Chronic throat clearing is your body’s natural response to irritants, but may require medical care if persistent

Dr. Rachel Jonas
University of Kentucky

“Ahem!” Clearing your throat occasionally can be a simple way to get someone’s attention. However, when it happens repeatedly, it may be a sign of chronic throat clearing.

Chronic throat clearing is a common problem that may be associated with a throat tickle, dry cough or the sensation of a “lump” in the throat. When throat clearing is persistent, it may require medical evaluation.

In general, chronic throat clearing is usually the result of hypersensitivity in the larynx (voice box) and pharynx (throat). Clearing your throat is usually your body’s response to this irritation and an effort to remove the irritation by rubbing your vocal folds (vocal cords) together. Chronic throat clearing often creates more irritation to the vocal folds because of the harsh contact, resulting in a cycle of frequent persistent throat clearing.

Chronic throat clearing can be frustrating and difficult to ignore. Understanding what it is — and what may be causing it — is the first step toward relief.

What is chronic throat clearing?

Often, patients with chronic throat clearing describe a sensation of mucus in the throat and clear their throat in an attempt to get rid of it. Throat clearing may occur a few times per day, several times per hour or only after meals.

It may also be accompanied by symptoms such as:

When throat clearing becomes frequent or persistent, medical evaluation may be needed.

Why does throat clearing become a problem?

One of the most important things to understand about chronic throat clearing is that it often becomes cyclical.

A patient may initially clear their throat because there truly is something irritating the vocal cords. Throat clearing may briefly relieve this irritation.

However, frequent throat clearing can inflame the delicate tissues of the vocal cords. The body then senses this inflammation as a new irritant and responds by clearing the throat again, creating an ongoing cycle.

Chronic throat clearing is often related to irritable larynx syndrome, an umbrella term used to describe hypersensitivity of the voice box, or larynx.

A helpful way to think about this condition is like a car alarm. You want your car alarm to go off if someone is trying to break into the car — but not when a leaf falls on it. Similarly, throat clearing is meant to protect the airway when something dangerous is present, such as food or liquid about to enter the lungs.

With irritable larynx syndrome, the throat may overreact to minor triggers like saliva, dust or smoke.

Common causes of chronic throat clearing

The causes of chronic throat clearing vary from person to person and should be determined through medical evaluation. Common contributors may include:

Because these causes differ greatly, a comprehensive evaluation is important to determine the most appropriate treatment.

How is chronic throat clearing evaluated and treated?

Diagnosis often begins with a primary care provider or allergist. If typical treatments for allergies or reflux are not successful, referral to an ear, nose and throat (ENT) physician may be recommended, along with evaluation by a speech-language pathologist who specializes in voice and swallowing disorders.

If empiric reflux medication prescribed by a primary care provider does not improve symptoms, further evaluation may help determine whether reflux is truly the cause. This may include a laryngoscopy, in which a thin, flexible camera is passed through the nose to examine the throat and vocal cords. Signs of reflux-related irritation can sometimes be seen during this exam.

Treatment options may include:

Dr. Rachel Jonas, M.D., is an otolaryngologist at the University of Kentucky Ear, Nose and Throat Clinic.