We all clear our throats sometimes without giving it much thought. We may do it to get someone’s attention, to clear our throats of mucus or the feeling that something’s stuck, or it may be a nervous habit.

While there are several reasons for throat clearing, when it becomes a chronic occurrence, it can cause problems, including damage to your vocal cords. 

So what are the underlying causes of chronic throat clearing, and what can we do about it?

Why We Clear Our Throats & When It Becomes a Problem

When we clear our throats, we are transferring mucus out of our airway and into the throat. It’s normal for us to secrete up to two liters of mucus per day! Throat clearing can become excessive when mucus is too thick or copious. 

When this throat-clearing process happens over and over again, it can cause redness and swelling of your vocal cords. If the clearing is very extensive, small growths called granulomas can form. If these granulomas get large, they can affect your breathing and your voice and may require surgery for removal. 

In addition, the irritation and swelling produced by chronic throat clearing can cause even more mucus production, which causes more throat clearing. As you can see, it can become a never-ending cycle. Without a conscious effort to break the cycle, chronic throat-clearing will likely continue. 

What Conditions Can Cause Chronic Throat Clearing?

Keep in mind that chronic throat clearing itself isn’t really a diagnosis. It’s a symptom of an underlying condition. Some of those might include:

1. Reflux

Laryngopharyngeal reflux (LPR) is a condition in which stomach acid escapes out of the stomach and goes into the esophagus and throat. The acid irritates the throat, the vocal cords, and even the nasal passages. It may result in voice problems, swallowing problems, sinus drainage, and the frequent need to clear the throat. The most effective treatment is usually a combination of medication and lifestyle changes, such as avoiding certain types of food and drink, reducing stress, and losing weight.

2.  Postnasal drainage

Another common cause of throat clearing is postnasal drainage, also called postnasal drip. Postnasal drip happens when your body starts producing extra mucus. You may feel it dripping down your throat from the back of your nose. Other symptoms may include cough, nausea, sore throat, and bad breath. Allergies are a common cause, along with viral infections, sinus infections, dry air, and changes in the weather.

Treatment for postnasal drip varies depending on the cause. If it’s related to allergies, avoiding the allergen or taking medications may stop the drip. Other treatments may include over-the-counter decongestants, antihistamines, saline nasal sprays, and staying hydrated.

3.  Allergies

Nasal allergies and food allergies can contribute to frequent throat clearing. In some cases, a food allergy or sensitivity may cause a tickling in your throat that makes you clear it. Dairy is a frequent cause, but foods such as eggs, rice, and soy may also be culprits. The treatment in such cases is avoiding the food that leads to symptoms.

Nasal allergies occur when the body’s immune system overreacts to the presence of substances, called allergens, that are usually harmless. Common allergens include pollen, dust, and animal dander. Nasal allergies can lead to excess mucus production, which can cause frequent throat clearing. Antihistamines, nasal sprays, and nasal rinsing can help with allergies, as well as avoiding the allergens when possible.

4.  Side Effect of Medication

Some blood pressure medications can cause a tickle in your throat that contributes to chronic throat clearing and chronic cough. If you’re taking blood pressure medication and are frequently clearing your throat, talk to your doctor about a potential substitute.

5.  Habit

Sometimes, there may be no underlying condition causing throat clearing. It can become a habit or something you subconsciously do when anxious or stressed. To break the habit, you can drink more fluids, ask someone to help you monitor your throat clearing, or look for an alternate activity to do when the need to clear your throat arises, such as tapping your fingers. Stress management can also be very helpful.

6.  Swallowing Problems

Swallowing problems can arise for many reasons, and there are many ways to address them, depending on the exact situation. In general, difficulty swallowing can lead to throat irritation and frequent throat clearing as well as hoarseness, coughing, and choking when eating.

7. Vocal Cord Growths

When abnormal growths, such as polyps, nodules, or cysts grow on the vocal cords, you may feel as though something unusual is in the back of the throat. If you do not know that this is a physical growth, you may try to clear your throat in an attempt to dislodge the perceived object.

Causes of these growths can include smoking; allergies; overusing or straining the vocal cords from excessive singing or shouting; and frequent or strenuous coughing.

Treatment for Chronic Throat Clearing

Long-term treatment for chronic throat clearing depends on determining the underlying condition causing it. Treatment may include lifestyle changes, medications, or, in some cases, surgery.

Here are a few general tips for the treatment and prevention of chronic throat clearing:

• Drink plenty of water to keep the throat moist, which may relieve or lessen the feeling that something has become lodged in the throat. When you feel like you want to clear your throat, take a sip of water instead. Also, increase your water intake to help thin mucus and make it easier to swallow.
• Eat and chew slowly if you have difficulty swallowing.
• Use a humidifier to keep the air moist, which may help reduce throat irritation.
• Clear your throat as few times as possible. Instead of clearing your throat, hold your breath and swallow.

