Q: I have chronic mucus in the back of my throat, which I constantly need to clear by coughing. It drives me (and my family) crazy!
-Carol I., Denver, CO
A: Irritants constantly come into contact with our nasal passages, mouth, throat, eyes, and other orifices. All of these structures contain membranes that secrete mucus-an important vector for ridding our systems of unwanted substances. While it can be annoying, mucus can tell us a lot about our health. Thick mucus that's green or yellow, for instance, likely contains spent white blood cells, which can be a sign of bacterial infection. On the other hand, if your mucus is mostly whitish, clear, and a bit frothy, it's most likely a reaction to an irritant. So it's essential to track down and eliminate as many irritants as possible.
Up in the Air
That's easier said than done, as airborne irritants such as pollens, pet dander, and cold viruses are pretty tough to avoid. But it's these types of irritants that create chronic sinusitis, which can produce a "post-nasal drip" down the back of the throat-and this may be the root of your cough. Your best bet may be to install a good HEPA (high efficiency particulate air) filter in your bedroom and office. These relatively inexpensive and effective air filtration devices can make a big difference in reducing the burden on your mucous membranes.
A Neti pot (or similar saline) lavage is another good preventive treatment. Wash out your nose, just as you would brush your teeth, daily. If you have chronic sinusitis, especially when multiple rounds of antibiotics don't seem to produce a permanent solution, you might have a fungal infection. You can add a few drops of antifungal volatile oils such as oregano, thyme, or tea tree into your Neti pot warm saline rinse.
You can also repaint the walls of your home with anti-fungal paint and swab down the windowsills of damper rooms with volatile oils. And don't overlook the fact that you spend 6-8 hours a day sleeping, because your bedding can also contribute to chronic congestion. Change your pillowcases weekly, wash them in hot water, and replace your pillow twice a year.
Food for Thought
Airborne irritants aren't the only potential source of your problem. Food irritants can also cause mucus buildup in your throat. If you think this might be the cause of your problem, try eliminating the most likely suspects from your diet. If your blood type is O, try cutting out wheat (or other grains). Dairy products are notorious phlegm-producers, especially if your blood type is A. And if you're a B blood type, your nemesis may be corn, chicken, or soy.
You might also consider finding a naturopathic physician or nutritional counselor who can administer a blood test that checks for antibodies to food. Ideally, food shouldn't engender an immune response. However, almost everyone has problems digesting a few foods, which effectively become "foreign matter" that the immune system attacks. If this is the case, the best idea is to figure out which foods you shouldn't eat, and stop eating them.
It's also possible, though less likely, that you have an atypical form of gastroesophageal reflux disease (GERD). This happens when stomach contents come swishing back up the throat and cause irritation in the esophagus, throat, or mouth. Most people experience this reflux as "heartburn" because stomach acid is very caustic-and it will definitely cause mucous membranes to hastily secrete a protective layer of mucus. GERD isn't necessarily accompanied by heartburn, however, especially in people whose systems don't produce enough stomach acid.
The solution is to repair the valve at the bottom of the esophagus, known as the lower esophageal sphincter (LES). Three known irritants to the LES are coffee, chocolate, and strong mints. Avoid these for 12 weeks if you suspect you have GERD, whether or not you experience heartburn. Additionally, drink ¼ cup aloe vera juice 2-3 times daily before main meals as a demulcent (soother) and healing agent for the LES. Also consider taking 200-300 mg of deglycerinated licorice root with meals for several months to help heal the sphincter.
And please note that most reflux is not due to "excess" stomach acid, an idea that has been pushed mainly by the makers of antacids. The actual cause of reflux is almost invariably some degree of hiatal hernia. The "hiatus" is another word for the diaphragm, a muscle at the base of the ribcage. The LES lives just below the diaphragm, and, when working properly, keeps stomach contents flowing downwards. But the LES can get stuck open if it is pushed up into a hole in the diaphragm, and if that valve isn't snapped shut and tight, reflux happens.
A hiatal hernia-a condition that occurs when part of the stomach protrudes through an opening in the diaphragm-can occur due to a variety of reasons. Sometimes it just happens spontaneously; sometimes it results from slouching on the couch or lying down too soon after a big meal. Sometimes it's just because the belly is a little chubby and puts excess pressure on the diaphragm. Regardless, heel thunks are an old-fashioned, effective treatment. They can make the stomach drop away from the diaphragm, which can help the healing power of nature tighten the hole around the esophagus so the stomach can't push through. Of course, surgery is sometimes required. But why not try the heel thunks-and not slouching on the sofa-first? See my Web site for more information.