Having the need to constantly clear your throat can be commonly caused by acid reflux disease (GERD), mucus buildup from bronchiectasis, or new-onset seasonal allergies. Read now for more information on causes and how to treat excessive throat clearing.
6 most common cause(s)
Throat clearing symptoms
Clearing the throat is a functional response to irritating substances. However, excessive throat clearing can be irritating. Several structures from the respiratory and digestive system may be involved in underlying causes of throat clearing, including the esophagus, larynx, and vocal cords. In many cases treatment for an underlying medical condition will be required to relieve excessive throat clearing.
Common accompanying symptoms of throat clearing are
Symptoms that can be associated with throat clearing include:
- Hoarseness
- Noisy breathing
- Sore throat
- Runny nose and congestion
- Difficulty swallowing
- Feeling that food is stuck in the chest
- Feeling drainage in the back of the throat
- Cough
- Heartburn
- Bad breath
- Tics: Making other movements or sounds that are difficult to control
Throat clearing causes
Gastrointestinal problems
Gastrointestinal causes of throat clearing may include the following.
- Reflux: When contents of the stomach re-enter the esophagus after meals, food particles and stomach acid can end up in the larynx and vocal cords. This results in irritation and damage over time, and frequent throat clearing is common along with sore throat and hoarseness.
- Swallowing disorders: Difficulty swallowing food completely due to structural or neurological abnormalities of the esophagus can cause regurgitation of food particles. The resulting irritation of the throat leads to excessive throat clearing. Bad breath and coughing may also occur.
Respiratory problems
Certain respiratory problems may lead to throat clearing, such as the following.
- Postnasal drip: Nasal drainage into the back of the throat causes irritation that commonly results in chronic cough and throat clearing. This condition can occur due to environmental allergies or a respiratory infection.
- Larynx and vocal cord conditions: Structural abnormalities of the vocal cords, such as polyps or nodules, can cause throat clearing along with voice changes and noisy breathing. Chronic inflammation of the larynx, which may be due to allergens in the environment and/or postnasal drip, can also cause throat clearing symptoms.
- Lung conditions: Medical conditions involving the lungs, including chronic bronchitis and asthma, can be associated with throat clearing. Other symptoms such as difficulty breathing and coughing will be present.
Other throat clearing causes
Other causes of throat clearing may include the following.
- Tic disorders: Certain neurological disorders including Tourette syndrome cause involuntary movements and vocalizations called tics. Examples of tics include throat clearing, shrugging, and sniffing.
- Medications: Inhaled steroids and certain blood pressure medications can cause throat clearing as a side effect.
- Habit: Some people develop habitual throat clearing due to the perception of an irritating sensation, even without any underlying medical condition causing throat irritation.
This list does not constitute medical advice and may not accurately represent what you have.
Viral throat infection
A sore throat is most often caused by the same viruses that cause influenza and the common cold. The illness spreads when an infected person coughs or sneezes, and then someone else inhales the airborne virus or touches a surface where it has landed.
Those most at risk for viral sore throat are children, smokers, those who work indoors with others, and anyone with a weakened immune system.
Symptoms include throat irritation; pain when swallowing or talking; red, swollen tonsils; fever; body aches; and cold-like symptoms of cough, sneezing, and runny nose.
If symptoms do not clear up within 24 hours – especially in children – a medical provider should be seen. A persistent sore throat can be a symptom of serious illness such as mononucleosis, measles, chickenpox, or croup.
Diagnosis is made through physical examination and throat swab.
Treatment involves rest, fluids, and over-the-counter pain relievers. Do not give aspirin to children. Antibiotics only work against bacteria and cannot help against a viral illness.
The best prevention is frequent and thorough handwashing.
Post-infectious cough
Post-infectious cough is a cough that begins with a cold or other upper respiratory infection, but does not clear up when the infection does. Instead, it lingers for three weeks or more and becomes chronic.
Most susceptible are smokers, because the irritation from the smoke provokes the cough. Other common causes are post-nasal drip, asthma, and some high blood pressure medications.
Symptoms include an irritating sensation in the throat that may provoke severe bouts of coughing. Some coughing is normal and is part of the body's mechanism to clear the air passages and expel any foreign material, but such a cough should only be brief and intermittent.
A post-infectious cough can interfere with quality of life. A medical provider should be seen for help with the condition, both to ease the symptoms and to rule out a more serious cause for the coughing.
Diagnosis is made through patient history, physical examination, and chest x-ray, with the goal of ruling out different conditions one by one until the actual cause is found and can be treated.
Rarity: Uncommon
Top Symptoms: cough, congestion, clear runny nose, mucous dripping in the back of the throat, hoarse voice
Symptoms that always occur with post-infectious cough: cough
Symptoms that never occur with post-infectious cough: fever
Urgency: Phone call or in-person visit
New-onset seasonal allergies
New-onset seasonal allergies, also called adult-onset seasonal allergies, are sensitivities to pollen, mold, and other irritants that cause nasal congestion, runny nose, sneezing, itchy eyes, and sore throat.
