A clicking in the throat when swallowing is uncommon but very discomforting and painful for those who experience it. It is such an unusual complaint that symptoms may be dismissed as psychogenic because a cause for clicking in throat problem may not be readily apparent.
Causes of Clicking Sounds during Swallowing
- Globus pharyngitis
Also known as “lump in the throat,” this condition is characterized by the sensation of having phlegm or some sort of obstruction in the throat when none exists. A person is still able to swallow fine, but it can become quite irritating. Occasionally, those affected also experience mild chest pain and/or a clicking sensation when swallowing. A fundamental difference between Globuspharyngeus and other throat issues is that there is no actual lump in the throat when a person experiences the globus sensation (globushystericus).
- Acid reflux (GERD)
A condition caused by the incomplete closing of the lower esophageal sphincter causing stomach acid to escape up into the esophagus causing pain. If occurring for long enough, it may become a condition called gastro esophageal reflux disease (GERD). Untreated GERD has been associated with the development of cancer in the long term. Some patients may experience clicking when swallowing with GERD.
- Eustachian tube function
Normally, the Eustachian tube is collapsed but opens up both when swallowing and with positive pressure (as is the case from taking off or landing on a plane).This change causes the air in the middle ear to expand and contract, which causes this structure to push into the back of the nose and mouth. A balance of varying pressures within the head needs to be maintained. However, they may consequently be producing a clicking sensation when you swallow.
- Cancer of the throat
Cancer of the throat is also a possible cause for feeling something in the throat. In this case, the sensation is more likely to be persistent and may be associated with other symptoms such as a constant sore throat, unexplained earache, difficulty swallowing, voice change or a neck lump that can be felt with the fingers.
A rare abnormal condition of the hyoid bone, which is a horseshoe-shaped boned found on the anterior portion of the neck. A clicking hyoid can be painful, as it is characterized by enlargement of the greater cornua of the hyoid bone, which can impinge on the cervical vertebrae. That may cause an abnormal clicking sound when swallowing.
- Temporomandibular joint syndrome disorder (TMJ disorder)
This disorder is characterized by excruciating pain or tenderness of the jaw. We use our jaw muscles every day to chew our foods, to speak, and even simply just breathing through our mouths. All of these actions rest upon a joint called the temporomandibular joint. This sliding hinge can be the source of pain felt in the joint itself as well as the muscles that control jaw movement. The exact reasons for TMJ disorder development may be difficult to determine, but it can be the result of several factors including genetics, arthritis, or jaw injury.
- Damage to the cartilage of the joints
When the cartilage is damaged, as in osteoarthritis, rheumatoid arthritis, and other types of arthritis, the cartilage loses some of its ground substance and eventually loses fibrils and becomes thin. The surfaces of damaged cartilage become pitted and irregular and no longer allow for the smooth, gliding motion of a normal joint. For this reason, when a joint with structurally damaged cartilage moves, the patient may feel a clicking, grating, or grinding sensation.
- Psychological factors
Psychological distress, such as stress, depression, and health anxiety, is associated with higher rates of globus sensation.
- Eagle’s syndrome
Eagle syndrome is characterized by recurrent pain in the middle part of the throat (oropharynx) and face. “Classic Eagle syndrome” is typically seen in patients after throat trauma or tonsillectomy.
- Cricopharyngeal spasm
cricopharyngeal spasm occurs when the cricopharyngeus muscle in the throat is overly or excessively contracted.
Symptoms of clicking sounds when swallowing
While the most obvious symptom is the production of a clicking sound, the following symptoms may also be present:
- Feeling of a lump in the throat
- Difficulty swallowing
- Dysphagia (pain when swallowing)
- Jaw pain
- Jaw soreness
- Throat soreness
- Mild chest pain
- white tongue when the throat has no saliva
- feeling of bead stuck in the throat or lower neck
- constant throat
- constant mucus build up at center base of neck
- bad breath
How to Diagnose
Examination will almost certainly include a camera examination (flexible nasoendoscopy) of your throat and voice box. The camera examination involves a flexible telescope (usually about the width of a mobile phone charger cable) going through your nose. Most helpful diagnostic procedure was careful examination and palpation of the neck while the patient swallowed to localize the side and source of the clicking. Laryngeal computed tomographic (CT) scans helped in some cases to demonstrate thyroid-cartilage and/or vertebral body asymmetry. The investigators performed a CT scan of larynx and found that it had something to do with a thyroid cartilage
- Endoscopy. A small light and camera are placed in your esophagus so your doctor can have a better look at the area.
- Manometry. This is the measurement of esophageal pressure waves.
Risk Factor that Increase Clicking in Throat Symptom:
- The damaging smoke passes through the larynx to get to the lungs.
- Drinking a lot of alcohol, especially spirits.
- A poor diet may be a risk factor, especially a diet lacking in certain vitamins and minerals.
- Long-term exposure to certain chemicals, fumes or pollutants may irritate the larynx if you breathe them in and may increase the risk.
Treatment for Clicking Sounds during Swallowing
- Over-the-counter medications, including muscle relaxants, may help lessen spasm symptoms.
- GERD will require the utilization of antacid medication to help reduce the production of stomach acid.
- Globus pharyngitis surgery to cut a portion of the thyroid cartilage that was causing the problem may be required to help provide relief.
- Surgery of the neck and larynx to trim the portion of the thyroid cartilage popping in throat that causing the clicking.
- avoiding stressful situations while experiencing spasms or until they have passed
- eating and drinking foods, slowly, to prolong the absence of symptoms
- gently massage of the throat and neck
- gentle neck-stretching exercises
- warm drinks or foods as well as heated bags or pads
When to see a doctor?
People should see a doctor for the Globus sensation when it is accompanied by:
- pain in the throat or neck
- weight loss
- choking when swallowing
- muscle weakness in the throat or elsewhere in the body
- sudden symptoms after the age of 50
- difficulty swallowing
- A mass that can be seen or felt in or around the neck or throat
- symptoms that get progressively worse
- symptoms that signal an infection or other serious health issues, such as fever or swollen lymph nodes
- pain during swallowing.
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