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by Joel Portnoy, M.D.
Whether patients call it postnasal drip, phlegm, mucus or a lump, the feeling of “something in my throat” is one of the most common throat complaints seen in an ENT office.
Mucus is critical for protection of body tissues and allows for safe, comfortable breathing. It allows for lubrication of the airway and filters out impurities and irritants that enter potential causing infection or injury. Our body makes between 1 and 1½ liters of mucus daily and is produced from tissues extending from the nose all the way to the lungs. The majority of this mucus is pushed to the back of the nose and down the throat, what most people refer to as postnasal drip. Some patients become more sensitive to the mucus that drips harmlessly from the nose, through the throat and into the stomach.
Mucus has watery (serous) and sticky (mucinous) components. The thickness of mucus is related to the overall health and hydration (how much water is in the body). Certain conditions, such as allergies, dehydration, irritation (smoking, dry environments) and infections can thicken mucus or increase production, making it less manageable.
Mucus in the throat also is required for proper voice production and swallowing. The perception of too much mucus in the throat may be due to excessive mucus production, overly thick mucus or from localized swelling in the throat.
Tickling in the throat, particularly with talking, is typically the result of improper voice usage, abusive throat behaviors (like throat clearing) or from outside factors. The sensation of a lump in the throat, known as globus, can be the result of local or external tissue damage or swelling. Examples of contributing factors include acid (or nonacid) reflux that burns the throat tissues, trauma (i.e. swallowing something “wrong”, neck trauma) and, less commonly, masses of the throat or neck (i.e. larynx/voice box, pharynx, or thyroid. Your ENT can help differentiate, diagnose and treat these conditions – if these problems.