Seasonal allergies commonly begin in childhood but can start at any age, especially among those with a family history. Moving to a different geographic location may trigger the allergy in someone with a genetic predisposition. Anyone with asthma is more likely to experience adult-onset seasonal allergies.
Sometimes the symptoms are actually from "pregnancy rhinitis" – nasal congestion and sneezing due to the effects of pregnancy hormones on the nasal tissue.
A new-onset allergy is often thought to be a cold, but a cold will clear up without treatment. Allergies persist, never getting better or worse, and can interfere with quality of life.
Diagnosis is made by an allergist, who will use skin tests and blood tests.
There is no cure for seasonal allergies but the symptoms can be managed for greater comfort and relief. Antihistamines, corticosteroid nasal sprays, and immunotherapy or "allergy shots" can be very effective.
Rarity: Common
Top Symptoms: sore throat, congestion, cough with dry or watery sputum, mucous dripping in the back of the throat, fatigue
Symptoms that never occur with new-onset seasonal allergies: fever, yellow-green runny nose, chills, muscle aches
Urgency: Self-treatment
Foreign body aspiration
Foreign body aspiration can be a life-threatening emergency. An aspirated solid or semisolid object may lodge in the larynx or trachea. If the object is large enough to cause nearly complete obstruction of the airway, asphyxia may rapidly cause death.
Call 911 immediately. If someone has been trained for this, the Heimlich maneuver should be attempted to expel the foreign object.
Rarity: Ultra rare
Top Symptoms: cough, fever, shortness of breath, cough with dry or watery sputum, wheezing
Symptoms that always occur with foreign body aspiration: swallowing of something potentially harmful
Urgency: Emergency medical service
Bronchitis
Bronchitis is an inflammation of the bronchial tubes, the tiny airways in the lungs.
Acute bronchitis, or "chest cold," comes on suddenly and is caused by the same virus that causes the flu or the common cold. Chronic lasts at least three months and recurs over two years. It is caused by cigarette smoking and/or exposure to other pollutants.
Other risk factors are weakened immune system and gastric reflux (heartburn.)
Symptoms include cough with clear, greenish, or yellowish mucus; fatigue; mild headache; body aches; shortness of breath; low-grade fever; chest discomfort.
Acute bronchitis can lead to pneumonia. Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD) and requires medical treatment.
Diagnosis is made with chest x-ray and sputum test.
Acute bronchitis lasts 7 to 10 days and needs good supportive care – rest, fluids, and over-the-counter pain relievers. Antibiotics do not work against viral illness.
Chronic bronchitis is treated with lifestyle changes – especially smoking cessation – and an inhaler or other lung medication.
Flu shots, frequent handwashing, and not smoking are the best prevention.
Bronchiectasis
Bronchiectasis is destruction and widening of the large airways. Mucus builds up in these airways and can get infected, causing a pneumonia.
You should visit your primary care physician within the next 24 hours if you might have an infection. Diagnosis involves a chest X-ray, sampling phlegm, blood tests, and other possible tests. Treatment is mostly coaching, actually, on exercises that strengthen your ability to cough up phlegm.
Rarity: Rare
Top Symptoms: cough, shortness of breath, wheezing, runny nose, mucous dripping in the back of the throat
Urgency: Primary care doctor
Adult-onset asthma
Asthma is a common ailment of children. Asthma is caused by hyperactive inflammation of the lung's airways.
You should visit your pediatrician to discuss the diagnosis of asthma, which requires a breathing test for confirmation. Upon diagnosis, your doctor will prescribe a treatment plan depending the severity of your symptoms. Typically an inhaled steroid (an inhaler) is prescribed. Your doctor will review how and when to use the inhaler.
Rarity: Uncommon
Top Symptoms: fatigue, wheezing, dry cough, shortness of breath at rest, shortness of breath on exertion
Urgency: Primary care doctor
Acid reflux disease (GERD)
Gastroesophageal reflux disease is also called GERD, acid reflux disease, and heartburn. It is caused by a weakening in the muscle at the end of esophagus. This allows stomach acid to flow backward, or reflux, up into the esophagus.
Risks factors for GERD include obesity, smoking, diabetes, hiatal hernia, and pregnancy.
Symptoms include a painful burning sensation in the chest and throat, and sometimes difficulty swallowing.
If heartburn occurs more than twice a week, a doctor should be consulted. If symptoms are accompanied by jaw or arm pain, and/or shortness of breath, these may be signs of a heart attack and constitute a medical emergency.
Repeated exposure to stomach acid damages the lining of the esophagus, causing bleeding, pain, and scar tissue.
Diagnosis is made by patient history and sometimes by x-ray, upper endoscopy, or other tests to measure refluxed acid.
Treatment begins with over-the-counter antacids and lifestyle changes. Medication may be used to reduce stomach acid, and surgery may be done to strengthen the sphincter muscle at the lower end of the esophagus.
Throat clearing treatments and relief
The majority of causes of throat clearing do not require urgent evaluation. However, excessive throat clearing can be associated with respiratory conditions that have dangerous exacerbations.
When it is an emergency
Seek emergency treatment if you are having severe difficulty breathing.
