What causes chronic cough and throat irritation. How are these conditions diagnosed. What treatments are available for chronic cough and throat irritation. When should you see a doctor for persistent coughing or throat discomfort. How can speech therapy help with chronic cough and throat irritation.

Understanding Chronic Cough: More Than Just a Tickle

Chronic cough is a persistent condition that extends beyond the typical duration of a common cold or respiratory infection. But what exactly constitutes a chronic cough? A cough is generally considered chronic when it lasts for eight weeks or longer in adults, or four weeks in children. This persistent coughing can significantly impact one’s quality of life, causing disruptions in sleep, work, and social interactions.

While coughing is a natural reflex that helps protect our airways, chronic coughing often indicates an underlying issue that requires medical attention. It’s important to note that chronic cough is not a disease in itself, but rather a symptom of various potential conditions.

Common Causes of Chronic Cough

• Postnasal drip
• Asthma
• Gastroesophageal reflux disease (GERD)
• Chronic bronchitis
• Medications (particularly ACE inhibitors)
• Smoking or exposure to irritants
• Chronic obstructive pulmonary disease (COPD)

Is chronic cough always a sign of a serious condition? Not necessarily. While chronic cough can be a symptom of serious underlying conditions, it’s often related to treatable issues such as postnasal drip or acid reflux. However, persistent coughing should never be ignored, as it can lead to complications and significantly impact quality of life.

Throat Irritation: When Discomfort Persists

Throat irritation encompasses a range of symptoms, including chronic throat clearing, pain, tightness, and a persistent feeling of fullness or a lump in the throat. These sensations can be incredibly frustrating and may lead to a cycle of further irritation through repeated throat clearing or coughing.

What causes chronic throat irritation? The causes can be multifaceted, including:

• Allergies
• Acid reflux
• Chronic sinusitis
• Vocal cord dysfunction
• Environmental irritants
• Muscle tension dysphonia

One of the challenges with throat irritation is that it can create a self-perpetuating cycle. The irritation leads to throat clearing or coughing, which in turn causes more irritation, leading to more clearing and coughing. Breaking this cycle often requires professional intervention and targeted treatments.

The Interplay Between Chronic Cough and Throat Irritation

Chronic cough and throat irritation often go hand in hand, creating a complex symptomatic picture for patients. How do these conditions influence each other? A persistent cough can lead to throat irritation due to the constant friction and pressure on the delicate tissues of the larynx and pharynx. Conversely, an irritated throat can trigger the cough reflex, leading to more coughing.

This interplay can make it challenging to determine which condition came first and can complicate treatment approaches. It’s not uncommon for patients to experience a “chicken and egg” scenario, where it’s unclear whether the cough or the throat irritation was the initial trigger.

The Role of Hypersensitivity

In many cases of chronic cough and throat irritation, the concept of hypersensitivity plays a crucial role. After an initial trigger (such as a respiratory infection), the throat and cough reflexes can become hypersensitive. This means that even minor stimuli, which wouldn’t normally cause coughing or throat clearing, can trigger these responses.

How does hypersensitivity develop? It’s believed to be a result of neuroplastic changes in the sensory nerves of the throat and airway. These changes can persist long after the initial trigger has resolved, leading to ongoing symptoms.

Diagnosis: Unraveling the Mystery of Persistent Symptoms

Diagnosing the root cause of chronic cough and throat irritation often requires a comprehensive approach. What steps do healthcare providers typically take to diagnose these conditions?

1. Detailed medical history: This includes questions about the duration and nature of symptoms, potential triggers, and any associated conditions.
2. Physical examination: A thorough examination of the ears, nose, throat, and chest.
3. Imaging studies: These may include chest X-rays or CT scans to rule out structural abnormalities or lung diseases.
4. Specialized tests: Depending on the suspected cause, tests such as allergy testing, pH monitoring for acid reflux, or pulmonary function tests may be ordered.

One key diagnostic tool mentioned in the original text is videolaryngostroboscopy. This advanced imaging technique allows specialists to visualize the vocal cords and larynx in great detail, providing crucial information about the structure and function of these delicate tissues.

The Importance of a Multidisciplinary Approach

Given the complex nature of chronic cough and throat irritation, a multidisciplinary approach to diagnosis and treatment is often beneficial. This may involve collaboration between otolaryngologists (ENT specialists), pulmonologists, gastroenterologists, allergists, and speech-language pathologists.

