1. Gastroesophageal reflux disease (GERD): the silent culprit
One of the most common causes of chronic phlegm in the throat is a condition that isn’t always considered: gastroesophageal reflux disease (GERD) . This is a condition in which stomach acid flows back up into the esophagus, the tube connecting the stomach to the mouth. While many associate GERD with the classic sensation of intense heartburn, it often manifests in much more subtle, even “atypical,” ways. These symptoms include persistent phlegm, a chronic dry cough, or a constant tickling sensation that makes you want to clear your throat.
So how does stomach acid cause mucus production? When this harsh acid flows back up the esophagus and irritates the delicate lining of the throat, the body goes into defense mode. It produces more mucus to form a protective barrier. In cases of chronic reflux, this mucus production spirals out of control. Even worse, the constant inflammation can damage the airways and reduce the body’s ability to effectively clear mucus, leading to buildup and even infections. A vicious cycle of irritation and mucus production then begins.
How can you tell if you have GERD? Pay attention to these signs:
- Timing is crucial. Do you notice phlegm, an acidic taste, or a burning sensation in your chest or throat after meals, especially if they are large or fatty? Do these symptoms worsen when you lie down at night?
- You have a nighttime cough. Many people with gastroesophageal reflux disease (GERD) experience a persistent cough at night. Your voice may also become hoarse and deep, especially in the morning.
- You wake up with a sore throat. Waking up with an irritated throat, a mouth full of thick phlegm, and a bitter taste is a classic sign that stomach acid has risen during your sleep.
If you think you might have this problem, the first thing to do is consult your doctor, who can prescribe an endoscopy to confirm the diagnosis. In the meantime, you can take steps at home. Avoid foods that worsen reflux, such as fatty meals, spicy foods, chocolate, coffee, carbonated drinks, and alcohol. Most importantly, stop eating at least two to three hours before going to bed. You can also elevate the head of your bed by about 15 to 20 cm or use a few extra pillows. Gravity is your ally: it helps keep stomach acid in its place.
2. Chronic sinusitis: much more than just a blocked nose
The second major cause is chronic sinusitis . Your face has a network of air-filled cavities called paranasal sinuses, located around your nose, between your eyes, and on your forehead. These sinuses are lined with a membrane that produces a thin layer of mucus, essential for trapping dust, pollen, viruses, and bacteria, thus protecting your airways.
However, when these sinuses become chronically inflamed—due to environmental pollution, uncontrolled allergies, nasal polyps, or even a structural problem like a deviated septum—the situation worsens. The inflammation causes the mucous membrane to swell and leads to an excessive production of thick mucus. If the sinuses cannot drain properly, this mucus accumulates, creating an environment conducive to bacterial growth and resulting in symptoms such as headaches, a feeling of pressure in the face, and that unpleasant sensation of mucus constantly dripping down the back of the throat.
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