At-home treatment
The following treatments for throat clearing can be tried at home and are likely to provide some relief.
- To alleviate reflux symptoms: Avoid eating meals late at night and cut back on spicy foods, caffeine, and alcohol.
- Cut back on smoking or quit: Ideally, quitting altogether will help with respiratory causes of throat clearing.
- To address postnasal drip: Several over-the-counter medications, including antihistamines, decongestants, and nasal steroid sprays can help with postnasal drip.
- Drink water: Try taking a sip of water when you experience the urge to clear your throat.
- To address trouble swallowing: If you experience difficulty swallowing, try eating slowly, taking smaller bites, and chewing food thoroughly.
Throat clearing treatment quiz
Take a quiz to find out how to treat your symptoms.
When to see a doctor
If at-home treatments are not enough, you should schedule an appointment. Also, make an appointment with your medical provider for the following.
- Strange sensation: Such as you have a feeling of something stuck in your throat or chest
- You have a chronic cough or difficulty breathing when you exert yourself
- You have previously been diagnosed with a chronic respiratory or gastrointestinal condition: And you are now are having worsening symptoms
- Social distress: Your throat clearing is causing personal discomfort and/or problems in social settings.
- You started a new medication: And the throat clearing has followed
- You have involuntary movements and vocalizations in addition to throat clearing: This may indicate another underlying condition in need of evaluation.
Your medical provider may prescribe one or more of the following treatments, depending on the cause of your throat clearing symptoms:
- Inhalers and possibly also oral steroids: These are used to treat asthma or chronic bronchitis.
- Medication to prevent tics such as throat clearing: If they are impairing daily functioning.
- Stopping a medication that may be causing throat clearing
- Medication to decrease stomach acid: In order to reduce the negative effects of reflux.
- Referral for surgical management of gastrointestinal disorders: If more conservative treatments are not effective.
- Referral to a "vocal hygiene" program: This is to help eliminate habitual throat clearing.
FAQs about throat clearing
Can throat clearing be caused by allergies?
Yes, allergies can cause the need for throat clearing. Allergens inhaled from the environment, such as dust, can cause irritation of the larynx that leads to throat clearing. In addition, environmental allergies can cause post-nasal drainage associated with chronic nasal discharge and congestion. The presence of drainage in the throat triggers coughing and throat clearing.
Could a new medication be causing my throat clearing?
Certain medications can cause throat clearing as a side effect. A class of blood pressure and heart medications called ACE (angiotension converting enzyme) inhibitors can cause coughing and throat clearing due to a buildup of substances that irritate the airways. Inhaled steroids can also cause throat clearing; in this case, the medication causes direct irritation to the larynx.
How can I get rid of the urge to clear my throat?
If throat clearing is a side effect of a medication, stopping the medication will lead to eventual improvement. Treatment for allergies or an underlying medical condition contributing to throat clearing will also help. Sometimes throat clearing becomes a habit, in which case taking a sip of water as a replacement can help get rid of the urge. For many causes of throat clearing, avoiding environmental irritants such as cigarette smoke will lead to improvement.
Can throat clearing be caused by GERD?
Yes, excessive throat clearing can be a symptom of GERD. Gastroesophageal reflux disease is a condition where acid and food particles from the stomach re-enter the esophagus. Although GERD is usually associated with heartburn, for some people, other symptoms due to irritation of the larynx are more prominent. Laryngeal symptoms include throat clearing, hoarseness, and coughing.
Can respiratory problems contribute to throat clearing?
Yes, problems with various parts of the respiratory tract can cause a need for excessive throat clearing. Asthma and chronic bronchitis can both cause throat clearing along with the more common symptoms of cough and difficulty breathing. In addition, the vocal cords and larynx can be irritated by voice overuse or reflux from the stomach, leading to throat clearing as well as hoarseness. The uppermost part of the respiratory tract can be affected by post-nasal drip, usually due to allergies or a respiratory infection. In this case, irritation of the throat triggers throat clearing.
Questions your doctor may ask about throat clearing
- Do you have a cough?
- Any fever today or during the last week?
- Do you currently smoke?
- Do you burp up food or liquids after a meal?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
- Chronic Throat Clearing and Silent Reflux. Mount Sinai Inside. Published Aug. 7, 2012. Mount Sinai
- Laryngeal Pharyngeal Reflux. International Foundation for Gastrointestinal Disorders. Updated Feb. 10, 2016. About Gerd Link
- Swallowing Disorders in Adults. American Speech-Language-Hearing Association. ASHA Link
- Post-nasal Drip. American Academy of Otolaryngology Head and Neck Surger: ENT Health. ENT Health Link
- Bonilha HS, Gerlach TT, Sutton LE, Dawson AE, Nietert PJ. Laryngeal sensation before and after clearing behaviors. J Voice. 2012;26(5):674.e1-7. NCBI Link
- Tourette Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke. NINDS Link
- Pinargote P, Guillen D, Guarderas JC. ACE inhibitors: upper respiratory symptoms. BMJ Case Rep. 2014;2014:bcr2014205462. Published July 17, 2014. NCBI Link