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Link between chronic throat clearing, non acidic reflux and/or allergie...
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Link between chronic throat clearing, non acidic reflux and/or allergies?

IMPORTANT: I'VE POSTED THIS IN THE ORL FORUM ALSO (don't want anyone to think i'm flooding)  

I have been living with (for about a year now) with something very much like (not to say exactly like) what many of you are describing. All this seem to have started after a series of sinusitis’s, bronchitis and allergy season last year!

My symptoms are

1) An annoying (chronic) throat clearing which seems to be related to ingestion of foods or beverages. It’s always present in the morning no matter if I’ve eaten or not (about ½ to an hour after I’ve gotten up). The symptoms oddly stop when I lie down completely. I’m thinking either non acidic reflux or some form of post nasal drip pr mucous thickening?

2) A whitish lump on my tongue which comes and goes depending on different food or beverage in ingest. My general doctor could'nt really recognize this (she seemed a little confused when looking at it). Sometimes, after I drink pear juice (for example), the bump swells up to the point I feel I have something moving around in my mouth (due to the swallowing muscle movements). Gross, I know …

Oddly, so many people are going though this and so little of us seem to find the solution!

So here goes …

I met with my ORL subsequent to getting a 24 PH study results. The 24PH study results indicated that the tracing did not indicate significant gastro-esophageal acid reflux. Due to this and the multiple inconclusive tests I’ve had previous to that, my ORL concluded that this is probably all in my head now and that I should stop trying to figure out what the source of the problem is and either adapt to it or slowly learn to stop clearing my throat!

For the record, here is a list of what I’ve done so far to eliminate possible causes for my throat clearing:

• Chest scans: all good
• Lower abdominal echo: nothing abnormal
• A gastrocopy : all ok in there
• A 24hour PH study and a motility test: no significant gastro-esophageal acid reflux
• A sinus scan: revealed a slightly deviated septum
• Allergy tests: some grass, weed allergies (I have not had food allergy testing yet)
• Home based acidity test (saliva sticks): almost always normal levels

Here is a list of the medications I’ve tried:

• Benadryl: Helps a lot but puts me to sleep (drastically)
• Nexium: no significant effect
• Gaviscon: “seem” to help but not much
• Nasonex and sinux flushing: clears the sinuses well and I haven’t had a sinus infection since
• Magic Mouthwash: no effect whatsoever

I don’t smoke, I train regularly, I eat really well, and I’ve stopped drinking coffee and really cut out acidic foods like tomatoes and citrus fruits.

I’m the first to believe that the human brain can cause the illusion of symptoms but these symptoms are real; chronic throat clearing, occasional phlegm in my saliva (slightly acidic tasting), a white infection like bump on my tongue which comes and goes with the level of “reflux” I have (almost a weekly cycle).

After meeting this meeting with my ORL, I contemplated the fact that 1) he is a renowned ORL (he is chief of the ORL department) and 2) there was no significant gastro-esophageal acid reflux in my 24 PH study which itself was done by a chief GI. However, over the past two weeks, I’ve stopped all medications and returned to my normal diet (nothing bad, just not watching the acidity levels as much). I have noticed that the reflux (assuming that’s it) is more frequent and I can especially see my tongue grossness factor increasing. I tried to brush it off (as suggested by the ORL) but it hurts and it bleeds!  

It’s in my nature to resolve things and I just can’t accept that this is psychological until I’ve gone through all possible other scenarios first. It’s a process of elimination thing that I have. So by sheer curiosity, I looked up “non acidic reflux” which I fell on a few months ago and found some interesting claims. From what I’m reading now, this seems to be exactly what’s going on for me!

From the research I’ve done, the 24 PH study I’ve had doesn’t measure “non acidic reflux”. Apparently I need a Multichannel Intraluminal Impedance (MII) for this. For your convenience, I’ve indicated a few websites that contain what I think to have pertinent information about “non acidic reflux”:

• Source: MedScape (Year of publication: 2004), http://www.medscape.com/viewarticle/493040
• Source: EndoNurse (Year of publication: 2008), htttp://www.endonurse.com/articles/i_left_my_heartburn_in_san_francisco.html
• Source: ABC (Healthbeat) article about non acidic reflux (Year of publication: 2008), http://abclocal.go.com/wls/story?section=news/health&id=6442172

So, my questions are;

1) The 24 PH study shows average levels of 7 which from the bellow extract of the EndoNurse article seems to point toward Non Acid Reflux!