Find the Cause of Chronic Throat Clearing at Excel ENT of Alabama

Our Speech-Language Pathologist, Amy Pittman, is an expert at working with patients to find the cause of chronic throat clearing and treating the underlying condition. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

A cough that just won’t go away is one of the most common reasons for a visit to the doctor. Many people initially visit their primary care physician, but if the issue isn’t easily resolved, other doctors and specialists may become involved, such as allergists, pulmonologists, otolaryngologists (ENT), and speech-language pathologists (SLP), such as Excel ENT’s SLP, Amy Pittman.

Amy sees patients often who complain of a chronic cough. It’s annoying for the person experiencing it and others in the home, and it can disrupt sleep and cause headaches. We’re thankful that there are many ways in which Amy can help get to the bottom of the cause and find an effective solution.

Definition & Causes of Chronic Cough

According to the American Speech-Language Hearing Association, coughing helps you clear your throat and lungs and can prevent infection. But sometimes a cough can become chronic, lasting more than four weeks in children and more than eight weeks in adults. Aside from the extended duration of the cough, signs and symptoms include the frequent need to cough and having a rough-sounding voice due to that frequent coughing.

Chronic cough can be tricky because there are several possible causes. Here are the most common ones we see.

Postnasal Drip

Also called upper airway cough syndrome, postnasal drip is a common cause of a persistent cough. When a virus, allergies, dust, chemicals, or inflammation irritate your nasal membranes, they make runny mucus that drips down your throat. This makes you cough, especially at night when you lie down.

Asthma

When you have asthma, the muscles around your airways tighten, the lining of your airways swells, and cells in your airways produce thick mucus. Coughing is your body’s way of trying to get air into those restricted areas and can be triggered by infections, weather, allergies, tobacco smoke, medications, exercise, and emotions.

Infections

After you have recovered from a cold, flu, or pneumonia, you may continue to have a cough as your body completely heals and gets over the infection. COVID-19, the illness caused by SARS-CoV-2, sometimes leads to lasting lung inflammation and a lingering dry cough. The prolonged cough from COVID-19 is no different than any other virus that affects your lungs. The injured parts of your lungs are trying to clear out the infection and heal.

Laryngopharyngeal Reflux (LPR)

LPR, sometimes confused with gastroesophageal reflux disease (GERD), is a condition in which acid escapes from the stomach and goes into the esophagus and throat. This causes irritation to the throat, vocal cords, and even the nasal passages. It may result in voice problems, swallowing problems, sinus drainage, the frequent need to clear the throat, and chronic cough. 

Blood Pressure Medications

ACE inhibitors for blood pressure can cause a chronic dry cough. When a patient has a persistent cough and takes an ACE inhibitor, a slight change in medication often helps resolve the cough.

Smoking

Smoking damages your lungs, as well as the rest of your body. Smokers often experience chronic cough because chemicals and particles in tobacco smoke irritate the lungs. In response, the body makes mucus to try to get rid of it through frequent coughing. In all situations, we recommend stopping smoking to address a chronic cough and for many other reasons.

Irritable Larynx Syndrome (ILS)

ILS involves a range of conditions including chronic throat clearing, chronic cough, and others. With ILS, the larynx (voice box) becomes very sensitive to stimuli, such as strong smells, cold air, talking, and more. There are several possible causes, including viral illnesses that cause inflammation of the nerve that supplies the voice box, GERD, allergies, sinusitis, certain medications, environmental exposures, and stressful life occurrences.

Symptoms of ILS usually last longer than three weeks and have no other identifiable cause. Symptoms may include frequent non-productive throat clearing, chronic coughing attacks that bring up little or no mucus, and difficulty breathing with the sudden onset of stridor (noisy breathing).

Testing & Treatment for Chronic Cough

Our SLP, Amy Pittman, will likely work with you to get a comprehensive history regarding your chronic cough. She may perform a thorough laryngoscopic and stroboscopic examination to visualize patterns of vocal fold motion and vocal fold vibration. She may also test your voice to see if there are any changes in vocal quality that the cough might be causing.

We can work to find out more about what triggers your cough so that you can avoid those triggers. In some cases, treatment is straightforward, such as recommendations to stop smoking or making changes to medications. In other cases, you may need treatment for medical conditions, such as allergies, asthma, or LPR if those are triggers for your chronic cough. 

