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Tickle feeling in throat, causing cough. I am hypochondriac. History of smoking. Suggest some cure

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I have a tickling in my throat that 2-3 times a day makes me cough (only once when it happens). I have the tickling since 2-3 weeks. I was diagnosed with chronic sinusitis (thorugh CT) 3 years ago and failed to get treatment thus far. I have a history of smoking (13 years regularily from age 16-30) and since then I smoked once a week the last 7 days while going out.
I'm a hypochondriac and thus madly in fear over lung cancer. Would the tickling in my throat warrant any such fears?

In addition I feel like I have to constantly clean my throat, and I also often have mucus running down the back of my throat. (6 weeks ago I had my larynx checked by an ENT during some routine check and it was normal.)
Posted Wed, 29 Aug 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 19 hours later

Thank you for your query.

1. The symptoms that you are experiencing are due to a Post Nasal Drip (PND) secondary to Chronic Sinusitis.

2. A PND will trigger off a cough once in a while and cause the tickling as it accumulates and trickles down the throat.

3. A differential will include mostly benign conditions such as acid reflux, lymphoid hypertrophy of the lingual tonsil (posterior one third of the tongue) and so on.

4. A PND also causes some gastritis and together with the acid reflux causes dryness and inflammation in the oral cavity and throat. This may also explain the tickling and discomfort in the throat. A PND, acid reflux and anxiety cause symptoms such as the 'globus' sensation in the throat and the constant uneasy feeling of the need to clear the throat.

5. The cough is typically dry with occasional phlegm.

6. The simplest course of action will be a course of steroid nasal sprays, anti-allergics, anti-leukotrienes, anti-inflammatory agents, mucolytics, steam inhalation and medicated gargles and anti-reflux medication for a few weeks. If there is no improvement I would like to review your CT images.

7. I must emphasize that the chance of a cancer at your age is rare. Cancer will be progressive and will not respond to medication. Lung cancer will have many other symptoms. You may get a routine chest x-ray done. It is good to hear that you have reduced smoking.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: Tickle feeling in throat, causing cough. I am hypochondriac. History of smoking. Suggest some cure 42 hours later
Thank you for your prompt and thorough response.
Since my fears over lung cancer have substantially diminished, I had the chance to look at myself a bit more closely regarding this matter.

First, I'm not even sure if it's a cough anymore, at least it's not triggered by the tickling and it certainly does not have anything to do with the lung or the bronchii as it originates around the larynx. Instead it seems to be me myself who's sort of coughing as additional means of clearing my throat because a lot of rather thick phlegm seems to be around my larynx. Or is THAT what's called pnd after all?

Could this tickling sensation be caused by very very bad neck tensions btw? I work in front of a computer for 16 hours / day and usually my complete neck right up to the chewing muscles is completely tense. Sometimes just before going to bed it's so bad that while I'm not dizzy at all I have troubles walking straight because my cervical spine feels like it's an immobile metal rod.

Answered by Dr. Sumit Bhatti 18 hours later

Thank you for writing back.

1. It is good to hear that the cough has reduced. The throat clearing and thick phlegm is usually due to the PND and acid reflux (and your lungs feel clear).

2. Cervical spine and neck muscle spasm due to may hours in front of the computer may worsen these symptoms since the entire throat slides up and down during swallowing, breathing, speaking and turning the head. Use a low pillow. Get Cervical spine X-rays done since you have unsteadiness at times. The muscles of mastication are usually sore due to prolonged clenching of the teeth during stress.

3. You may follow up here with the results of the examination and investigations.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Above answer was peer-reviewed by
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