Treatment Strategies: Breaking the Cycle of Irritation

Treating chronic cough and throat irritation often requires a multi-faceted approach tailored to the underlying cause and individual patient factors. What are some of the key treatment strategies employed by specialists?

Medications

Depending on the underlying cause, various medications may be prescribed:

• Antihistamines and decongestants for allergies or postnasal drip
• Inhaled corticosteroids for asthma or airway inflammation
• Proton pump inhibitors for acid reflux
• Antitussives (cough suppressants) for symptomatic relief

Speech Therapy

Speech therapy plays a crucial role in treating chronic cough and throat irritation. How can speech therapy help with these conditions? Speech-language pathologists employ various techniques to address the underlying issues:

• Breathing exercises to improve respiratory control
• Vocal hygiene education to reduce throat strain
• Techniques to suppress the urge to cough or clear the throat
• Exercises to optimize vocal production and reduce muscle tension

These interventions aim to break the cycle of irritation and hypersensitivity, allowing the throat tissues to heal and reducing the frequency of coughing and throat clearing.

Lifestyle Modifications

In many cases, lifestyle changes can significantly improve symptoms of chronic cough and throat irritation:

• Smoking cessation
• Avoiding known irritants or allergens
• Proper hydration
• Dietary modifications (especially for those with acid reflux)
• Stress reduction techniques

The Role of Specialized Care: When to See a Laryngologist

While many cases of chronic cough and throat irritation can be managed by primary care physicians or general ENT specialists, some patients may benefit from the expertise of a laryngologist. But what exactly is a laryngologist, and when should you consider seeing one?

A laryngologist is an otolaryngologist (ENT doctor) with advanced training in disorders of the larynx (voice box) and related structures. These specialists are particularly skilled in diagnosing and treating complex cases of chronic cough and throat irritation.

When should you consider seeing a laryngologist? Here are some situations where specialized care may be beneficial:

• Persistent symptoms despite initial treatment
• Cough or throat irritation affecting your voice or ability to speak
• Suspected vocal cord dysfunction or other laryngeal disorders
• Need for advanced diagnostic procedures like videolaryngostroboscopy
• Complex cases involving multiple potential causes

Laryngologists often work closely with speech-language pathologists to provide comprehensive care for patients with chronic cough and throat irritation. This collaborative approach can be particularly effective in addressing the multifaceted nature of these conditions.

Long-term Management: Living with Chronic Cough and Throat Irritation

For some patients, chronic cough and throat irritation may require ongoing management. How can individuals effectively manage these conditions in the long term?

Adherence to Treatment Plans

Consistency is key when it comes to managing chronic conditions. This may involve:

• Taking prescribed medications as directed
• Regularly practicing speech therapy exercises
• Attending follow-up appointments with healthcare providers
• Monitoring symptoms and reporting any changes or exacerbations

Self-care Strategies

Patients can often improve their symptoms through self-care measures:

• Using a humidifier to keep the air moist
• Practicing good vocal hygiene (avoiding shouting, whispering, or excessive talking)
• Staying well-hydrated
• Avoiding known triggers or irritants
• Managing stress through relaxation techniques or mindfulness practices

Support and Education

Living with chronic cough and throat irritation can be challenging. Patient education and support are crucial components of long-term management. This may include:

• Joining support groups or online communities
• Staying informed about new treatment options and research
• Educating family and friends about the condition to foster understanding and support

Future Directions: Emerging Research and Treatments

The field of laryngology is continuously evolving, with ongoing research into the mechanisms underlying chronic cough and throat irritation. What are some of the promising areas of research in this field?

Neuroplasticity and Cough Hypersensitivity

Researchers are increasingly focusing on the role of neuroplasticity in chronic cough. This involves studying how changes in the nervous system contribute to persistent cough and hypersensitivity. Understanding these mechanisms could lead to new targeted therapies that address the root cause of chronic cough.

Novel Pharmacological Approaches

Several new medications are in development for chronic cough, including:

• P2X3 receptor antagonists
• Neurokinin-1 receptor antagonists
• TRPV1 antagonists

These drugs aim to target specific receptors involved in the cough reflex, potentially offering more effective and targeted relief for patients with chronic cough.

Advanced Diagnostic Techniques

Improvements in imaging and diagnostic technologies are enhancing our ability to visualize and understand the structures involved in chronic cough and throat irritation. This includes advancements in high-resolution endoscopy and 3D imaging of the larynx and surrounding tissues.

