Tonsillectomy Doesn’t Lead To Illness, But Tonsillitis Just Might

A recent study reveals that individuals suffering from tonsil infections might also experience other chronic diseases. This finding is noteworthy as it challenges a 2018 study that suggested a connection between tonsil surgery and the subsequent development of chronic illnesses, implying the surgery itself was the cause.

In the past, tonsillectomy was a common procedure for children with frequent sore throats due to the high risk of complications from throat infections. However, with advancements in antibiotics in the late 20th century, the number of these surgeries declined. Later, ear, nose, and throat specialists noted issues related to tonsils, such as snoring and obstructive sleep apnea in very young children, leading to a resurgence in tonsil surgeries. Today, tonsillectomy remains one of the most frequently performed surgeries in children, despite a recovery period involving significant throat pain and a slight risk of postoperative bleeding. The surgery generally leads to improved sleep and fewer illnesses.

The 2018 study, which examined over one million children over several decades, indicated a higher prevalence of chronic respiratory diseases in children who had tonsil surgery compared to those who did not. This sparked widespread concern and misleading headlines suggesting tonsil surgery was the cause of lifelong diseases.

Dr. Tali Lando, a pediatric otolaryngologist and Assistant Professor of Clinical Otolaryngology at Touro College of Medicine, has extensive experience in treating children and addressing medical misinformation. She notes, “The fundamental flaw with many population studies is that it confuses correlation with causation. A classic example is that ice cream sales and shark attacks both rise during the summer. While these things are highly correlated, eating ice cream does not cause shark attacks.” She continues, “The headline grabbing 2018 study suggested that children who had tonsillectomy had a greater lifetime risk of developing airway disease. The data was not vetted by specialists and was based solely on coding data and memory.”

The current study, featured in the April 2026 issue of the Journal of Otolaryngology-Head and Neck Surgery, uses data from the UK Biobank, which tracked nearly 500,000 individuals over several decades. The findings confirm that those who underwent tonsillectomy were more likely to develop inflammatory disorders like irritable bowel syndrome (IBS), but these conditions were linked to their history of tonsil infections or enlargement before any surgery was performed.

Dr. Lando remarks, “This study demonstrates what we in pediatric otolaryngology have believed for ages, that tonsillectomy doesn’t cause inflammatory disease. Rather, the same inflammatory factors that predispose children to chronic tonsil infection also puts them at high risk later in life for inflammatory bowel diseases. The same inflammatory prone phenotype that drives these young children to present to a specialist for tonsil surgery to begin with is the same inflammation that impacts the gut later in life.”

Similarly, some studies suggest a higher incidence of asthma in children who had tonsil surgery. Conversely, a large study on children with severe asthma found that those who had undergone tonsillectomy experienced a notable reduction in asthma symptoms compared to those who had not. As Dr. Lando points out, large population studies spanning millions of individuals over decades can struggle with distinguishing causation from correlation. Nonetheless, she adds, while millions eat ice cream each summer, fortunately, there aren’t millions of shark attacks.