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Enlarged adenoids

Key points

  • The adenoids are two small lumps of tissue (glands) at the back of your throat. They help to fight infections.
  • In young children, adenoids can grow big enough to block the back of the nose and throat.
  • The cause of enlarged adenoids isn’t clear, but in some children they may be caused by infection.
  • Your child's adenoids will shrink as he or she gets older.

Featured FAQ

What's the difference between the adenoids and the tonsils?

Adenoids and tonsils are very similar. They are made of the same type of tissue and both help the body to fight infection. However, they are located in different parts of the throat.

Read all our FAQs on enlarged adenoids

The adenoids are small glands in the throat, at the back of the nose. They help to fight infection in children and usually disappear as they get older. Enlarged adenoids can cause ear and breathing problems.

About enlarged adenoids

The adenoids are two small lumps of tissue (glands) at the back of your child’s throat. They help to fight ear, nose and throat infections.

Your child’s adenoids get bigger from birth and usually reach their largest size when your child is between five and seven years old. Adenoids start to shrink as your child gets older. They usually become small enough to cause no symptoms by the time your child reaches his or her teenage years. Adenoids can swell up again in adulthood because of infection, but this isn’t common.

Illustration showing the location of the adenoids

Large, swollen adenoids can block your child’s nose and throat. If both your child’s adenoids and tonsils are enlarged, it may make it more difficult for him or her to breathe or swallow.

This can be a particular problem when your child is sleeping. This is because he or she will have to breathe through their mouth rather than their nose. This means your child may snore and he or she may also temporarily stop breathing for a few seconds (sleep apnoea).

If your child’s adenoids become swollen, they can also block or cover the tubes that join the nose to the ear (the Eustachian tubes). These tubes help to drain fluid from your child’s ears and keep the right amount of pressure in the ears. If they stop working properly, your child may have hearing problems or develop an ear infection. These ear infections can keep coming back or become chronic. A chronic illness is one that lasts a long time.

Enlarged adenoids can also cause infected sinuses (sinusitis) in older children.

Symptoms of enlarged adenoids

Common symptoms of enlarged adenoids may include:

  • a runny nose
  • a cough
  • a blocked nose
  • a fever (if your child’s adenoids are infected)
  • snoring and sleeping with the mouth open
  • sleep apnoea
  • ear infections and glue ear (a build up of sticky fluid in the ear)

If your child has any of these symptoms and they don’t improve after a few days, you should see your GP.

Complications of enlarged adenoids

If your child’s adenoids are always swollen and enlarged, it can affect his or her breathing and sleep, cause ear infections and affect their hearing. These problems can lead to complications.

If your child is snoring or has sleep apnoea, he or she may be very tired during the day. Sleep problems can lead to behaviour problems and a short attention span, or your child may become hyperactive.

Regular ear infections or a build up of sticky fluid in the ear (glue ear) can cause hearing loss. The severity of hearing loss varies from child to child. If your child has mild hearing loss, he or she might struggle to hear in a noisy environment. Severe hearing loss can cause more serious problems and your child may have difficulty speaking and understanding. Hearing problems can also affect your child’s behaviour and how well they do at school.

Causes of enlarged adenoids

The exact causes of enlarged adenoids aren’t clear. In some cases, an infection (adenoiditis) can cause your child’s adenoids to become enlarged, but some children have them with no obvious cause.

Diagnosis of enlarged adenoids

Your GP will ask about your child’s symptoms and examine him or her. Your GP may also ask about your child’s medical history.

If your child regularly gets problems associated with enlarged adenoids, your GP may refer him or her to an ear, nose and throat (ENT) surgeon.

Treatment of enlarged adenoids

Your child's adenoids will shrink as he or she gets older. So, you may decide to wait and see if any nose and ear problems get better over time, rather than having treatment. Your doctor will discuss the risks and benefits of treatment with you.

Medicines

If your child has pain or a fever, you can give him or her over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Your doctor may prescribe a steroid nasal spray. This can help to reduce swelling and inflammation and may ease your child’s symptoms. Your doctor may suggest that you try a nasal spray before you think about surgery.

Antibiotics aren’t used to treat enlarged adenoids. This is because they may not work for very long and infection can keep coming back.

Surgery

If your child has enlarged adenoids because of regular infections, or if the adenoids are affecting your child’s day-to-day life and development, your doctor may refer you to an ENT surgeon to discuss an operation to remove them.

The operation to remove your child’s adenoids is called an adenoidectomy. An adenoidectomy involves removing the adenoids through your child’s mouth. The operation is done under general anaesthesia so your child will be asleep throughout the procedure.

If your child has other related health problems, such as ear or tonsil infections, then the surgeon may also put in grommets. Grommets are tiny plastic tubes fitted into your child’s eardrum to help treat glue ear. He or she may also suggest that your child has their adenoids and tonsils removed at the same time.

 

Produced by Alice Rossiter, Bupa Health Information Team, July 2013.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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