Personalized Medicine Approaches

As our understanding of the genetic and molecular basis of chronic cough and throat irritation improves, there is growing interest in personalized medicine approaches. This could involve tailoring treatments based on an individual’s specific genetic profile or biomarkers, potentially leading to more effective and targeted interventions.

In conclusion, while chronic cough and throat irritation can be challenging conditions to manage, ongoing advancements in diagnosis and treatment offer hope for improved outcomes. By combining current best practices with emerging research, healthcare providers can offer increasingly effective solutions for patients struggling with these persistent symptoms. As always, individuals experiencing chronic cough or throat irritation should consult with their healthcare providers to develop a comprehensive and personalized treatment plan.

Chronic Cough and Throat Irritation

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Overview

Chronic cough and throat irritation can disrupt your daily life. Breaking the cycles that cause these conditions requires care from voice specialists who are experienced in diagnosing and treating their root causes. Duke’s laryngologists and speech-language pathologists work together to discover what’s causing your chronic cough or throat irritation and to improve your symptoms.

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About Chronic Cough and Throat Irritation

Content

Chronic Cough
Coughing is a natural response that helps protect your airway when you are sick or when food or liquid goes down the wrong way. However, coughing frequently when you are not sick, especially if the cough is dry and non-productive, may indicate a chronic cough. This can be caused by a dry or irritated throat, certain medications, medical conditions (such as acid reflux or allergies), or hypersensitivity in the throat after an acute upper respiratory infection like a common cold. Coughing (and throat clearing) irritates the delicate tissues of the voice box and can cause more coughing or throat clearing. Once the body is in a chronic cough pattern, it is difficult to break the cycle. 

Throat Irritation (Chronic Throat Clearing, Pain, Tightness, and/or Hypersensitivity)
Throat irritation — including frequent throat clearing, pain, tightness, or a sense that there is a constant lump or fullness in your throat — can also occur when the throat is “stuck” in a pattern of hypersensitivity. It can be caused by coughing, vocal injury, or muscle tension. Sometimes, throat irritation can cause near-constant throat clearing, coughing, hoarseness, or painful swallowing, and it can disrupt daily life.

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Treatments

Speech Therapy for Chronic Cough and Throat Irritation

Description

Speech therapy is an integral part of treating chronic cough or other forms of throat irritation. Your speech-language pathologist will teach you how to use breathing strategies, voice exercises, and good vocal hygiene to help your throat recover from the constant irritation caused by chronic cough, throat clearing, and hypersensitivity of the voice box. These techniques will help you break the cycle of chronic cough and throat irritation.

Voice Therapy

Description

Throat strain can be a symptom and also a cause of irritation — creating a vicious cycle. In order to break the cycle of chronic throat irritation, you need to learn how to speak and use your throat without strain. A speech-language pathologist will guide you through vocal exercises to improve breathing, reduce throat strain, and find your optimal pitch and volume for strong, healthy speaking. Improving your voice will not only help you speak more easily and clearly, but it can reduce your throat irritation and cough.

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Tests

Tests Overview

Our team will take a detailed history of your symptoms to note patterns or triggers. A laryngologist — an ear, nose, and throat (ENT) doctor with advanced training in voice and throat disorders — will also evaluate whether any medical conditions, surgeries, or recent illnesses may have caused changes in your voice or throat. We will perform a head and neck examination and a visual examination of your voice box.

Videolaryngostroboscopy

Description

This detailed visual exam helps us evaluate how your vocal cords vibrate when you speak or sing. A tiny camera attached to a small tube called an endoscope is inserted through your nose and into your throat. It allows us to see your vocal cords and larynx (voice box). A flashing strobe light simulates slow-motion video images of your vocal cords. The exam takes about two minutes, and your nose can be sprayed with topical anesthetic for comfort.

Your team will look for lesions, stiffness, paralysis, irregular movements, throat strain, or incomplete closure of the vocal cords. After the exam, your team will review the images with you to discuss your diagnosis and treatment plan. Videolaryngostroboscopy is essential to reaching an accurate diagnosis and determining the best treatment.

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Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2022–2023.

Why Choose Duke

Content

A Team of Experts
At Duke, one of the few comprehensive voice centers in the Southeast, your care team will include laryngologists and speech-language pathologists specially trained to evaluate and treat people with voice problems and laryngeal disorders. Our team has years of experience treating chronic cough and throat irritation problems. 

Team Care Approach
If you have other medical conditions that may contribute to your voice issues — such as allergies, asthma, or acid reflux — we will work with your other providers throughout Duke Health to ensure you receive the best care from an integrated team.

