Constant Need to Clear Throat

[trpri]

Hi,

I've had a very distressing problem that's been going on for about a year now. I have a constant feeling of phlegm in my throat, though I'm not able to cough anything up, and while I am always clearing my throat, it barely helps for more than a minute or so. I've been to the ENT, and after an endoscopy, he told me it was probably GERD (said he didn't see post-nasal drip) and progressively put me on the following medications over the past eight months or so when I failed to improve:

1. Aciphex 1/day
2: Aciphex 2/day
3. Aciphex 2/day + Astelin nasal spray
4. Short course of Prednisone and then Zegerid 2/day + Astelin + Mucinex

I've also tried anti-allergy meds like Claritin. Nothing has really improved, and my throat is feeling worse than ever because a year of clearing and coughing means it's constantly raw and hoarse. I'm really at my wits' end and I'm having trouble concentrating on work or sleeping. What could this be? And what should I do now?

[C124Ace]

Forgot to ask,  you mention Claritin, but didn't say if you had gone to an allergist?   If not, maybe that would be another option - have the scratch tests and see if it is an allergy.   Claritin/Astelin not for all allerigies...

[Kevin Pho, MD]

GERD and allergies would indeed be the most common cause of the symptoms.

Chronic sinusitis and rhinitis are also possible.  A sinus CT scan can be done to exclude these possibilities.

Obtaining a 24-hr pH study to definitively exclude GERD can be considered.  

You can also consider another ENT opinion, or a referral to an allergist.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[C124Ace]

have you been to an endocrinologist?  to check thyroid?  

[trpri]

No, haven't been to an endocrinologist...which thyroid condition would cause such symptoms?

Haven't gone to an allergist either, I want to do that next, but my ENT wants to refer me to a gastro instead...I think he feels it has to be acid because he's never able to see any post-nasal drip when I go in. I could swear it feels like it, though, and I can hear it in my voice sometimes. Just really confused. Thanks.