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What’s that tickle in your throat?

by Jessica Bristol, Speech-Language Pathologist

Did you know that speech-language pathologists help to identify and treat irritable larynx syndrome (ILS)? ILS includes conditions along a continuum of severity, from chronic throat clearing (seemingly benign) to laryngospasm (a potentially life-threatening condition in which the vocal cords involuntarily slam shut, making it difficult to breathe). Those who suffer from ILS are thought to be hypersensitive to irritants in the upper airway, after other underlying medical causes are treated or ruled out (i.e., structural or neurological changes). Of the conditions found on the ILS continuum, perhaps the most common are chronic cough and/or throat clearing. Ultimately, cough/throat clearing is meant to protect the lower airway, but if it becomes non-productive, frequent and persistent, it quickly becomes an undesirable physiological response.

There are many quality-of-life implications for those who suffer from chronic cough, including fatigue, embarrassment and isolation, insomnia, MSK pain, voice changes, etc. In many cases, the cough is initially triggered by an underlying illness – post nasal drip syndrome, asthma, reflux, pulmonary disease, etc. However, what initially triggered the cough may not be what maintains it.

Treatment for ILS conditions can involve improving the laryngeal environment after identifying likely triggers, training awareness of sensations that precipitate a cough, and implementing a substitute behaviour in order to recalibrate the sensitivity threshold of upper airway or voice box. For more serious conditions, respiratory exercises, including rescue breathing, may be indicated.

If you or a loved one need support to manage chronic cough or throat clearing, or more serious ILS conditions, such as paradoxical vocal fold movement (PVFM) or vocal cord dysfunction (VCD), please reach out!

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