This page was medically reviewed on 03/08/2023 by

Meghan Esper, CCC-SLP, MA
| Speech Pathologist

Causes of Sore Throat & Cough

In light of recent public health concerns, having a sore throat and a nagging cough has become cause for significant alarm. However, waking up with a scratchy throat should not trigger immediate panic. While a hacking cough is a potential symptom of coronavirus (COVID-19), there are several other, less serious conditions that are more likely cause a sore throat and cough. Let’s take a closer look at some of the most common.

Flu (Influenza)

The flu is a viral infection that peaks on an annual basis, usually between October and March. The Centers for Disease Control and Prevention (CDC) estimates that up to 20% of Americans are affected by the flu every year. This infection can cause a sore throat, wet or dry cough, fever, chills and other symptoms that may last for several days or weeks.

The Common Cold

The “common cold” is appropriately named. Millions of Americans catch a cold on an annual basis, with many getting multiple colds over the course of a year. This viral infection can produce symptoms like sore throat, cough, congestion, sneezing and body aches that may linger for a week or more.

Sinus Infection

Sinus infections can be viral and develop as a result of a cold, or they may be caused by bacteria or fungi. Whatever its origin, a sinus infection can trigger several weeks or even months of unpleasant symptoms, including sore throat and persistent coughing as a result of postnasal drip.

Strep Throat

Strep throat is a bacterial infection that can produce inflammation and significant pain and soreness in the throat. It’s rare for strep throat to cause a cough, but it can lead to nausea, headache and fever. This condition can occur in people of all ages, although it most often affects kids and teens.

Allergies

Seasonal allergies are very common and are often to blame for a scratchy throat. Allergies can trigger a wide variety of problems, including sore throat, cough, sneezing, red and watery eyes, congestion and other bothersome symptoms that may linger until the season changes.

Other Causes

Several other factors may cause a sore throat or cough, such as:

• Dry indoor air
• Indoor or outdoor air pollution
• Irritants such as cigarette smoke, alcohol and chemicals in household products
• Talking too long or loudly without rest
• Other medical conditions, including gastrointestinal reflux disease (GERD) and certain sexually transmitted infections (STIs)

While a sore throat or cough usually does not indicate a life-threatening emergency, it is important to call 911 if you or someone around you cannot swallow or breathe easily.

Find Relief From Your Symptoms

Tufts Medical Center Community Care is a multispecialty medical group with dozens of physicians who provide sore throat and cough treatment at our conveniently located centers throughout north suburban Boston. To schedule an appointment for you or your child, contact our friendly team today or reserve an appointment online.

Pain when coughing – causes, in which diseases it occurs, diagnosis and treatment

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Pain when coughing: causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Definition

Cough pain is most often associated with respiratory diseases and is localized in the chest.

The respiratory system consists of the upper respiratory tract (nasal cavity, larynx) and the lower respiratory tract (trachea, bronchi and lungs). The air passing through the respiratory tract is purified, warmed, moistened. At the end of the smallest bronchi (bronchioles) are the alveolar passages and alveolar sacs, in which gas exchange occurs. Respiratory bronchioles, alveolar ducts and alveolar sacs with alveoli make up the alveolar tree, or respiratory parenchyma of the lung. The listed structures, originating from one terminal bronchiole, form a functional-anatomical unit – the acinus. The alveolar ducts and sacs belonging to one respiratory bronchiole make up the primary lobule (there are about 16 of them in each acinus). The number of acini in both lungs reaches 30,000, and the alveoli – 300-350 million. Slices are made up of acini, segments are made of lobules, lobes are made of segments, and the whole lung is made of lobes.

Each lung is enclosed in a double membrane – two sheets of pleura, between which there is an airtight pleural cavity filled with a very small amount of fluid.

Cough is a protective reaction of the body to any irritation of the respiratory tract. Irritants of cough receptors can be sputum, blood in the respiratory tract, nasal mucus flowing down the back of the throat, various allergens, smoke, dust, foreign bodies, cold air, some drugs, etc.

Types of pain when coughing

Pain when coughing can be strong or weak intensity, acute or dull, limited or spilled. Localization of pain depends on the cause of the cough and on the affected organ. It can be felt in the throat, behind the sternum, inside the chest, under the ribs, in the back, abdomen, and radiate to the head. Cough and pain can be both symptoms of the same disease, and independent of each other.