"The ACG practice guidelines define acid reflux and non-acid reflux as follows: Acid Reflux = reflux that reduces esophageal pH to below 4 or reflux that occurs when esophageal pH is already below 4. Non-Acid Reflux = esophageal reflux where the pH remains > 7 or increases to > 7.

Should I push to get the MII test?

2)  Could whatever is happening to me be related to some form of anxiety? I’ve read a lot about acid reflux (or non acid reflux) having a connection to this?  The fact that lying down (relaxing) stops the symptoms (pretty much) could be a hint of that? If so, what type of cure exists for that?

3) Is there any chance some type of food allergies could be causing an excess mucous build up in my throat (or Larynx area)?

I’m so desperate for answers …

Thanks
iDanny
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11 Comments Post a Comment
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1215994_tn?1322071391
have you herd of black harry tounge.look it up it can be caused from dry mouth.it can cause white and black patches on tounge.look under differnt types of thrush.also have you herd of sjogrenes syndrome.it can cause not enouph saliva .it can cause clearing in throat and dry sore tounge.i just wanted you to be aware of those things. you started having these problems after a round of sinusitus.has any one checked your sinuses for yeast.it could cause a dry mouth and constant clearing of the throat.you could have got it after several rounds of antibiotics. also did you know your tast buds on your tounge could be sore and cause you to have tounge spasms.like a charly horse. yep look it up .it could happen to any one.when you feel the bump stretch  your tounge out of your mouth. i dont know if it will help but its worth a try.your tast buds are probly sore and swelling up and going back down.let me know if you have herd of any of this sue
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1215994_tn?1322071391
also just a constant sinus drainage could cause that.sue
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Avatar_m_tn
the drainage ? mmm, that's contradictory to all the ORL advise i've gotten over the past year! Every one of them claim the drainage to be nothing but good ?

Anyhoot, I've gone ahead and created my own sympton specific website in order to try and focus on this common and unresolved problem.

Please visit (and join) our community to help fight chronic throat clearing !

http://www.chronicthroatclearing.com

Danny
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Avatar_n_tn
I have had post nasal drip my entire life.  I don't have any allergies.  I tried stopping dairy, but it does not help that much.  I even have this when I lay down.  I use Triaminic for Chest Congestion to help this. I don't actually have chest congestion but it helps this problem.  If I don't use it, I wake up coughing because the secretions go down the "wrong track."  I don't think there is is cure.  Most meds have side effects that are worse than the problem.  Drying up the drip can be done by taking Claritin too.  But I don't want to take that forever.  So I am stuck with this.                   Leah
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681148_tn?1285160820
Mild sensitivities can cause the post nasal drip.  I often get more mucus when I eat something that I don't test positive for true allergy but still have sensitivity to.  You may have a little bit of congestion.  Guifenisen, which is what Mucinex is could help.  You should get the extended release form.  Otherwise the standard one works great for an hour or two and you're right back to the same thing.
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Avatar_m_tn
It's been a while and I just answered a direct message to someone which I'd like to share with everyone:

----------------------------

I'm going on year 3 now with this problem and I've learned to deal with it ... Highly experienced ORLs and plenty of other specialists concluded this to a reaction to stress/anxiety.

It is common that some reflux issues are amplified by stress as well as mucus thickening or sensitiveness to it caused but the tightening of the throat but ultimately, what I have was compared to a stuttering problem! I was actually offered a referral to follow the same treatment people that stutter go through (speech therapy). I thought that was weird at first but I can see the logic now.

For me, the compelling proof that this is mind related is that it stops when I am in very calm environments (like on vacation or in a movie theater). This all started with a wicked sinus infection and I guess we can say it just developed into a stress habit over time.

