Chronic Cough and Throat Clearing | Causes & Assessment

A Patient’s Story

Sophie, a 29-year-old yoga instructor from London, noticed she was clearing her throat constantly and coughing during classes. She had no signs of a cold or flu and felt hoarseness in her voice every morning. Despite trying over-the-counter remedies, nothing improved.

At LSDC Healthcare, we see patients like Sophie frequently. Persistent throat irritation can sometimes be linked to digestive issues, not just respiratory infections.

What Causes Chronic Cough and Throat Clearing?

While occasional coughing is normal, persistent coughing or throat clearing may indicate an underlying problem. Digestive conditions are a common cause, though other issues such as asthma or allergies may also play a role.

Related symptoms to watch for:

• Acid reflux (heartburn) or indigestion

• Hoarseness of voice

• Difficulty swallowing (dysphagia)

Digestive-Related Causes

Acid Reflux
Stomach acid may rise into the esophagus and throat, causing LPR (silent reflux), even without chest pain. Symptoms can include:

• Bitter taste in the mouth

• Bloating

• Nausea

• Bad breath

Barrett’s Oesophagus
Long-term acid reflux can damage the esophagus lining. Signs include:

• Recurrent heartburn

• Regurgitation

• Dysphagia

GORD / GERD
A weakened lower esophageal sphincter can cause frequent and severe reflux. Symptoms may include:

• Heartburn multiple times a week

• Bloating or belching

• Halitosis or sore throat

Eosinophilic Oesophagitis (EoE)
A rare cause of chronic throat irritation, EoE involves inflammation that may create food impaction or chest discomfort.

Swallowing Problems (Dysphagia)
Difficulty swallowing can irritate the throat and trigger persistent coughing. Causes include achalasia or other structural abnormalities.

Functional Cough
Some people develop a heightened throat sensitivity, causing constant throat clearing. This is harmless but benefits from professional assessment.

Other potential contributors:

• Nasal allergies

• Anxiety disorders

• Medication side effects

• Lung conditions, such as asthma, COPD, bronchiectasis

How We Diagnose

At LSDC, we start with a detailed consultation, reviewing your symptoms, frequency, and potential triggers. We may then recommend targeted tests, such as:

• Barium swallow – to view the upper GI tract

• Laryngoscopy – to inspect the throat and voice box

• Bravo pH capsule test – to measure esophageal acidity

• 24-hour pH impedance test – to track fluid and acid in the esophagus

• High-resolution oesophageal manometry – to check esophageal muscle and valve function

If needed, endoscopy can provide a clearer view of the upper GI tract. Allergy testing may be suggested if nasal causes are suspected.

Treatment Approaches

Treatment depends on the underlying cause. Digestive-related issues may be managed with:

• Diet adjustments (e.g., Mediterranean diet, avoiding cow’s milk)

• Bed elevation of 30 degrees to reduce reflux

• Hydration and soothing teas

• Sugar-free cough drops

• Antihistamines if allergies contribute

• Lifestyle changes: reduce smoking, alcohol, and stress

If home strategies are insufficient, our specialists may recommend:

• Medications to reduce reflux

• Endoscopic procedures such as Stretta therapy

• Targeted treatments for structural or functional issues

When to Seek Specialist Review

• Persistent throat clearing or cough without a cold or flu

• Hoarseness lasting more than two weeks

• Difficulty swallowing or food sticking in the throat

• Symptoms affecting your daily activities or voice