Possible causes of cough pain

The following causes of pain when coughing are distinguished:

• overstrain of the respiratory muscles involved in coughing;
• diseases of the respiratory system;
• heart disease;
• injuries and diseases of the bones, muscles and nerves of the chest;
• diseases of the digestive system;
• kidney disease, etc.

What diseases cause pain when coughing?

In diseases accompanied by constant painful cough, the intercostal muscles and diaphragm are overstrained, which is manifested by dull, diffuse muscle pain.

Inflammation of the tracheal mucosa (with tracheitis) causes a dry, loud, hoarse, rough cough, which is characterized by burning and pain behind the sternum.

The severity of the pain decreases when a dry cough turns into a wet one. Tracheitis is more often infectious, caused by viruses or bacteria.

In patients, the general state of health worsens, the body temperature rises.

With inflammation of the lungs (pneumonia) there is a deep cough with sputum, there is pain in the chest in the projection of the inflamed area of ​​the lung.

The pain increases with coughing and deep inspiration due to the movement of the pleura, and decreases if the patient lies on the side of the affected lung.

Inflammation of the lungs can be primary, in which case the disease begins acutely – with chills, weakness, fever up to 38-39°C, accompanied by cough and difficulty breathing, more often proceeds as a lobar lesion, that is, the inflammatory process captures the whole lobe with the involvement of a large area of ​​the pleura. And it happens secondary, when inflammation passes from the bronchi to the lung tissue. A focus of bronchopneumonia occurs, but even in this case the pleura may become inflamed, with the only difference being that the size of the lesion is much smaller. Pneumonia can be caused by bacteria, viruses, fungi, parasites.

Pleurisy (inflammation of the pleura) may or may not be infectious. Infectious pleurisy occurs with pneumonia, lung abscess, bronchiectasis (expansion and deformation of the bronchi with the development of chronic purulent inflammation), tuberculosis, abscess under the diaphragm, inflammation of the perirenal adipose tissue, inflammation of the pancreas. Non-infectious pleurisy due to systemic connective tissue diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.), spread of tumor cells to the pleura, decreased pumping function of the heart (for example, with myocardial infarction, pulmonary embolism), chest trauma (closed fracture of the ribs ) etc. Pleurisy can be dry, in this case the amount of fluid in the pleural cavity decreases, the inflamed pleura sheets do not slide, but rub against each other when breathing, which provokes a very painful reflex cough, which increases with inspiration. Pleurisy is exudative when, due to the inflammatory process, fluid is secreted and accumulates in the pleural cavity. During the period of fluid accumulation, the clinical picture is similar to dry pleurisy, then the fluid pushes the pleura sheets apart, the pain becomes weaker, but at the same time, due to compression of the lung, shortness of breath occurs.

With gastroesophageal reflux disease , due to the reflux of acidic gastric contents into the esophagus, its mucous membrane becomes inflamed, heartburn, acid belching, pain, burning behind the sternum and a cough that aggravates pain are observed.

The lung tissue does not have pain receptors, therefore in lung cancer pain appears when tumor cells grow into the surrounding tissues – the pleura, trachea, bronchi, etc. In this case, the patient is worried about a painful cough, often with blood. General well-being worsens, weakness, weight loss for no apparent reason worries.

A similar situation occurs if metastases from other organs enter the lungs, this may be with cancer of the breast, stomach, esophagus, rectum, skin (melanoma), kidneys, liver, etc.

Pericarditis (inflammation of the lining of the heart), by analogy with pleurisy, it is dry and effusion. It can be caused by heart diseases (myocardial infarction, inflammation of the heart muscle, etc.), various infections, systemic connective tissue diseases, heart injuries, tumors, etc. Dry pericarditis is accompanied by gradually increasing dull, pressing pain behind the sternum, radiating to the neck, left shoulder blade. In this case, there is a rapid heartbeat, shortness of breath, dry cough, which increases the pain. As fluid accumulates between the sheets of the pericardium, the condition worsens due to compression of the heart.

Intercostal neuralgia occurs when the intercostal nerve is compressed at the level of exit from the spine or along its course. It is manifested by acute, aching pain, aggravated during a deep breath and cough.

Cough increases pressure in the abdominal cavity and pelvic area, therefore, in

inflammatory diseases of the gastrointestinal tract (for example, appendicitis), pelvic organs (for example, inflammation of the ovaries), hernias (white line of the abdomen, umbilical, inguinal) cough can induce or exacerbate existing pain.

