We’ve all been there—the nagging urge to clear your throat, often accompanying a cough or cold, typically vanishing once you’re back to full health.

However, for some individuals, this irritation lingers far beyond the usual recovery period.

According to a 2022 study, approximately 60,000 people in the UK may suffer from chronic throat issues. These include persistent throat clearing, a sensation of a lump in the throat, or a hoarse voice, which can last for months or even years.

This issue was highlighted by Dr. Ellie Cannon, a Mail on Sunday columnist and general practitioner, in her column last month.

Dr. Cannon shared an anecdote about a friend who found a colleague’s incessant throat clearing to be quite bothersome. She then posed a question to her readers: Have you ever been caught in the cycle of repeatedly clearing your throat, and if so, did you uncover the underlying cause? The response was overwhelming, with numerous readers reaching out to share their own struggles with chronic throat clearing, often without any relief.

One 78-year-old woman shared her experience, writing, “I frequently find myself apologizing for clearing my throat, and at night, I often have to sit up, sipping water and coughing.”

‘I am so fed up with it, especially if I am out or at the theatre,’ said another. One 69-year-old man said: ‘It drives me mad – and my wife too! On occasions, I panic because I don’t feel I will manage to settle and go to sleep. I don’t know what to do.’

Experts say there are many reasons why patients may experience chronic throat clearing – and that the symptom, if it persists for more than a few weeks, should always be discussed with a GP. But, intriguingly, some now believe there could be a simple issue repeatedly missed by doctors that would put thousands out of their misery.

As many as 60,000 people in the UK could be living with chronic throat issues – throat clearing, the feeling of a lump, or a hoarse voice 

Professor Anthony Hobson, a gastrointestinal scientist at London’s Functional Gut Clinic, says a common but little-known food intolerance could be a major driver of throat irritation, particularly in older adults.

‘Chronic throat clearing can be due to things such as acid reflux or serious issues like cancer,’ he says. ‘But for the vast majority of patients, there will be a much more common explanation. And there are simple lifestyle changes that can get rid of this. But many GPs don’t know about them – meaning thousands of patients are potentially living without treatment or taking medication that is entirely unnecessary.’

While tens of thousands the UK are seen annually by specialists for persistent throat issues, many more will see their GP without being referred to a throat expert.

In most cases, throat clearing, like a cough, will just be a long-lasting symptom from a viral respiratory infection, such as a cold. Known as post-nasal drip, it can occur when excess mucus from the nose drips down the throat, causing a tickling sensation, and can persist after an infection for more than eight weeks. But when the sensation continues for longer than this – or worsens – it can be a sign of an underlying problem.

For some, especially older adults, this can be due to damage to the nerves or muscles in the food pipe – the oesophagus.

Professor Alyn Morice, head of respiratory medicine at the University of Hull, says: ‘The problem can be triggered by viruses or infections – which increase the susceptibility of the nerves to damage – or simply by age, as the nerves become more sensitive.

‘One of the most common symptoms of this nerve irritation is throat clearing, as it can feel like a tickle in the throat.’

Diagnosed once other conditions are ruled out through a medical examination of the oesophagus, the issue can be dealt with through speech therapy and with certain medications, says Professor Morice.

Drugs, including antibiotics and the anti-nausea medication metoclopramide, appear to help, though both must be discussed with a medical professional first.

In other cases, throat clearing can also be caused by acid reflux, also known as heartburn – whereby the acidic contents of the stomach travel back up into the oesophagus.

One in three people in the UK will experience acid reflux, but many wrongly presume they don’t have acid reflux if they don’t have heartburn, an uncomfortable feeling in the chest. But in some cases, throat clearing can be the only symptom of the condition as the acid causes irritation in the throat. This triggers the production of mucus, and throat clearing is simply a reflex response to clear this.

Without treatment, acid reflux can lead to serious complications such as oesophageal sores and inflammation. It can also increase the risk of throat cancer.

The first step when looking at throat issues is ruling out things like cancer, some forms of which can cause symptoms like throat clearing.

Patients are then usually sent to a gastrointestinal specialist, who will insert a camera through the nose to look for signs of acid reflux.

‘More often than not, there’ll be a bit of redness there – and patients can be prescribed very strong medications for the condition,’ says Professor Hobson.

Drugs known as proton-pump inhibitors (PPIs), which work by reducing the amount of acid produced in the stomach, have also been relied upon for years by GPs to treat the condition.

But recent research suggests there can be serious health risks from taking PPIs for too long, with long-term use linked to mental health problems, bone-thinning osteoporosis, cancer, Parkinson’s and dementia.

Instead, lifestyle changes are now considered the most effective treatment for acid reflux.

Being overweight or obese, smoking, eating a diet high in fatty or processed foods and drinking alcohol are all considered risk factors. Patients may also be given over-the-counter medications that neutralise stomach acid, and are safe to take long term.

