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Dr. Marcelo Campos works as a primary care doctor at Atrius Health. He is a lecturer at Harvard Medical School and a clinical assistant professor at Tufts University School of Medicine. Dr. Campos completed medical school …
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Ahem! Ahem! Ever feel the need to move the mucus that annoyingly sits all the way at the back of your mouth? Most of us do at one time or another. The sensation usually lasts for just a few days when dealing with symptoms of a common cold.
But what happens if throat clearing lingers for weeks or months? That nagging feeling may be uncomfortable for the person who has the problem, and might also bother friends and family who hear the characteristic growling sound.
So what causes all that throat clearing? There are many causes, but I’ll focus here on four of the most common culprits. It’s important to know that throat clearing lasting more than two to three weeks deserves an evaluation from a medical professional.
Post-nasal drip is probably the most common cause of throat clearing.
Your nose makes nasal mucus to help clear infections and allergens, or in response to irritants such as cold weather. A frequently runny nose can be quite disturbing. Just as mucus can drip toward the front of the nose, some mucus may also drip from the back of the nose toward the throat, sometimes getting close to the vocal cords. If the mucus is too thick to swallow, we try to force it out with a loud AHEM!
Solutions: The best solution to this problem is to treat the cause of post-nasal drip. An easy way to do it without medications is to try nasal irrigation with a neti pot. If you notice no improvement, different types of nasal sprays may help. It is best to discuss these options with a health professional, because some sprays may cause your symptoms to worsen. The key is to understand what is causing excess mucus production.
Another common cause of throat clearing is laryngopharyngeal reflux (LPR). Acid in your stomach helps digest food. But excess stomach acid sometimes flows backward up the tube called the esophagus that links throat to stomach. This may splash on the vocal cords or throat, causing irritation and throat clearing.
Not everyone with acid reflux experiences a burning sensation in the throat. Nor does everyone have heartburn, which is a classic sign of a related condition called gastroesophogeal reflux disease (GERD). Some people merely feel an urge to clear their throat or have a persistent cough.
Solutions: Eating an anti-reflux diet and not lying down shortly after eating may help in some cases. Often, people have to use medications for several weeks or months to lower stomach acid production.
A common class of heart and blood pressure medicines can also cause throat clearing. These are called ACE inhibitors. The funny thing is that these medications can trigger the urge even after years of people taking them daily without experiencing that symptom. If that’s the cause there is an easy fix. The sensation would be completely gone after stopping the medication, although in some cases it can take several weeks to abate. It is very important to talk to your doctor before stopping a prescribed medicine, so you can switch to something else.
Damaged nerves responsible for sensation around the throat area is another possible cause. These issues are more difficult to treat, and are usually diagnosed after most of the other possibilities are ruled out. People often have this type of throat clearing for many years.
Solutions: A multidisciplinary team with ear, nose, and throat doctors (otolaryngologists) and neurologists may need to investigate the problem. Medicines that change how a person perceives sensation can help.
There are many other reasons for throat clearing. Some people, for instance, just have a tic of frequently clearing their throat. Noticing any clues that point to the root cause can help. Maybe constant throat clearing happens only during spring, pointing toward allergies, or perhaps after drinking coffee, a reason to consider reflux.
An observant eye and jotting notes in a diary may help shine a light on the problem and its possible solutions. Very often, when the cause remains elusive, your primary care doctor may recommend a trial of treatment as a way to diagnose the problem.

Marcelo Campos, MD ,
Contributor

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California's premier laryngologist dedicated to helping patients with voice, swallowing, and breathing conditions.

Orange County Physician of Excellence 2015-2020
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NOTE : The information presented on this site is for educational purposes only, and is not intended to replace consultation with a qualified physician. It may not be appropriate to your individual case, and should not be used in making treatment decisions, especially with regard to medication. Considerable effort is made to ensure that the information on this site is accurate, but medicine is a changing field, and this website is not responsible for errors or omissions. Use of this website acknowledges the above.
Chronic throat clearing is a problem complained of by many people. Individuals clear their throat to loosen secretions which may be irritating the throat. Patients with chronic throat clearing often complain that phlegm or secretions that are sitting in the throat must be loosened.
Throat clearing is irritating for the individual who must do this often, in the middle of conversations, meals, or meetings.
Evaluation of an individual with throat clearing involves a full head and neck exam. Laryngoscopy and stroboscopy may be necessary to study the vocal folds and larynx. These examinations may be recorded to allow the patient to look at the throat anatomy as well.
Treatment of throat clearing depends on the cause. For cases of laryngopharyngeal reflux, dietary changes, behavioral modifications and medications may be used to control symptoms. Vocal fold paralysis and granulomas have both surgical and non surgical treatment options.
For patients without a defined cause of throat clearing, a physician may consider the idea that patients may have habitual throat clearing. Some individuals clear their throat during times of anxiety, stress, or nervousness. Others may clear their throats subconsciously, much like tapping fingers or shaking a leg. For those individuals “breaking the habit” may be difficult and require help of others, but in the long pays off.
Throatdisorder.com is an online resource for patients and physicians to learn more about common voice, swallowing, breathing and throat disorders. Throat complaints, from cough to cancer, are a common reason for patients to seek medical treatment. This website developed as a result of Dr. Sunil Verma's passions: that of education, patient care, and interest in technology.
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