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Dr. Andrew Rynne

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Suggest treatment for severe phlegm in the throat

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16386 Questions

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Posted on Thu, 2 Mar 2017 in Ear, Nose and Throat Problems
Question: My mom has severe phlegm in her throat in morning. So bad that she can not swallow. Many mornings has to throw it up. Dr.s in our small town can not figure it out. Antibiotics do nothing to help. Its been 4 months.
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Answered by Dr. Michelle Gibson James 48 minutes later
Brief Answer:
anti histamine, oral and topical decongestant, montelukast , ketotifen

Detailed Answer:
HI, thanks for using healthcare magic

The most common cause for mucus in the throat in the majority of persons would be either an allergy or infection (viral or bacterial).
A viral infection would only cause symptoms for a short period of time and a bacterial infection should have responded to a course of antibiotics unless the bacteria is resistant.

Allergies can occur to dust, pollen, medications, foods,drinks , lotions, soaps, perfumes anything. These are some persons who develop allergic reactions late in life.
I had a 70 yr patient with persistent mucus at the back of her throat, allergy testing revealed that she was allergic to banana.

Allergy tests can help determine if there is a particular allergen that your mother is reacting to.
Allergy testing can be in the form of skin prick testing or a blood test.

Skin prick testing would require a dermatologist or allergist but a the blood test can be done by a family doctor and sent off to the lab.

If the allergen is determined then her exposure can be reduced.

In addition to these tests , medication would help.

Typically for post nasal drip of mucus (mucus at the back of the throat) includes the use of anti histamine/ decongestant combination (even if the nose is not congested, reduces the mucus in the throat) along with nasal spray such as nasonex, nasocort, flonase.

Eg of the anti histamine/decongestant combination : zyrtec d, allegra d, claritine d, benadryl d.
Unfortunately it can sometimes take 2 to 3 weeks for these medications to kick in.

Some persons may also needs meds such as montelukast or ketotifen which slightly differently than the anti histamines.

Summary: (1) drip of mucus most likely due to reaction to some agent

(2)finding the agent and reducing or eliminating her exposure to it would be the best route. This can be done by a blood test sent to a lab

(3)anti histamine/decongestant combination along with a nasal spray would help though can take 2 to 3 weeks of consistent use before it kicks in. Need to be continued

(4)some persons may need additional medication such as ketotifen or montelukast

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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