Chronic Throat Clearing

[Aliohpntz]

I am a 32 y/o white female, not overweight, non-smoker and feel like everyone thinks I am nuts!  I have had a chronic throat clearing problem, primarily after eating, for 2 years now. It is so miserable it is hard for me to work after lunch and embarrassing (sp?) to eat around others. I have no nausea, diarrhea, vomiting or pain.  In addition to the throat clearing I will have to blow my nose immediately after eating, usually twice.

I have seen an ENT (what seems like 50 times), I have been to two primary care docs, two GI docs, had ultrasounds of all my abdominal organs, had CT scans of my sinuses (have had several infections but even when clear no change), chest X-Ray, had allergy testing, had two different esophageal tests (one for function, one to look for pockets), had an endoscopy...... I have been on several reflux meds, allergy meds, TUMS, Atrovent, Nasal steroids, and everything else you can possibly think of. I do not have heartburn, abdominal or subscapular pain, just massive phlegm production associated with eating. It used to not happen with breakfast, just lunch and dinner. Now it is all meals, all foods (regardless of fat content etc).

The only two abnormal findings were a small hiatal hernia and a mildly reduced ejection fraction on HIDA scan (17%).  But I cannot produce phlegm on command so I know I am not crazy. The throat clearing is very intense and productive, the phlegm is so thick it takes a big throat clearing to loosen it so I can cough it up. I am considering the cholecystectomy but don't want to go removing parts (essential or otherwise) just to "see" if if helps. Does anyone have any suggestions?
Thanks
Aliohpntz

[Kevin Pho, MD]

Typically GERD and post-nasal drip would be the two causes.  GERD can be definitively excluded with a 24-pH study and sinusitis has been ruled out with the CT scan you had.

I am not aware of a low GB ejection fraction leading to the symptoms.

You can also consider a referral to an allergist to see if allergy testing may help with the evaluation.

Regarding the low EF, some small studies suggest that removing the gallbladder can help in relieving some gallbladder-like symptoms.

These options can be discussed with your personal physician.


Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Idab]

Hi, to alleviate the phlegm build-up - drink vitamin C and loads of it, make a concoction when you wake in the morning.  They say 1000mg per day, but I drank almost 2000mg per day, if not more.  This is an amazing vitamin, if I could take it via drip I would. A guaranteed cure for phlegm relief.

[StormShadows]

I have this too, except I will actually be able to feel the phlegm sticking to my "voice box" and will have to clear my throat and do that nasty sinus sucking, throat rattling thing that guys do before they hock a loogie. I have to do this many times, semetiems for hours until I can get this nasty, super super sticky, thick glob of mucous out of my throat, and then my throat is sore for days. It sucks. I have already had my gallbladder out, and have GERD, and Barrett's esophogus and am on Nexium twice a day for the gerd and Carafate four times a day for the Barrett's so I don't know what else could be causing it or if its one of the problems I already have, what else can be done to alleviate this. I also get the constant burps some of the other forums have talked about. Like for days, nonstop, keep burping and burping cuz it feels like I have an air bubble in my throat. It kinda feels like when I feel that phlegm stuck in my throat. I'm sure the two must be closely related.

[marilynjl]

A related discussion, throat clearing was started.