Constant Throat Clearing | Nasal Voice

Question: I am wondering if constant throat clearing and a nasal voice can be related?  I am constantly clearing my throat, mainly due to thick mucus draining down my nose into my throat.  Because of that sensation I always suck the mucus and then swallow (I know it sounds gross).  It gets worse with certain foods (thick sauces, spicy) but its usually a constant thing.  I also have a nasally voice.  I have had these issues for probably the 2nd half of my life, I am 31 now.  I have just put up with it but I would like to know if anything can be done.  Thanks.

Answer: Thanks for your question.  As always, I can only speak in generalities and cannot offer a true medical opinion about your symptoms without a thorough and complete history and medical examination.

However, your symptoms (constant throat clearing and nasal voice) are consistent with gastric reflux disease (gerd) or more specifically lpr (laryngopharyngeal reflux).   It is not uncommon for someone to have gastric acid back up the throat to the level of the vocal cords and even to the nose and sinuses.  When people have symptoms at the upper level of the throat, but not heartburn- we often call this “silent reflux”. Although a better term might be reflux without heartburn.

The tissues of the nose and throat are not well suited to dealing with acid coming up from the stomach.   The acid irritates the voice box (vocal cords) and may cause hoarseness.  The irritated tissues make mucous as a response to the irritants-  causing the feeling of flegm in the throat and a post-nasal drip.  Acid may even go up as high as the nasal cavity, predisposing one to nasal congestion and even sinusitis.

There are other causes of these symptoms, such as chronic sinusitis- but this is the most likely.

My suggestion would be to see an otolaryngologist (Ear Nose and Throat) doctor-  who can usually make this diagnosis quite readily and make sure that this is nothing more serious.  We have information about reflux on our web site and there is a reflux questionnaire that you might find useful.   This problem should be readily curable..

Of course, if you’re in the NY area, we’d be happy to see you and help you at the NY Sinus Center.

Robert L. Pincus MD