Throat Clearing

WHEN TO SEE YOUR DOCTOR

* Your repeated throat clearing has persisted for a week or more.

* Clearing your throat is disturbing your sleep or affecting your speech.

* Your throat clearing has begun to cause hoarseness or pain in your throat.

* You also have trouble breathing or swallowing.

What Your Symptom Is Telling You

Ahem. Clearing your throat is a time-honored way to draw polite attention. Just ask Miss Manners. But you may be clearing your throat so often that it's drawing negative attention. Perhaps a family member is wondering if you have some kind of throat problem. It's even starting to annoy you.

Chances are, it's just a habit that got started when you had an upper respiratory or throat infection a while back. Even though the original secretions that produced the tickle were over, you continued to clear your throat. That repeated throat clearing has been banging your vocal cords together, and when they meet so forcefully, they swell and create the sensation that something is still there in your throat. Your response? Ahem-and-ahem—more swelling, more sensation, and the cycle goes on.

Another common cause of throat clearing is acid reflux—excess stomach acid that creeps up the esophagus and irritates your throat, usually while you sleep. You may have reflux even without experiencing heartburn, doctors say.

Inadequate fluid intake and smoking can also dry and irritate the throat, prompting you to clear it. A good case of stage fright can do the same thing.

Aging can also have a drying effect on mucous membranes and prompt throat clearing. And if you've undergone radiation therapy, that may have dried your throat as well.

Symptom Relief

There's a lot you can do to clear up a throat-clearing problem.

Raise your fluid level. You need a crutch if you want to quit the throat-clearing habit, says David Alessi, M.D., an otolaryngologist in Los Angeles. And that crutch is water. "Feel like clearing? Stop and think—drink instead. Always carry a bottle of water with you," he says. "In three weeks, your habit will be broken."

Hydrate for stage fright. "Warm liquids are good if you're fighting stage fright," says Howard Levine, M.D., director of the Mount Sinai Nasal Sinus Center in Cleveland. "Your mouth and throat are drier when you're scared," he points out. Try this concoction when you need to use your voice in front of a group: Warm water with lemon juice and honey. "It creates humidity, coats the throat and gives soothing relief," says Dr. Levine.

Humidify the air. In winter, when there's dry forced hot air inside and cold dry air outside, use room humidifiers, suggests Steven Zeitels, M.D., an otolaryngologist at the Massachusetts Eye and Ear Infirmary in Boston. The vapor will ease irritated throat membranes.

Swallow the problem. "Instead of clearing your throat, do a hard swallow—an extended swallow as though you had something in your throat," suggests Glenn Bunting, a senior speech pathologist at the Massachusetts Eye and Ear Infirmary. "It may alleviate the sensation that something is there."

Try the hard stuff. Bunting recommends sucking on hard candy to increase saliva and moisturize the throat. But don't use menthol lozenges, he says. They may be drying.

Be gentle. Your vocal cords are very small, about the size of a nickel, says Bonnie Raphael, Ph.D., a vocal coach for the American Repertory Theatre in Cambridge, Massachusetts. Imagine blowing into a tiny musical instrument, she suggests. "How hard would you blow? You need to avoid overpowering the vocal mechanism and think instead of providing just a steady, gentle breeze." Here is her prescription for reducing your ahem-ing.

"The safest way to clear the throat is to sharply sniff and then swallow. If you feel you must clear the throat, then do so silently without any voice at all. The more you avoid abusing your throat, the less damage you'll do to your vocal cords," she says.

Dry up the drips. If postnasal drip from an allergy or sinusitis is the culprit, treat these underlying conditions first, suggests Dr. Levine.

Relieve reflux. "If throat clearing is occurring after meals or when you're asleep, it may be the result of reflux," says Dr. Zeitels. Try taking antacids. (For more information on how to recognize reflux and tips on how to deal with it, see Heartburn on page 249 and Regurgitation on page 439.)

See also Nose, Runny; Postnasal Drip; Sinus Problems