This was the case for 82-year-old Rocky Gooding.

Having recovered from thyroid cancer just a few years before, Rocky grew panicked after finding herself clearing her throat for weeks on end.

‘I would get a lot of phlegm in my nose that would go down the back of my throat in the night, so when I woke up in the morning I would have to clear my throat endlessly,’ she says.

‘It was getting to the point where I was having trouble swallowing – if I took a vitamin or pill that was too big I would choke slightly. I began to get nervous that the cancer had come back.’

Eventually, Rocky mentioned her throat clearing to her GP during a routine check-up, and after further tests was diagnosed with acid reflux.

Now the grandmother-of-two uses nasal rinses twice a day and takes heartburn relief medication Gaviscon before she sleeps – which she says has massively improved her throat clearing.

‘If you’re experiencing other symptoms – like heartburn, regurgitation or a cough – there’s a high chance acid reflux is behind persistent throat clearing,’ says Professor Hobson.

‘But most people with throat symptoms don’t have the rest of these – and doctors will put them on anti-acid medications for two months or longer, which won’t cure the issue.’

However, Professor Hobson argues that many people with chronic throat clearing are suffering from another underdiagnosed problem: an intolerance to common foods such as onions and garlic.

A food intolerance is not the same thing as an allergy – a damaging immune reaction to certain compounds. Instead, an intolerance occurs when the digestive system has trouble breaking down certain foods.

For Jan Kirby, 68, throat clearing was the first – and only – sign of the stage four liver cancer that later took her life

In this case, Professor Hobson claims an intolerance to a carbohydrate called fructan is likely to be to blame for chronic throat clearing.

Fructan is also found in fruits such as watermelon and grapefruit, as well as legumes such as kidney beans.

Studies estimate as much as four in ten of the population may have some sort of sensitivity to fructan, which can worsen with age, as digestion naturally slows.

When the body can’t fully digest fructan, Professor Hobson says excess gas builds up in the stomach.

‘This gas pushes up stomach fluid into the throat,’ he says. ‘It’s similar to when people burp and a bit of fluid comes up. However, the difference is that, normally, we swallow that fluid, meaning it doesn’t affect the throat.

‘But at night the throat muscles relax, leaving that fluid to pool at the back of the throat for hours, causing irritation.

‘This is why many people report symptoms of throat clearing being worse in the morning. And why, unlike with acid reflux – where pure stomach acid is being pushed into the throat – it causes more mild symptoms, like feeling the need to clear your throat, rather than ulcers and burning.’

Luckily, he says, there are some easy fixes.

First, patients who suspect their gut may be behind their throat problems should try to modify their diet – cutting out foods that are high in fructan.

There is also a product, called Fodzyme, which can help digest foods high in fructan. A month’s supply can be purchased for around £65.

‘If you’re going out for dinner, and can’t control the amount of fructan in your meal, then you can take this alongside your food,’ says Professor Hobson.

Medications such as Gaviscon – which creates a barrier to keep the contents of the stomach down – can also help when taken before bed. And, crucially, experts say it is important that patients consider when they eat big meals.

‘If you want to eat a heavy meal, eat it for breakfast or lunch, not last thing at night before you sleep,’ says Professor Hobson. ‘This reduces the risk of stomach fluid pooling in the back of the throat.

‘There is no easy cure for this problem but, with the right knowledge and planning, patients can reduce their symptoms.’

…But for Jan it was a sign of terminal cancer

While the family will never know for sure, it’s likely that the throat clearing was caused by the cancer in Jan’s lungs

For fit and healthy Jan Kirby, 68, throat clearing was the first – and only – sign of the stage four liver cancer that later took her life.

The doting mother and grandmother developed the symptom in the summer of 2024, says husband Rob. ‘She started clearing her throat all the time,’ he recalls. ‘It didn’t keep her up at night, but it was really obvious when we were doing things like sitting and watching telly.’

Rob urged Jan to visit her GP, but she refused – and the throat clearing went away.

Then, in November of that year, Jan’s health declined.

‘She would complain of feeling queasy after a glass of wine and felt bloated after eating,’ says Rob. ‘So I took her in for further tests.’ On Christmas Day, they received the tragic news – Jan had advanced liver cancer that had spread to her spine and lungs.

While the family will never know for sure, it’s likely that the throat clearing was caused by the cancer in Jan’s lungs.

The doctors told the couple that nothing more could be done.

‘I said in that case, I’m taking her home – she didn’t want all those tubes and wires coming out of her nose and veins,’ says Rob. And he did. Just weeks later, Jan passed away.

Now, Rob hopes that Jan’s story will encourage others to seek help when they develop similar symptoms.

‘Jan never complained about anything,’ he says. ‘You wouldn’t believe she was so ill in those last months. She had no other symptoms at all.

‘We’re all heartbroken and devastated but have to carry on. I just hope her story might help somebody else.’