Feeling of mucus or phlegm in the throat is a sensation, which can be experienced by anyone irrespective of their age or gender. This sensation or symptom is commonly experienced if the person has been suffering from viral upper respiratory illness along with other symptoms, which this condition carries. Having a feeling of phlegm in the throat can precede any illness or the person can have this feeling without any illness too. Healthy individuals usually self-diagnose this condition of phlegm in throat or mucus in throat due to post-nasal drainage which they have.
Associated Symptoms of Phelgm in Throat or Mucus in Throat
Other than having this phlegm or mucus in the throat sensation, patients also can experience some of the below symptoms:
- Constant throat clearing which is chronic.
- Globus which is a feeling of lump in the throat.
- Tickle like sensation in the throat.
- Having a voice which sounds "wet."
Anatomical Description for the Region of Phlegmy Throat
The area of the midline external neck from superior to inferior level is made up of the chin, Adam's Apple, hyoid bone, thyroid cartilage, rings of the trachea, cricoid cartilage and lastly the sternum. Patient usually experiences the globus sensation in the region of the cricoid cartilage.
Cricopharyngeal Muscle is located behind the cricoid cartilage and is attached to the cricoid cartilage. There is another muscle which forms a sling around the esophagus and this muscle functions like a sphincter to prevent food from regurgitating back into the mouth after swallowing. If this sphincteric muscle becomes very tight due to some cause, there is a lump sensation, which is known as globus, felt by the patient. The feeling of phlegm in throat or mucus in the throat is localized just above this particular region which is surrounded by the cricopharyngeal muscle.
Causes of Phlegm in Throat or Mucus in Throat?
Phlegm in Throat or Mucus in Throat Caused due to Laryngopharyngeal Reflux (LPR)
In majority of the patients, the sensation of phlegm in throat or mucus in throat is felt due to "Laryngopharyngeal Reflux." This condition occurs due to reflux, which can be acidic or non-acidic mucus reflux, which travels back from the stomach to the throat region and settles there. Fiberoptic endoscopy reveals this mucus collection in this region. It is a point to remember that many of the patients having Laryngopharyngeal Reflux do not complain of heartburn, indigestion, nausea and other such symptoms, which are commonly seen with reflux. There is tightening of the cricopharyngeal muscle to prevent the reflux of the mucus from the stomach to the voice box. However, what happens sometimes is this action, instead prevents the saliva or the mucus from going down leading to buildup of mucus in the throat. Treatment for Laryngopharyngeal Reflux as a cause for Phlegm in throat or mucus in throat is same as GERD disorder, the only difference being that treatment for Laryngopharyngeal Reflux takes longer from 6 weeks to 3 months. Some lifestyle changes can be incorporated, such as avoiding spicy food, sleeping with the head of the bed elevated etc. If patient does not find relief, then surgery needs to be done.
Phlegm in Throat or Mucus in Throat Caused due to Post-Nasal Drainage
Post nasal drainage also causes the sensation of phlegmy throat. This post nasal drainage can be visualized at the back of the throat. Treatment for post nasal drainage depends on the cause of it. If sinusitis is causing this, then antibiotics are prescribed. Allergy medications are given if allergy is the cause of post nasal drainage.
Phlegm in Throat or Mucus in Throat Caused due to Food Sensitivities
Sensitivity to certain foods can cause accumulation of phlegm or mucus in the throat. This occurs pretty much like the reaction of eye watering when exposed to the irritant. Common foods which cause sensitivity include egg and wheat. Treatment is avoiding these foods. Other symptoms of food sensitivity include stomach unease, mental fog, gases/flatulence, skin complaints and fatigue.
Phlegm in Throat or Mucus in Throat Caused due to Sjogren's Syndrome
Certain rheumatological conditions, such as Sjogren's syndrome, lead to reduction in the production of saliva, which leads to thick spit which can get stuck posterior to the mouth or throat. Mouth-breathing or dehydration can also cause a similar condition.
Phlegm in Throat or Mucus in Throat Caused due to Cricopharyngeal Muscle or Esophageal Pathology
- Feeling of Phlegm in throat or Mucus in Throat can also occur when there is formation of muscle scars, hypertrophies, and chronic spasticity of the cricopharyngeal muscle or development of ring or stricture in the esophageal lining.
- Conditions, such as Zenker's Diverticulum or eosinophilic esophagitis can rarely cause phlegmy throat.
- Problems with esophageal motility can also cause accumulation of phlegm.
- Formation of a mass such as cancer, granulomas or cysts can also cause this sensation of phelgm or mucus in the throat.
Ways to Get Rid of Phlegm in Throat or Mucus in Throat
Treatment to get rid of phlegmy throat is done by treating the underlying cause. Investigations, such as a baseline fiberoptic endoscopy are done to visualize the area of concern. If reflux is causing the feeling of phlegm in throat or mucus in throat, then proton pump inhibitors, such as Prilosec are prescribed for some weeks to help get rid of phlegm in throat or mucus in throat. In some patients, complete resolution of the symptoms can take as long as three to six months.
If the patient still has symptoms of phlegmy throat even after taking anti-reflux medications for a considerable amount of time, then upper esophageal manometry or a barium swallow are done to assess any damage or abnormality of the muscle along with any other physical anatomic abnormalities.
Other than this, a multichannel intraluminal impedance testing and 24 hour pH probe can also be done. In case the barium swallow is abnormal, then an esophagoscopy may be required. Presence of LPR can be determined by doing a simple spit test.
So, it takes lot of patience and many investigations to determine the exact cause of phlegm or mucus in the throat and determine the ways to get rid of it.