Keep coughing and feels like something in throat

If you feel like you have food stuck in your throat, it can be uncomfortable, annoying or even painful. Here’s how to determine what’s causing the unpleasant sensation and how to get relief.

“The most common reason people feel like they have food stuck in their throat is dysphagia due to gastroesophageal reflux disease (GERD),” says Loreli Garnica, M.D., a Piedmont family medicine physician. “GERD is also known as heartburn or reflux.”

That said, the first thing you want to do is make sure you don’t actually have food stuck in your throat, as this can cause a medical emergency.

“Food can get stuck in the top part of the esophagus, which can go into the windpipe and cause air obstruction and choking,” says Dr. Garnica.

What to do if someone is choking

The signs that someone is choking include:

• Inability to talk

• Difficulty breathing

• Noisy or squeaky breathing

• Blue lips, nails or skin

• Skin that’s flushed, then turns pale or bluish

• Coughing

• Drooling

If a person can cough forcefully, encourage them to keep coughing. If they are choking and can’t talk or cough forcefully, try the following techniques from the American Red Cross:

• Start by giving them five back blows. Bend them forward and hit them on their back between the shoulder blades with the heel of your hand. Repeat five times.

• Perform the Heimlich maneuver and give them five abdominal thrusts. Stand behind the person and wrap your arms around their waist. If a child is choking, kneel behind them. Make a fist with one hand and place the thumb side at the person’s midsection. Cover your fist with your other hand. Squeeze their abdomen with five quick, upward thrusts.

• Repeat these two techniques until the person can breathe or cough again. If they become unconscious, call 911 and start CPR.

• Never perform a blind finger sweep (where you use your finger to try to dislodge the item from their mouth or throat). This can push the object further into their airway.

If you’re choking and alone:

• Call 911.

• Place your fist just above your belly button.

• Wrap your other hand around your first.

• Bend over a hard surface like a chair or countertop.

• Firmly press your first inward and upward.

It can be helpful to take a first aid class to learn these techniques from a professional. Having these skills can save someone’s life.

Signs of gastroesophageal reflux disease

If you feel like food is stuck in your throat, but you’re not choking, the most common culprit is GERD. Sip some water and take an over-the-counter antacid like Tums, Dr. Garnica suggests.

Symptoms of GERD include:

• Feeling like there’s a lump in your throat

• Trouble swallowing

• Chronic cough

• A burning sensation in your chest (Unlike a heart attack, GERD presents as more of a burning sensation, while a heart attack feels like chest tightness or pressure, she says.)

For chronic heartburn symptoms, Dr. Garnica recommends making lifestyle changes first. The following lifestyle modifications can help relieve symptoms: 

• Avoid triggers like spicy, fatty or acidic foods.

• Don’t lie down for at least three hours after eating.

• Quit smoking if you currently smoke.

• Eat smaller meals.

• Elevate the head of your bed by about six inches.

“If lifestyle changes don’t work, we have medications we can try, including over-the-counter and prescription antacids,” she says. “Left untreated, GERD can potentially cause damage to the esophagus and even lead to esophageal cancer.”

When to seek medical care if you feel like something is stuck in your throat

“Be aware of your symptoms and listen to your body,” says Dr. Garnica. “If you have any health concerns, it’s always a good idea to seek medical evaluation.”

We make getting great health care simple and convenient. Schedule an appointment today through your Piedmont MyChart account or our website.

Laryngeal pharyngeal reflux (LPR) At A Glance

• Reflux of gastric acid can cause several throat problems
• Symptoms and treatment of LPR are often different from typical GERD symptoms
• LPR will usually heal well with proper diagnosis and treatment

Many people with throat discomfort are surprised when they are told by their doctor that they have laryngeal pharyngeal reflux (LPR). Gastric acid can cause significant inflammation when it falls on the vocal cords.

If this happens repeatedly, a person can be left with a number of bothersome throat problems. Examples include:

• Hoarseness
• Frequent throat clearing
• Coughing,
• Sensation like something stuck in the throat

There are individuals with gastroesophageal reflux disease (GERD) who have throat discomfort. People with GERD have gastric reflux into the esophagus. This typically causes heartburn and regurgitation (a sense of fluid coming up).

