Persistent Cough and Foreign Body Sensation: ENT Concerns Explained

Feeling of a foreign body sensation with persistent cough?

I have been coughing for almost six months.
At first, it was just an itchy sensation (which I could suppress) and occasional feelings of something stuck in my throat (which would make me cough involuntarily).
Over time, the frequency of the sensation increased, and the itchiness became more pronounced, leading to daily coughing.
I consulted a doctor who prescribed expectorants, but they had no effect.
I then visited another clinic where they diagnosed me with a Mycoplasma infection, but the treatment also yielded little improvement.
As soon as I stopped taking cough suppressants, the coughing returned immediately.

Over the past six months, my symptoms have progressed from occasional itchy coughs to constant coughing every minute, with sudden, intense coughing fits at certain times of the day.
The sensation of something stuck has become more severe, feeling like there is something lodged in my throat near the collarbone, which then spreads upward, causing me to suppress violent coughing that I cannot relieve.
Is there an issue with my throat? Should I see an otolaryngologist or another specialist? P.S.
I have hardly experienced any nasal discharge or allergies during this time.

Ru, 20~29 year old female. Ask Date: 2022/09/09

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the situation you described may be indicative of chronic pharyngitis.
It is recommended to seek medical attention for a laryngoscopy examination (to rule out any masses) and to consider pharmacological treatment.
In addition to medication, please pay attention to the following lifestyle recommendations: avoid lying down for two hours after eating, and refrain from coffee, tea, cigarettes, alcohol, fried foods, and spicy foods, as these can help improve symptoms.
Wishing you safety and good health.

Reply Date: 2022/09/09

More Info

Persistent cough and the sensation of a foreign body in the throat can be quite distressing and may indicate several underlying issues. Given your symptoms, it is essential to consider various potential causes and the appropriate medical specialties to consult.

Possible Causes
1. Postnasal Drip: Even if you haven't experienced significant nasal symptoms, postnasal drip can occur without noticeable nasal congestion. Mucus can accumulate in the throat, leading to irritation and a persistent cough. This often feels like a foreign body sensation, as mucus drips down the back of the throat.

2. Chronic Allergies: Allergies can cause throat irritation and a cough without the typical symptoms of a runny nose. Allergens can lead to inflammation in the throat, resulting in a persistent cough and the sensation of something being stuck.

3. Gastroesophageal Reflux Disease (GERD): GERD can cause chronic cough and a sensation of a lump in the throat (globus sensation). Acid reflux can irritate the throat and lead to coughing, especially at night or after meals.

4. Infections: While you mentioned being treated for a mycoplasma infection, other infections such as viral or bacterial infections can also cause prolonged cough. If the initial treatment was ineffective, it may be worth re-evaluating the diagnosis.

5. Laryngeal or Pharyngeal Issues: Conditions affecting the larynx or pharynx, such as laryngitis or pharyngitis, can lead to chronic cough and a sensation of a foreign body. These conditions can be caused by infections, irritants, or even vocal strain.

6. Psychogenic Cough: Sometimes, a cough can be habitual or psychogenic, where there is no underlying physical cause, but the cough persists due to behavioral or psychological factors.

Recommended Specialists
Given the complexity of your symptoms, it would be advisable to consult an Ear, Nose, and Throat (ENT) specialist. An ENT can perform a thorough examination of your throat, larynx, and nasal passages to identify any abnormalities or sources of irritation. They may also conduct tests such as a laryngoscopy to visualize the throat and vocal cords directly.

If the ENT rules out structural or infectious causes, they may refer you to an Allergist to evaluate for potential allergic reactions or sensitivities that could be contributing to your symptoms. Additionally, if GERD is suspected, a consultation with a Gastroenterologist may be warranted to assess and manage any reflux issues.

Diagnostic Steps
1. History and Physical Examination: A detailed history of your symptoms, including their onset, duration, and any associated factors, will help guide the diagnosis. A physical examination will focus on the throat and nasal passages.

2. Allergy Testing: If allergies are suspected, skin prick tests or blood tests can help identify specific allergens.

3. Imaging Studies: In some cases, imaging studies such as a CT scan may be necessary to evaluate for structural abnormalities.

4. Laryngoscopy: This procedure allows the doctor to visualize the throat and larynx directly, helping to identify any lesions, inflammation, or other abnormalities.

5. Trial of Treatment: Sometimes, a trial of treatment for GERD or allergies may be initiated to see if symptoms improve.

Conclusion
Persistent cough and the sensation of a foreign body in the throat can be caused by various factors, including postnasal drip, allergies, GERD, infections, or laryngeal issues. Consulting an ENT specialist is a crucial first step in diagnosing and managing your symptoms effectively. They will be able to provide a comprehensive evaluation and guide you toward appropriate treatment options. If necessary, further referrals to allergists or gastroenterologists may be beneficial based on the findings. Remember, addressing these symptoms early can significantly improve your quality of life.

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