.

The procedure for an adenoidectomy involves a doctor putting the child under general anesthesia and removing the adenoids through the mouth. In most cases, the child returns home the same day.

After the surgery, the child will likely experience mild pain and discomfort, including minor bleeding, a sore throat, a runny nose, or noisy breathing.

During recovery, which usually lasts about 1 week, the child should rest and avoid strenuous activities. They should also eat soft, low-acid foods.

Possible complications

A child with enlarged adenoids can experience the following complications:

  • otitis media with effusion, or glue ear, a middle-ear infection with chronic fluid buildup that can lead to hearing problems
  • sleep apnea, which causes pauses in breathing while sleeping, as well as snoring
  • problems breathing through the nose, which leads to excessive mouth-breathing


Outlook

Enlarged adenoids are common in children. If a person suspects that the adenoids are enlarged, they should visit a doctor.

If the issue does not resolve on its own, doctors can often provide effective treatments. If enlarged adenoids become problematic, surgery to remove the glands may be necessary.

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