I don’t know if you’ve seen the recent events involving a few American high school students who all developed some sort of turrets syndrome? I was watching this on Anderson Cooper the other day  and on the show, one doctor had a theory that the propagation of this syndrome could be caused by the fear of having it ? This, in some way, made me realize that the mind/brain is a controller that can very well have our body react in the way it wants to.

My point is, for the longest time, I just would NOT believe this wasn't a physical bug or some kind of infection when in reality, it isn’t. Its habit and unfortunately, it's not something that can be fixed with a pill.

Accepting it helps me control it. Mornings are worse a mucus drains more dramatically then. Milk and other thick products are not helpful as they thicken mucus. When it’s bad, I just stop what i am doing, take a pause (lying down helps) and realize that I am indeed either stressed or anxious about something.

So there you have it! I hope this has been some help to you.

----------------------------

Perhaps others have experiences, tips or tricks to add ?

Danny



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168348_tn?1379360675
HI  .. so glad you've found a solution for your reflux problems and sharing with us.  Sometimes it's physical, I do agree .. But for some, though, it's triggered by allergies or anatomical issues .. sometimes, even conditions are there causing reflux from birth and can cause asthma, too by micro-aspiration.

C~
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168348_tn?1379360675
WELCOME BACK!!!!!

It would be super if you could stop by and meet/greet members!!!

This is awesome that you are able to stop back after a year.

C~
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Avatar_m_tn
that was a pretty good follow-up and story about throat clearing/mucous/anxiety. That sounds like an unfortunate run around in the medical community. Remember, doctors are technicians, and they rely on researchers to make a diagnosis. There is more to learn, certainly. "its in your head" means "we don't understand the brain yet", pretty much. Dave
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Avatar_m_tn
Interesting post. It would be good to hear how the OP is doing now that some years have past. The lack of follow-ups is frustrating since we can't learn from others whether they got better.

I am a 34 year old male in otherwise good health. I am currently suffering with a non-productive throat clearing condition, which I believe may be psychosomatic. This started about a month ago, and typically follows a daily pattern of being at its worst an hour after rising/breakfast. Strange thing is I had the very same problem between June 2001 and early 2004. I even had a septoplasty because the ENT thought that it might be caused by a deviated septum. I have a good memory for these things and I remember back in 2001 it started following a longish cycle ride, where potentially I might have inhaled some allergens/pollutants/dust. Shame I can't remember much about how it resolved. Coincidentally (or not), it also started this time round following another long cycle ride. This would put pay to the reflux theory, though it could be that the cycle ride was the inciting event that caused the irritation to my throat and the reflux (which might have always existed) is maintaining the irritation so that the mucus membrane responds more vigorously by producing more mucus, and perpetuating the throat clearing.

I definitely believe in psychosomatic symptoms. I have had a few over the last few years. Last year it was globus sensation, a few years back a need to **** frequently, and some strange dizziness -- all disappearing in the end, and all attributed to some underlying anxiety. I think part of the problem may well be my need to find out the answer to it, and I can't help think that - if it is psychosomatic - then even googling around is perhaps perpetuating the condition. I wish I could accept that a definitive answer is probably not out there and that by letting go it will likely disappear, as most conditions such as this do, eventually. My fear is that it will last for years again and that I will become miserable about it; at it's worst I find it difficult to talk because I have this gravel on my throat and have to clear/cough/drink water.

Also, the OP mentioned a lump on the tongue. Not sure if it's the same as the OP's but I'll mention it anyway. I have recurring small mucoceles that appear on the underside of my tongue. Right along the midline "pipe". They never get too big and disappear if I leave them alone. Most of the time only one comes back, and can be absent for up to a month. But one always seem to recur. After a few days they go white from rubbing on my lower teeth. I've learnt it's best to leave them alone rather than pop them. Generally they appear when I'm really hungry, like if I take a late lunch; this makes sense for the following reason (IMHO): when the salivary glands are on overdrive, the pipe gets overloaded with saliva and a "water balloon" is formed.
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