Many patients experience the feeling of fullness in the throat or a sensation of a lump in the throat. Others have a chronic cough or throat clearing. These common conditions are quite bothersome but rarely are associated with conditions that might threaten one’s health. Patients often confuse phlegm or mucous in the throat with true post nasal drainage or a sensation of the “drainage coming from
behind the nose.” Conditions that commonly cause the above problems and some treatment options are listed below:
Treatments for a “self perpetuating” cough include:
Usual Rx: prednisone 10mg: 3 tabs qAM X 14 days, 2 qAM X 3 days, 1 qAM X 3 days. Evaluation: Evaluation of the chronic cough patient includes a thorough history focusing on sinonasal, laryngeal, pulmonary and gastroesophageal symptoms as well as tobacco, caffeine and alcohol use history. This is followed by a head, neck and pulmonary exam. Consideration to obtaining sinus and chest X-rays as well as an esophogram, dysphagia evaluation or EGD should be given especially if symptoms persist after conservative management, a trial of medication or a change of medication as outlined above. If symptoms persist, one should consider referral, as directed by the patient’s history, exam and other studies to otolaryngology, pulmonology, gastroenterology, or perhaps to an allergist. |