Throat clearing is a common reflex involving a forceful expulsion of air through the vocal cords to dislodge mucus or irritants from the throat. While often unconscious, persistent throat clearing can become a bothersome habit. It attempts to alleviate a sensation of something present in the throat, even if nothing is physically there.
Understanding the Underlying Reasons
Persistent throat clearing often stems from post-nasal drip, where excess mucus flows down the back of the throat. This can result from conditions like allergies, acute sinusitis, or the common cold. The dripping mucus irritates the throat and vocal cords, triggering clearing.
Laryngopharyngeal Reflux (LPR), also known as silent reflux, is another common cause, differing from typical heartburn. In LPR, stomach acid and digestive enzymes travel up to the throat and voice box, causing irritation without the burning sensation of typical heartburn. This acid exposure can cause a constant feeling of a lump or excessive mucus, prompting throat clearing.
Environmental or food allergies can also provoke throat clearing by causing inflammation and increased mucus production. Allergic reactions can lead to a sensation of tickling or irritation in the throat, which individuals try to alleviate by clearing.
Vocal cord issues can contribute to persistent throat clearing. Overuse or misuse of the voice can lead to chronic irritation or the development of benign growths like nodules or polyps. These physical changes can alter vocal cord function and create a sensation requiring throat clearing.
Sometimes, throat clearing can become a learned or habitual behavior, even after an initial irritant has resolved. This is known as psychogenic throat clearing and may be exacerbated by stress or anxiety. The act can provide temporary relief, reinforcing the behavior even without a physical need.
Insufficient hydration or dry environmental conditions can lead to a sensation of dryness or stickiness in the throat, prompting throat clearing. Certain medications, such as angiotensin-converting enzyme (ACE) inhibitors, can cause a dry cough or throat clearing as a side effect.
While less common, persistent throat clearing can occasionally signal more serious underlying conditions, including certain neurological disorders or tumors in the throat or neck. Medical evaluation is important if symptoms are prolonged or accompanied by other concerning signs.
Recognizing When to See a Doctor
Consulting a medical professional is advisable if throat clearing persists for more than a few weeks without improvement. Chronic symptoms warrant further investigation.
Medical attention is recommended if throat clearing is accompanied by other concerning symptoms. These include persistent hoarseness, difficulty swallowing (dysphagia), unexplained throat or ear pain, or unintended weight loss. Blood in mucus or a persistent, unexplained cough alongside throat clearing also warrants medical evaluation.
If constant throat clearing significantly impacts daily life, interferes with sleep, or causes social embarrassment, a doctor’s visit is advised. Even without severe symptoms, chronic throat clearing’s disruptive nature justifies professional assessment. If over-the-counter remedies or lifestyle adjustments provide no relief, a medical understanding of the cause may be necessary.
Medical Diagnosis and Evaluation
A medical professional will begin by taking a detailed medical history to understand the throat clearing’s duration, nature, associated symptoms, and contributing factors. This is followed by a physical examination, often including a focused head and neck examination.
Depending on initial findings, a doctor might refer the individual to an Ear, Nose, and Throat (ENT) doctor, an otolaryngologist. The ENT can conduct specialized diagnostic procedures to identify the throat clearing’s origin.
Laryngoscopy is a common diagnostic procedure, using a thin, flexible tube with a light and camera to visualize the vocal cords and throat directly. This checks for inflammation, irritation, or structural abnormalities like nodules or polyps. For suspected allergies, allergy testing may be performed to identify specific environmental or food triggers.
When LPR is suspected, pH monitoring can be used to measure acid levels in the esophagus and throat over 24 hours. In rare cases, for serious conditions like neurological disorders or tumors, imaging studies like X-rays or CT scans may be ordered to provide detailed images.
Strategies for Relief and Management
Maintaining adequate hydration helps manage throat clearing by keeping mucous membranes moist and reducing irritation. Drinking plenty of water throughout the day can thin mucus, making it less likely to adhere to the throat. Avoiding environmental irritants like tobacco smoke, excessive dust, or known allergens can also reduce throat irritation.
Dietary adjustments are helpful for managing throat clearing related to LPR. This often involves avoiding acidic foods like citrus fruits and tomatoes, plus fatty, spicy, and fried foods that can trigger acid reflux. Eating smaller, more frequent meals and avoiding eating close to bedtime can also help minimize acid reflux into the throat.
For throat clearing stemming from allergies, medical treatments may include antihistamines to reduce allergic reactions and mucus production. For inflammation, a doctor might prescribe corticosteroids, oral or nasal spray, to reduce swelling and irritation in the throat and nose. For LPR, proton pump inhibitors (PPIs) or antacids are commonly prescribed to reduce stomach acid production.
Behavioral therapy or speech therapy can effectively treat habitual or psychogenic throat clearing. These therapies increase awareness of the habit and teach alternative behaviors, such as sipping water or swallowing, to replace clearing. Vocal exercises and techniques to reduce vocal cord strain may also be introduced.