The brain and spinal cord is washed with cerebrospinal fluid, its fluctuations during coughing increase intracranial pressure , headache occurs. This process can be of a natural nature, or it can hide serious diseases: volumetric formations in the cranial cavity, vascular anomalies that prevent the movement of cerebrospinal fluid.

Which doctors to contact?

First of all, you should refer to
general practitioner or general practitioner, and he, if necessary, will refer you for a consultation with a specialist (
gastroenterologist,
neurologist
cardiologist, etc. ).

Diagnosis and examination in case of pain when coughing

To identify the causes of pain when coughing, the doctor collects an anamnesis, conducts a thorough examination of the patient and prescribes additional laboratory and instrumental studies.

• Clinical blood test with expanded leukocyte formula.

Clinical blood test: general analysis, leukogram, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, KLA. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

Up to 1 business day

Available with home visit

RUB 810

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Biochemical blood test.

Blood biochemistry: advanced profile

Up to 1 business day

Available with home visit

RUB 6,995

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General urinalysis (Urine analysis with sediment microscopy)

Method of determination

Determination of physical and chemical parameters is carried out on an automatic analyzer using the “dry chemistry” method.

Hardware microscope…

Up to 1 business day

Available with home visit

410 RUB

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Plain chest x-ray

X-ray examination of the structure of the lungs to diagnose various pathologies.

RUB 2,440

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ECG without interpretation

ECG is a study based on the registration of biopotentials of the heart. It is used to diagnose the functional activity of the myocardium.

RUB 890

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Culture of sputum and tracheobronchial washings for microflora with determination of sensitivity to antimicrobial drugs and smear microscopy

Synonyms: Lower respiratory tract culture, routine. Bacteria identification, antibiotic susceptibility testing. Sputum culture routine. Bacteria identification, antibiotic susceptibility testing.

Brief description of the study “Sowing wet…

Up to 6 business days

Available with home visit

RUB 1,535

Add to cart

Esophagoduodenoscopy, etc.

Gastroscopy

Examination of the mucous membrane of the upper gastrointestinal tract with the possibility of performing a biopsy or endoscopic removal of small pathological …

RUB 4,490

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What should I do if I have pain when coughing?

Cough pain is a reason to see a specialist.

If the pain is of high intensity or is accompanied by a deterioration in well-being, a rise in body temperature, increasing shortness of breath, heart palpitations, hemoptysis, nausea, vomiting and other serious symptoms, seeking medical help should be immediate.

Cough pain treatment

Pain when coughing is only a symptom, therefore, to eliminate it, the underlying disease is treated.

In infectious and inflammatory lesions of the respiratory system, antiviral, antibacterial and other drugs that affect the infectious agent are used. Symptomatic treatment is carried out with anti-inflammatory, sputum-thinning and expectorant drugs, less often – drugs that stop coughing.

If pleurisy or pericarditis has an effusion (accumulation of fluid in a cavity), puncture the lung or heart membrane to remove the fluid and unload the lungs or heart.

Gastroesophageal reflux disease is treated with drugs that reduce the acidity of gastric juice and reduce its quantity, as well as drugs that speed up the passage of food through the gastrointestinal tract.

An attack of intercostal neuralgia is relieved by the use of painkillers in the form of tablets, injections or transdermal patches.

Sources:

1. Clinical guidelines “Community-acquired pneumonia in adults”. Developed by: Russian Respiratory Society, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. – 2021.
2. Cough: a guide for general practitioners (family doctors). – 2015.
3. Clinical guidelines “Pneumonia (community-acquired)” (children). Developed by: Union of Pediatricians of Russia, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. – 2022.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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how to treat, why it appears, ways to alleviate dryness and relieve the symptom

Tickle and dry cough is one of the most common health problems: up to 40% of visitors come to the ENT with complaints of discomfort in the throat ¹ . There are many reasons for the appearance of pain: among them are diseases of the respiratory system, pathologies of the gastrointestinal tract, environmental problems, stress and other factors. Let’s figure out why it usually tickles in the throat, and how to get rid of this symptom.

What is tickling

Everyone’s perspiration manifests itself in different ways. Some patients describe this sensation as itching and tickling in the throat, others as a scratching pain and tingling, an unpleasant feeling of dryness that causes coughing. The saliva becomes more viscous, the patient feels a lump in the throat, which cannot be got rid of. Why perspiration appears depends on the cause of the disease.

