Tonsil infections continue to be a common illness in children.

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A new study reports that individuals with tonsil infections may also have other chronic illnesses. This is significant, as it counters a 2018 study showing a link between having tonsil surgery and later developing chronic illnesses, implying that these illnesses were due to the surgery itself. Tonsillectomy used to be considered a rite of passage-- something to be done if any child developed sore throats, as the risk of complications from these throat infections was high.

With the advent of better and more targeted antibiotics in the late 20th century, tonsillectomy surgery fell by the wayside. A decade or two later, otolaryngologists (ear, nose and throat specialists) began encountering a new issue due to tonsils-- snoring and obstructive sleep apnea-- in children as young as two years old. This phenomenon led to a resurgence of tonsil surgery in recent decades, and it remains one of the most common surgeries performed in children. While recovery can be rough, with throat pain for one to two weeks, along with a 1 to 5% risk of postoperative bleeding, the health outcomes after tonsil surgery tend to be favorable, with improved sleep quality and reduced frequency of illness.

The 2018 study, looking at over 1 million children over a several decade period, reported a higher incidence of chronic respiratory illnesses in the children who had undergone tonsil surgery than those who had not. This raised a great deal of concern, as this quickly became a hot headline, erroneously linking tonsil surgery to causing lifelong illnesses down the line.

Dr. Tali Lando, a pediatric otolaryngologist and Assistant Professor of Clinical Otolaryngology at Touro College of Medicine, has been treating children in her surgical practice for several decades, and speaks and writes about how to decipher medical misinformation. She is very aware of how health information can get misconstrued, especially online: “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 explains, “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, published in the April 2026 issue of the Journal of Otolaryngology-Head and Neck Surgery, utilizes the UK Biobank, which followed nearly 500,000 individuals and their health status over several decades. The authors were able to determine that, indeed, those who had undergone tonsillectomy had a higher incidence of inflammatory disorders such as irritable bowel syndrome (IBS), but that these illnesses were linked to their history tonsil infections or tonsil enlargement, prior to any surgical intervention.

According to Dr. Lando, “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 report higher incidence of asthma in children who underwent tonsil surgery. On the other hand, a large study looking at children with a history of severe asthma found that those who underwent tonsillectomy surgery had substantial reduction in asthma symptoms compared to those who did not. As Dr. Lando stated, even large population studies, looking at millions of individuals over decades, can pose challenges regarding causation versus correlation. There is one caveat regarding all of the gray areas of causation and correlation here: millions of people eat ice cream each summer, but thankfully there are not millions of shark attacks.