Persistent Throat Irritation and Cough: Potential Causes

Itchy throat and cough, as if there is a lump?

I smoked from the age of 14 until I quit on October 24, 2013, when I started working at my current job in customer service, which involves talking all day.
I also talk a lot at home.
Since quitting smoking, I've been speaking more, and I occasionally cough but didn't pay much attention to it.
Around October 2016, I noticed an increase in my coughing.
One night in October, I felt something drop on the left side of my throat while sleeping, but I didn't think much of it and continued to sleep.
The next day, my throat started to hurt, and I developed ulcers and inflammation.
I only applied an oral ulcer ointment, and it healed in about one or two days.
During this time, my coughing increased slightly compared to previous years, and I thought it might be due to talking too much.
About a month later, I experienced a similar situation where I felt something drop again while sleeping, and I swallowed something that felt gritty and foul.
I didn't get up to check, but the next day, I started experiencing inflammation again.
This time, I used a flashlight and mirror to examine my throat and applied medication until it healed.
I suspected it was caused by tonsil stones, as I noticed an ulcer on the left side beneath the tonsil and a white spot on the right tonsil that looked like a stone.

Earlier this year, after the second episode of inflammation healed, about a month later, I had inflammation on the right side without the sensation of something dropping.
I checked with a flashlight and saw the white spot on the right tonsil was still there, indicating it wasn't tonsil stones.
I treated the inflamed area until it healed, and all three episodes of inflammation were about the size of a ten-dollar coin.
In February, I caught a cold and didn't take much medication for the inflammation; I used a throat spray prescribed by my daughter's doctor that contained benzydamine, although I forgot the name.
I had typical cold symptoms like a runny nose, and then I recovered.
In early March, I experienced throat pain again and used the spray directly.
My family also caught the cold and recovered, but I started coughing frequently.

The cough that began in early March was in the same area as the first and second episodes of inflammation, and sometimes I felt an itchy sensation in my throat, making it difficult to speak.
I would have to cough before I could talk again.
I coughed more during work calls and less at home, though it still occurred.
When I looked in the mirror, I noticed a lump that felt harder than the surrounding tissue.
As of today, it appears to have shrunk somewhat, but there is still a lump present.
(I'm not entirely sure if the itchy area and the lump are the same.) I haven't seen a doctor yet, and I'm a bit worried but hesitant to seek medical attention.
What could be the issue?

Mr. Mu, 30~39 year old female. Ask Date: 2017/03/24

Dr. Ji Zhaoyun reply Otolaryngology

Hello Mr.
Mu, based on your description, it is most likely that you are experiencing pharyngitis and oral ulcers along with tonsilloliths.
Treatment typically involves the use of certain medications, and antibiotics may be prescribed if necessary.
It seems that there are multiple small lesions in your mouth, which could be ulcers.
Most ulcers heal within two weeks of treatment; however, if they persist beyond two weeks, further examination is required.
Your current condition appears to lean towards pharyngitis and oral ulcers with tonsilloliths, and the disease process seems to be ongoing.
It is recommended that you consult an otolaryngologist and take medications as needed.
Wishing you safety and health.
Sincerely, Dr.
Chi Chao-Yun, Head of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2017/03/24

More Info

Persistent throat irritation and cough can be quite concerning, especially given your history of smoking and the symptoms you've described. Let's break down the potential causes and considerations for your situation.

Potential Causes of Throat Irritation and Cough
1. Post-Nasal Drip: Given your history of frequent throat irritation and cough, one common cause could be post-nasal drip. This occurs when excess mucus accumulates in the back of the throat, often due to allergies, sinus infections, or even common colds. The sensation of something "dripping" down your throat can lead to irritation and coughing.

2. Chronic Bronchitis: Your history of smoking for 18 years could have led to chronic bronchitis, which is characterized by a persistent cough and mucus production. Even after quitting smoking, the respiratory system can take time to heal, and chronic bronchitis can persist.

3. Gastroesophageal Reflux Disease (GERD): GERD can cause throat irritation and a chronic cough due to stomach acid irritating the esophagus and throat. Symptoms may worsen at night or after eating, and you might not always be aware of the reflux.

4. Tonsillitis or Tonsil Stones: The episodes of throat pain and the presence of white spots on your tonsils suggest possible tonsillitis or tonsil stones. These conditions can cause inflammation, pain, and contribute to chronic throat irritation.

5. Laryngeal Irritation: Given your job in customer service, where you talk a lot, you may be experiencing laryngeal irritation or vocal cord strain. This can lead to a sensation of a lump in the throat, hoarseness, and a persistent cough.

6. Allergies: Allergic reactions can lead to throat irritation and coughing. If you have seasonal allergies or are exposed to irritants (like dust or pet dander), this could exacerbate your symptoms.

Recommendations
1. Medical Evaluation: It is crucial to see a healthcare provider for a thorough evaluation. They may perform a physical examination, including a laryngoscopy, to visualize your throat and vocal cords. This can help identify any abnormalities or inflammation.

2. Allergy Testing: If allergies are suspected, consider getting tested to identify specific triggers. Managing allergies can significantly reduce throat irritation.

3. Lifestyle Modifications: Since you have a history of smoking, avoiding irritants such as smoke, strong odors, and allergens can help. Staying hydrated and using a humidifier at home can also soothe throat irritation.

4. Voice Rest: Given your vocal demands at work, try to incorporate voice rest periods throughout the day. This can help reduce strain on your vocal cords.

5. Medications: Over-the-counter antihistamines or nasal corticosteroids may help if post-nasal drip or allergies are contributing to your symptoms. If GERD is suspected, lifestyle changes and medications to reduce stomach acid may be beneficial.

6. Follow-Up: If your symptoms persist or worsen, follow up with your healthcare provider. They may recommend imaging studies or further tests to rule out any serious conditions.

Conclusion
While your symptoms may stem from a variety of causes, it is essential to seek medical advice to determine the underlying issue. Early intervention can prevent complications and improve your quality of life. Don't hesitate to reach out to a healthcare professional; they can provide the necessary guidance and treatment options tailored to your specific situation.

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