Clear throat

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The term throat clearing (from Middle High German riuspern = (in the throat) to scratch) describes the voluntary or reflexive, multiple strong expulsion of air through the closed vocal folds . The vocal cords vibrate, creating a sound similar to a cough . Most people clear their throat to remove (supposed) foreign objects from the larynx area or to attract attention. Clearing a throat puts a much greater mechanical strain on the vocal cords than coughing.

Reflex mechanism

Vocal cord when looking into the larynx

Clearing your throat is based on the same reflex mechanisms as coughing. If a foreign body, such as a speck of dust, gets into the airways, the larynx muscles immediately contract and bring the vocal cords together. The vocal folds are closed. This process leads to reflex coughing or coughing. The diaphragm contracts and shifts its position downward, like when you inhale. The lungs follow the movement of the diaphragm, expand, and draw in air from the outside. Now the epiglottis closes the windpipe. The abdominal muscles contract, which pushes the diaphragm upward. Exhalation is forced through overpressure in the chest cavity. The air forces its way out through the closed vocal folds. The airflow, which can reach speeds of 120 km / h, carries foreign bodies up into the throat. The strong force with which the vocal folds are pressed apart damages the mucous membrane. Due to the micro-injuries, more mucus is formed.

Pathological throat clearing

Occasional throat clearing is not a symptom of the disease, but if the throat clearing occurs very often or constantly, a pathological cause can be assumed.

Selection of possible organic causes

  • Asthma : Asthma is a permanent inflammation of the bronchial mucosa, which results in hypersensitivity of the airways . This leads to swelling of the airways and excessive secretion production, which narrows the bronchi . Asthma is particularly often diagnosed in childhood. Typical symptoms are: frequent forced coughing and throat clearing, difficult exhalation, wheezing breathing noises, acute shortness of breath ( dyspnea ), tightness of the chest.
  • Sinubronchial Syndrome : In sinubronchial syndrome, also called postnasal drip syndrome, the upper and lower airways are affected. The syndrome usually develops from a cold . More mucus is formed in the paranasal and frontal sinuses, which reaches the lower airways , especially when lying down . Here the dripping mucus irritates the mucous membrane of the pharynx. In addition to frequent clearing of the throat, dry cough is a common symptom of sinubronchial syndrome.
  • Reflux disease : Gastroesophageal reflux is the reflux of food from the stomach back into the gullet ( esophagus ). The essential components of this gastric secretion are stomach acid and pepsin . The stomach acid can irritate the lining of the esophagus ( silent reflux ) or inflame ( reflux esophagitis ). The symptoms of both variants are the same and are particularly evident when lying down. In addition to heartburn, they include: voice problems and hoarseness, a feeling of lump in the throat ( globus syndrome ), chronic irritable cough and frequent clearing of the throat. The reflux is usually due to cardiac insufficiency or an axial hiatal hernia . It is assumed that one in ten of the western industrialized nations is affected by gastroesophageal reflux disease.
  • Hypothyroidism : The thyroid gland produces the two iodine-containing thyroid hormones triiodothyronine (T 3 ) and thyroxine (T 4 ). They stimulate most of the metabolic processes in the body. 40 percent of Germans do not consume enough iodine . Due to the diet-related iodine deficiency, the thyroid gland enlarges to be able to filter more iodine. This is the case for around a fifth (18.7%) of Germans. As soon as the enlargement is visible, palpable or measurable, the clinical picture is called goiter or goiter. Depending on the size, the trachea , neck vessels and esophagus are mechanically narrowed. This can lead to swallowing difficulties and shortness of breath and, associated with this, to increased throat clearing.
  • Cysts : The term "having a frog in your throat" originally goes back to the ranula (Latin for "little frog"), a cyst that is created when the duct of the sublingual salivary gland is blocked. The larger the ranula, the more likely it is to have difficulty swallowing, speaking, and breathing. Chronic coughing is rare in a ranula, but a common symptom in cysts in the throat and pharynx.
  • Larynx cancer : Larynx cancers are divided into glottic, supraglottic, and subglottic carcinomas. Persistent hoarseness is characteristic of carcinoma of the glottis . Additional symptoms are a sore throat, throat clearing, and chronic cough. In Germany the incidence rate is 6.5 / 100,000 for men and 0.7 / 100,000 for women.

Web links

Individual evidence

  1. ↑ Xiao, Y., Carson, D., Boris, L., Mabary, J., Lin, Z., Nicodème, F., Cuttica, M., Kahrilas, PJ and Pandolfino, JE (2014), The acoustic cough monitoring and manometric profile of cough and throat clearing , Diseases of the Esophagus, 27: 5-12. doi : 10.1111 / dote.12038
  2. ↑ Bergauer, U., Janknecht, S. Practice of Voice Therapy: Logopedic diagnostics, treatment suggestions and exercise materials ISBN 978-3-642-10531-9
  3. ^ German Allergy and Asthma Association What is asthma? last checked on February 15, 2016
  4. ↑ Koop, H., Schepp, W., Müller-Lissner, W., Madisch, A., Micklefield, G., Messmann, H., Fuchs, KH, Hotz, J. (2005), Gastroesophageal Reflux Disease - Results of a evidence-based consensus conference of the German Society for Digestive and Metabolic Diseases , Z Gastroenterol; 43 (2): 163-164. doi : 10.1055 / s-2005-857870
  5. ↑ Thamm, M., Ellert, U., Thierfelder, W., Liesenkötter, K.-P., Völzke, H. (2007) Iodine supply in Germany: Results of iodine monitoring in the Children and Adolescent Health Survey (KiGGS) , Federal Health Gazette - Health Research - Health protection; 50 (5): 744-749. doi : 10.1007 / s00103-007-0236-4
  6. ↑ Reiners, C., Wegscheider, K., Schicha, H., Theissen, P., Vaupel, R., Wrbitzky, R., Schumm-Draeger, P.-M. (2004) Prevalence of thyroid disorders in the working population of Germany: ultrasonography screening in 96,278 unselected employees , Thyroid; 14 (11): 926-32. doi : 10.1089 / thy.2004.14.926 . PMID 15671771 .
  7. ↑ Verma, G. Ranula: A Review of Literature ( Memento of the original from February 15, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Arch CranOroFac Sc 2013; 1 (3): 44-49. @1@ 2Template: Webachiv / IABot / doaj.org
  8. ↑ Deutsche Krebsgesellschaft eV SYMPTOMS IN TUMORS OF THE UPPER AIRWAY AND FOOD TRAIL AND LARCOAT CANCER last checked on February 15, 2016
  9. ↑ Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J.-W., Comber, H., Forman, D., Bray, F. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013 Apr; 49 (6): 1374-403. doi : 10.1016 / j.ejca.2012.12.027 . PMID 23485231 .