Many people with LPR do not have any of the typical GERD symptoms.

Learn more about the symptoms of GERD

This has lead to some controversies and misunderstandings about LPR:

• Is it a symptom of GERD?
• Are patients with it a subset of GERD?
• Is it a completely different medical problem?

There is not a good answer to these questions, as there is some truth to each of them. It may be easier for physicians to manage LPR if it’s approached as a completely different problem.

People with GERD nearly always have heartburn. Additionally, they:

• Usually improve quickly with appropriate medical treatment
• Frequently require life-long medical treatment
• Are at risk for developing significant damage to the lining of the esophagus, including esophagitis or sometimes Barrett’s esophagus

On the other hand, LPR is quite different. Many people with LPR do not have heartburn. Additionally, they:

• Require larger doses of medications for weeks to months before seeing any improvement
• Usually do not require long-term treatment
• Rarely develop complications

Causes

LPR frequently begins after an upper respiratory illness. However, some of the symptoms seem to linger after the cold or flu is better. The theory is that there is some reflux of stomach acid into the throat, which irritates the already irritated vocal cords. If the acid reflux continues, the damage to the vocal cords will progress.

The amount of acid reflux required to cause this is very small. This explains why most of these individuals do not have heartburn. The injury may be greater in people who use their voice vigorously, such as singers or teachers.

Symptoms

Individuals with persistent throat symptoms, such as hoarseness, frequent throat clearing, or coughing should seek medical attention. The feeling that there is something stuck in the throat, a globus sensation, is a classic symptom of LPR.

Read more about Globus

Throat pain, weight loss, or smoking history should be considered worrisome. Throat pain is an uncommon manifestation of LPR.

Most patients eventually have a test called laryngoscopy by an ear, nose and throat (ENT) doctor. With this test, the ENT physician can visualize the vocal cords and look for the characteristic findings of LPR, such as swelling. Unfortunately, many people with normal examinations or a little redness are told incorrectly that they have LPR.

Treatment

Once the diagnosis is suspected, two things will help:

1. The reflux needs to be well controlled. This usually requires a twice a day dose of a proton pump inhibitor (PPI). These powerful medications suppress stomach acid and relieve acid reflux. It often requires treatment for 2–6 months before significant improvement is seen.
2. Attempts to improve vocal hygiene should be undertaken. The person should drink plenty of liquids to prevent a dry throat. Caffeine, alcohol, antihistamines, and menthol containing cough drops all have a drying effect and should be avoided. Avoid tobacco. Care needs to be taken to not overuse the voice by shouting, whispering, speaking for a long period of time, or clearing the throat.

Throat clearing is a common symptom. However, it tends to worsen the injury. Here are 3 things that may help stop the throat clearing:

1. Try swallowing to clear the throat
2. Exhale forcefully rather than cough
3. Gently tap the vocal cords together rather than a forceful effort to clear the throat

People who improve should talk to their doctor to try to stop their anti-reflux medications. The majority of individuals with LPR do not require life-long medical treatment for their reflux.

Those who do not improve should see their doctor and consider a repeat laryngoscopic examination to re-evaluate the diagnosis.

The doctor may also consider doing a test to precisely measure acid reflux, such as ambulatory pH monitoring. In this test, a thin tube is passed through the nose and into the esophagus. The pH can be measured every few seconds for 24 hours. Rarely, people with LPR have severe enough symptoms that they require anti-reflux surgery.

Individuals with LPR usually do well with proper diagnosis and treatment. It may take several months for this to happen.

The keys to success are:

• An accurate diagnosis
• Good control of acid reflux
• Good vocal hygiene during the healing process

Adapted from IFFGD Publication: Another Complication of Reflux: Laryngeal Pharyngeal Reflux (LPR) by J. Patrick Waring, MD, Digestive Healthcare of Georgia, Atlanta, GA.

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