Can Asthma Improve with Tonsillectomy?

Asthma is the third most common chronic disease amongst children, and the third most common reason for admission to the hospital. The CDC estimates that 7.1 million children suffer from this condition, costing over $50 billion a year. A new study from the University of Chicago found that children who undergo tonsillectomy had 37% reduced hospitalizations and 26% less visits to the emergency room. They compared about 13,000 children with asthma who underwent adenotonsillectomy to 27,000 who didn’t undergo the procedure. This finding builds on previous smaller-scale studies finding similar results. A Fox News article summarizing the findings concludes with a standard disclaimer that since this was a retrospective study, causation can’t be linked, and that large-scale prospective studies are needed.

What the paper doesn’t address is the possible reason why removing tonsils may help asthma. I’ve described in the past about the strong association between large tonsils, obstructive sleep apnea and reflux. Every time a child stops breathing, a vacuum force is created in the chest and throat, with normal stomach juices coming up into the throat. What comes up not only includes acid, but also bile, digestive enzymes, and bacteria. In fact, one recent study found pepsin (a stomach enzyme) in the lungs in the vast majority of children and teens with chronic lung disease. There are also numerous reports of pepsin being found in chronic ear and sinus infection fluid.

While tonsillectomy is not a completely benign surgical procedure, this study adds to the multiple potential benefits that improved breathing and sleep can have on your child’s health. 

For the parents out there, did you notice any improvements in your child’s asthma symptoms after tonsil surgery?


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2 thoughts on “Can Asthma Improve with Tonsillectomy?

  1. My brother has asthma and had his tonsils removed. No change that I’m aware of. My daughter doesn’t have asthma but she did have her tonsils removed. Her sleep apnea definitely improved.

  2. Fascinating. My toddler son has issues with CLD, mild sleep apnea, grade 3 tonsils, and FTT with difficulty eating. He had reflux disease as an infant and still throws up really easily, especially when he’s battling a cold and has extra nasal drainage. We have been going back and forth about a tonsillectomy for months because of potential gains and potential risks, and because the apnea issue was mild enough that he wasn’t in any immediate need of the tonsillectomy. We’ve decided to go through with this now that we’ve given him time to grow (and yet he’s still drastically underweight) and hopefully, as your article suggests, his CLD/asthma and reflux will also improve.

    If your theory is right, we should notice huge improvements with my son in the next few months. I’ll let you know.