Bleeding After a Tonsillectomy

Some people experience bleeding after a tonsillectomy. Small amounts of dark red blood in saliva or vomit is usually not a concern. Bright red bleeding, however, often requires immediate medical attention. Major arteries are very close to the tonsils, so blood loss can be substantial.

You may see or taste blood, or you may only notice that you feel the need to swallow more often than usual. It's important to be aware of these signs of bleeding after tonsillectomy and know when treatment is needed.

This article discusses bleeding after tonsillectomy, what to do when it happens, and other possible complications of tonsil removal surgery.

Bleeding after tonsillectomy
Illustration by Joshua Seong. © Verywell, 2018. 

Signs of Bleeding After Tonsillectomy

Signs of bleeding after a tonsillectomy include:

  • Bright red blood coming from the mouth or nose
  • Frequent swallowing
  • Spitting out bright red blood
  • Tasting blood/a metallic taste in the mouth

It is normal to see a few specs or streaks of red blood in your saliva, especially just after the procedure or as the scabs start to fall off.

You may also swallow blood during a tonsillectomy and then vomit old blood the day of surgery. Old blood is dark brown in color and is sometimes described as looking like coffee grounds.

Severe vomiting containing significant amounts of blood, however, is a sign of a more serious problem.

When Bleeding Might Occur After Tonsil Removal

Generally speaking, this procedure is a very safe one. If bleeding after tonsillectomy is going to occur, it is most likely to start after surgery or about a week later when the scabs come off. Bleeding can also occur at any point in the recovery process, which takes around two weeks.

You may hear your healthcare provider refer to primary hemorrhage or secondary hemorrhage. This refers to is the length of time that passed before bleeding occurred:

  • Primary hemorrhage is bleeding that occurs within 24 hours after a tonsillectomy.
  • Secondary hemorrhage is bleeding that occurs more than 24 hours after a tonsillectomy.

When to See a Healthcare Provider

If you see more than just a few specs or streaks of blood but the bleeding does not seem to be constant or heavy, call your healthcare provider right away.

When Emergency Care Is Needed


Call 911 or go to the emergency room at once if you notice or experience:

  • Severe bleeding
  • Continuous bleeding
  • Sudden increase in bleeding
  • Severe vomiting or vomit that contains blood clots
  • Tonsil beds covered with bright red blood
  • Bright red streaks running down the back of your throat

The tonsil beds are the fleshy pads on either side of your throat where your tonsils were removed. To examine them, push your tongue down with a tongue depressor or popsicle stick and shine a flashlight in your mouth. You might ask a friend or loved one to help with this.

While tonsil beds covered with bright red blood are a concern, know that white or dark brown coloring in the days after surgery is normal.

Treating Bleeding After Tonsillectomy

Minor bleeding after tonsillectomy does not usually require treatment. Your healthcare provider may recommend gargling cold water to help control the bleeding. Keep your head elevated until the bleeding subsides.

Severe bleeding after tonsillectomy can be stopped by cauterizing the tonsil beds. During this procedure, heat is applied to the area to seal the blood vessels and stop the bleeding. In some cases, you may be kept in the hospital overnight.

Other Potential Complications

Bleeding is the most common and severe complication to a tonsillectomy. There are, however, other complications that you should look out for.

Contact a healthcare provider if you notice any of the following, with or without bleeding:

  • Dehydration
  • Difficulty breathing
  • Infection

Summary

Tonsillectomy is among the most common surgeries in the world. Many people have their tonsils removed every day in the United States and most do just fine. Sometimes, though, complications like bleeding can occur.

If you notice signs of bleeding after your tonsillectomy, such as bright red blood coming from your mouth or nose, frequent swallowing, or the taste of blood, seek medical attention right away.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. University of Iowa Health Care. Tonsillectomy bleed (hemorrhage) management (post-tonsillectomy hemorrhage).

  2. Children’s Minnesota. Patient & family education materials, Tonsillectomy: information.

  3. Richardson M, Friedman N. In: Clinician's guide to pediatric sleep disorders. Boca Raton, FL: CRC Press; 2016.

  4. Pope, J. MyHealthAlberta. Problems after tonsillectomy in children: care instructions.

Additional Reading
Kristin Hayes

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.