Why does it tickle in the throat

Infectious causes. About 80% of the diseases in which the throat is tickled are SARS ² . Viruses enter the mucous membrane, multiply and infect the cells of the integumentary layer – epitheliocytes. The integrity of the epithelium of the respiratory tract is broken, and substances that trigger inflammation are released into the blood – cytokines and inflammatory mediators. Because of this, unpleasant sensations and perspiration appear in the throat ³ .

More than 200 types of viruses are known that affect the respiratory system, but the most common are:

● orthomyxoviruses;

● rhinoviruses;

● adenoviruses;

● Bocaviruses;

● parvoviruses;

● coronaviruses;

● influenza virus;

● parainfluenza virus;

● respiratory syncytial virus;

● Metapneumovirus ⁴ .

Much less often, respiratory diseases are caused by bacteria ⁵ . Common pathogens:

● β-hemolytic streptococcus group A;

● Staphylococcus aureus;

● Haemophilus influenzae;

● Streptococcus pneumoniae.

Microbes provoke the development of pharyngitis – inflammation of the pharynx, tonsillitis – inflammation of the tonsils and catarrhal laryngitis – inflammation of the larynx ⁶ .

Noninfectious causes. Occasionally, sore throat and discomfort provoke:

● chronic vasomotor rhinitis – problems with the vessels of the nose, which often causes uncontrolled use of vasoconstrictor drops;

● benign neoplasms of the pharynx, such as polyps;

● osteochondrosis and herniated intervertebral discs that put pressure on the nerve endings and coughing occurs;

● neurotic disorders, including nervous tics and obsessive movements;

● muscular-tonic syndrome, that is, muscle spasms, their involuntary contraction;

● gastroesophageal reflux disease – reflux of stomach contents into the esophagus, which irritates its walls and provokes coughing;

● irritable bowel syndrome;

● Enlargement of the thyroid gland, including nodular goiter.

Other reasons. Perspiration may not be associated with diseases, but with constant irritation of the mucous membranes of the respiratory tract. Often the cause of irritation is ¹ :

● cold or hot climate;

● air pollution;

● work with chemical reagents;

● smoking;

● alcohol abuse;

● general hypothermia;

● emotional stress;

● Hypovitaminosis ³ ;

● other chronic diseases in the patient: cardiovascular or endocrine system, gastrointestinal tract.

How to determine the cause of discomfort

To correctly diagnose, it is worth contacting a therapist. The doctor will listen to complaints, draw up an examination plan and appoint a consultation with a narrow specialist, if necessary.

Investigations that a doctor may prescribe ¹ :

● general blood test;

● general urinalysis;

● x-ray or computed tomography of the paranasal sinuses;

● biochemical blood test, including glucose content;

● Fluorography.

If the cause is not an infectious disease, consultation with an otorhinolaryngologist, gastroenterologist, and neurologist may be required.

How to get rid of a sore throat

Treatment for a sore throat depends on the cause. If perspiration has appeared recently and is combined with symptoms of SARS – a runny nose, fever, muscle aches, weakness and other signs of infection – you can help yourself.

The severity of ARVI for a patient is largely determined by the local inflammatory reaction, which manifests itself in the form of pronounced catarrhal symptoms. This explains the need for the use of symptomatic (relieving inflammation) drugs, along with antiviral agents designed to combat the cause of the disease. One of the drugs with a complex effect is Nobasit ^® Forte. The results of a clinical study conducted by the Research Institute of Influenza. A.A. Smorodintsev, showed that in patients taking enisamia iodide – the active ingredient Nobasit ^® Forte, the severity and duration of symptoms was significantly lower compared to patients taking symptomatic therapy. ⁷

Non-drug treatment. It is impossible to completely cure a sore throat with non-drug methods, but it is possible to alleviate the condition and reduce the severity of symptoms. It is better to combine non-drug therapy with drug therapy. At the first signs of SARS, it is recommended to drink plenty of warm liquids. Drinking plenty of water allows the body to remove toxins and waste products of infectious agents from the body. Doctors recommend drinking tea with honey or mint, taking an infusion of chamomile.

Another non-drug method is rinsing. Solutions can be prepared from soda, salt and iodine. To relieve a sore throat, inhalations with essential oils of coniferous plants, tea tree, eucalyptus ² are suitable. However, care must be taken: natural ingredients can cause allergies.

Also, non-drug treatment includes physiotherapy, which includes procedures ² :

● UVR – local irradiation with ultraviolet;

● drug electrophoresis;

● phonophoresis of the pharynx;

● microwave therapy;

● Ultrasound therapy;

● diathermy, that is, heating the area of ​​the neurovascular bundles.