Many times, the goal of treatment for chronic cough is to give you the tools to better manage it, and Amy can teach you more about keeping your vocal cords healthy.

Address Chronic Cough with Excel ENT of Alabama

We are happy to answer questions about chronic cough and other ear, nose, and throat issues. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.

When you think of “good hygiene” you may immediately come up with washing your hands, brushing your teeth, showering often, and keeping your nails clipped. But did you realize that there is such a thing as “vocal hygiene,” and that it’s very important for your ability to speak and communicate?

We use our voices constantly, although some jobs, professions, and roles may require more speaking. We all have the risk of developing voice problems, but people who use their voices more often may have an increased risk. An estimated 17.9 million adults in the U.S. report problems with their voice, but some of these disorders can be avoided by taking care of your voice, according to the National Institute on Deafness and Other Communication Disorders.

So what should you be on the lookout for, and how can you keep your voice healthy?

What Is Vocal Hygiene?

Your vocal cords are two tiny muscles covered with layers of tissue, and they are very delicate. When you speak, your vocal cords vibrate to produce sound. Any problems with the vocal cords significantly impact the voice. This might include growths on the vocal cords, infections, or improper use of the vocal musculature.

Good vocal hygiene encourages your vocal cords and voice are working properly with no problems. Signs that you have a voice problem might include:

• Hoarse or raspy voice
• Lost ability to hit some high notes when singing
• Voice that suddenly sounds deeper
• Throat that often feels raw, achy, or strained
• Talking has become an effort
• Repeatedly feeling the need to clear your throat

What Causes Voice Problems?

There are many things that can cause voice problems such as:

• Upper respiratory infections
• Inflammation caused by gastroesophageal reflux (sometimes called acid reflux, heartburn, or LPR)
• Vocal misuse and overuse
• Growths on the vocal folds, such as vocal nodules or laryngeal papillomatosis
• Cancer of the larynx
• Neurological diseases (such as spasmodic dysphonia or vocal fold paralysis)
• Psychological trauma

Most voice problems can be reversed by treating the underlying cause or through a range of behavioral and surgical treatments. In some cases you have little or no control over what’s happening to your voice, but in other instances, there are several healthy habits that will help you have good vocal hygiene.

Improve Your Vocal Hygiene

• Stay hydrated — Drink plenty of water, especially when exercising. If you drink caffeinated beverages or alcohol, balance your intake with plenty of water.
• Take vocal breaks — Rest your voice throughout the day.
• Use a humidifier in your home — This is especially important in winter or in dry climates.
• Avoid or limit use of certain medications — Some medications may dry out the vocal folds, including some common cold and allergy medications. If you have voice problems, ask your doctor which medications would be safest for you to use.
• Don’t smoke and avoid second-hand smoke — Smoke irritates the vocal folds. Also, cancer of the vocal folds is seen most often in individuals who smoke.
• Avoid spicy foods — Spicy foods can cause stomach acid to move into the throat or esophagus, causing heartburn or laryngopharyngeal reflux (LPR).
• Eat healthy foods — Include plenty of whole grains, fruits, and vegetables. These foods contain vitamins A, E, and C that help keep the mucus membranes that line the throat healthy.
• Hand hygiene — Wash your hands often to prevent getting a cold or the flu.
• Get enough rest — Physical fatigue has a negative effect on voice.
• Exercise regularly — Exercise increases stamina and muscle tone which will help provide good posture and breathing, which are necessary for proper speaking.
• Try not to overuse your voice — Avoid speaking or singing when your voice is hoarse or tired.
• Avoid using the extremes of your vocal range — This includes screaming or whispering, both of which can stress your voice. Consider using a microphone when appropriate.
• Practice good breathing techniques — When singing or talking, support your voice with deep breaths from the chest, and don’t rely on your throat alone. Talking from the throat, without supporting breath, puts a great strain on the voice.

Let Excel ENT Help You Improve Your Vocal Hygiene

No matter what voice problems you may be experiencing, our Speech-Language Pathologist, Amy Pittman, is experienced in treating voice problems, and she can teach you how to use your voice in a healthy way.

She may conduct an examination using video laryngoscopy to see your throat, larynx, and vocal cords. The short procedure involves putting a tiny camera through the lower nasal passage to reach the throat. You will be awake so that you can speak, which helps Amy see the vocal cords while they vibrate and move. The procedure isn’t painful and lasts less than one minute.

Amy will be able to see if there are any growths or signs of an infection. She also watches how you use your voice and whether there’s tension in the muscles. Then, she’s able to determine whether you would benefit from voice therapy or if other medical or surgical treatment is needed.

If you or your loved one are experiencing voice problems, we can help. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.