The duration of the session and the course of treatment should be determined by the doctor.

Medical treatment. Therapy includes topical agents that act on the throat and systemic agents – tablets, suspensions, injections.

Preparations for topical therapy ⁸ :

● antiseptics in sprays and rinses – furatsilin, chlorhexidine and others;

● enveloping agents to reduce pain;

● anesthetics – lidocaine, menthol;

● local antibacterial agents – framycetin, fuzafungin.

You can supplement local therapy and speed up recovery with systemic drugs. If antiviral agents are added to the treatment in a timely manner, this will reduce the risk of a bacterial infection. As a result, you will not have to use antibiotics, which will reduce the drug burden on the body, in particular on the liver ⁹ .

What antiviral drugs are:

● With direct antiviral action. The action of the drug is directed against the pathogen. Drugs prevent the reproduction of the virus at different stages.

● Interferons. These are artificially synthesized analogues of proteins with immune function, which give a quick result, but can cause side effects and lose effectiveness with long-term use.

● Interferon inductors. They stimulate the production of their own interferons, but it takes 24 to 48 hours to start this process. During this time, the virus actively multiplies, therefore, interferon inducers are not used as emergency prevention of acute respiratory viral infections.

Antibiotics are prescribed only if a bacterial pathogen is confirmed. Drinking antibacterial drugs without a doctor’s prescription is not worth it – this increases the risk of developing resistance in the pathogen and side effects in humans ¹⁰ .

When to see a doctor

Uncomplicated SARS can usually be cured without going to the doctor. But if complications arise, you should definitely seek medical help.

When to suspect the development of complications ¹¹ :

● ear hurts – otitis may have begun;

● swollen face – rhinosinusitis, sinusitis;

● a white coating appeared on the tonsils – tonsillitis, tonsillitis;

● severely swollen tonsil on one side – paratonsillar abscess;

● swollen neck – neck phlegmon;

● enlarged lymph nodes – the risk of suppuration of cervical lymphadenitis;

● Lungs hurt – possible pleurisy ¹² .

Help is also required for a person with febrile convulsions and a long-term temperature above 38.5 ° C.

Briefly about the main

➢ Most often, sore throat is associated with infectious diseases of the respiratory system, which in 80% of cases are caused by viruses.

➢ Uncomplicated ARVI can be cured on its own.

➢ Drug treatment can be local, that is, acting on the surface of the throat, and systemic, having an effect on the entire body. Local remedies include antiseptics, painkillers and enveloping. And to the systemic ones – antiviral drugs with direct action, interferons and interferon inducers.

➢ To alleviate the discomfort will help a plentiful warm drink, rinsing with soda, inhalation with essential oils.

➢ You should consult a doctor if the child is sick, the temperature does not fall below 38.5 ° C for a long time, the person has febrile convulsions or signs of complications of SARS.

Bibliography:

¹ Mikhailova I.V., Orlova Yu.Yu. The role of gastroesophageal reflux disease in the development of chronic pharyngitis.

² Slavsky A.N., Meitel I.Yu. Acute inflammatory diseases of the pharynx: modern possibilities of topical therapy // BC. 2015. No. 23. S. 1399–1402.

³ Svistushkin V.M., Morozova S.V., Artamonova P.S. Symptomatic therapy of acute respiratory viral infections with lesions of the upper respiratory tract. Consilium Medicum. 2020; 22(11): 37–42.

⁴ Svistushkin V.M., Morozova S.V., Keda L.A. Actual aspects of the use of phytopreparations in acute infectious and inflammatory diseases of the upper respiratory tract. Medical advice. Infections in otorhinolaryngology. 2021;(6):36–42.

⁵ Karpishchenko S.A., Kolesnikova O.M. Local therapy of acute tonsillopharyngitis. breast cancer. 2022;2:50–54.

⁶ Petrovskaya M.I. Combined preparation of local action in the treatment of symptoms of pain and sore throat. In the practice of a pediatrician. 2012: 73-74.

⁷ Lioznov D.A., Karnaukhova E.Yu., Zubkova T.G., Shakhlanskaya E.V. Evaluation of the effectiveness of the ARVI treatment regimen, including etiotropic (enisamia iodide) and symptomatic therapy // Therapeutic archive No. 3 – 2020 G.

⁸ Nikolaeva S.V., Usenko D.V., Shabalina S.V., Khlypovka Yu.N., Feklisova L.V., Gorelov A.