Throat tickle cough
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Understanding Throat Tickle and Chronic Cough: Insights from Recent Research
Throat Tickle and Chronic Cough: Common Triggers and Symptoms
Prevalence and Patient Characteristics
Chronic cough is a persistent condition affecting a significant portion of the population, often leading to a reduced quality of life. Research indicates that chronic cough is more prevalent among middle-aged and older adults, with a higher incidence in females. A study involving 253 subjects with refractory chronic cough found that the mean age was 60 years, with 76% of the participants being female. The median duration of cough among these subjects was 11 years1.
Sensations and Triggers
Patients with chronic cough frequently report sensations localized to the throat, such as a persistent tickling or irritation. These sensations are often unpredictable and can be triggered by various environmental factors. In a study, 73% of subjects reported a tickle in their throat as a frequent trigger for their cough, while 50% cited poor air quality and 43% mentioned changes in air temperature as common triggers1. Another study highlighted that chronic cough patients often experience sensations like irritation, tickle, and an urge to cough (UTC) when exposed to low-dose tussive agents like citric acid4.
Laryngeal Hypersensitivity
The concept of laryngeal hypersensitivity (LHS) is crucial in understanding chronic cough. LHS refers to an increased sensitivity of the laryngeal area, which can lead to symptoms such as throat tickle, irritation, and discomfort during swallowing. Recognizing LHS in chronic cough patients is essential for selecting appropriate treatment strategies, such as specialist speech and language therapy (SLT) interventions2.
Diagnostic and Therapeutic Approaches
Visual Analogue Scale (VAS)
A throat visual analogue scale (VAS) is a simple and effective tool for detecting laryngeal hypersensitivity in chronic cough patients. This scale helps in rapidly assessing the severity of throat discomfort and identifying patients who may benefit from targeted interventions2.
Experimental Models
Experimental models using low-dose tussive agents, such as citric acid, have been employed to study the sensations associated with chronic cough. These models help in understanding the heightened urge-to-cough and other sensations experienced by chronic cough patients compared to healthy controls4.
Case Studies and Unique Presentations
In some cases, chronic cough can be associated with unique anatomical abnormalities. For instance, a case study reported a 28-year-old male with a chronic cough and a constant tickle sensation in his throat, which was eventually linked to a lingual thyroid. The patient underwent successful transoral laser excision of the lingual thyroid, which alleviated his symptoms5.
Conclusion
Chronic cough, often accompanied by a throat tickle, is a complex condition influenced by various triggers and underlying hypersensitivities. Understanding the patient characteristics, common triggers, and sensations associated with chronic cough is essential for effective diagnosis and treatment. Tools like the throat VAS and experimental models using tussive agents provide valuable insights into the condition, while recognizing unique cases can lead to targeted therapeutic interventions.
Sources and full results
Most relevant research papers on this topic
Patient characteristics and triggers eliciting refractory chronic cough
Refractory chronic cough patients in this study were mostly female, middle/older, slightly overweight, with unpredictable triggers, including throat tickle and irritation, and external factors like poor air quality and temperature changes.
RCT
Rigorous JournalAn evaluation of a throat discomfort visual analogue scale in chronic cough
The throat discomfort visual analogue scale (VAS) is a rapid and simple method to detect laryngeal hypersensitivity in chronic cough patients, potentially guiding targeted treatment strategies.
Rigorous JournalDoing the day's work well: my unlikely COVID-19 renaissance.
COVID-19 has re-energized me, and I am now more committed to my life's work as a doctor, despite the challenges and the re-evaluation of my ideals.
S30 Sensations associated with experimentally evoked cough: a comparison of chronic cough patients with healthy controls
Chronic cough patients exhibit heightened urge-to-cough sensations in response to low-level tussive agents, while healthy volunteers experience higher irritation, tickle, and taste sensations.
Non-RCTRigorous JournalLingual Thyroid Associated with Chronic Cough
Lingual thyroid, a mass in the midline of the tongue, may contribute to chronic cough and should be surgically removed.
Case ReportP104 Sensations associated with experimentally evoked cough: influence of low dose morphine sulphate in opioid responders
Low dose morphine significantly reduces the noxious sensations driving cough, particularly tickle and irritation, suggesting reducing somatic sensations may be an important component of opioid treatment for chronic cough.
RCTRigorous JournalPost-infectious persistent cough: pathogenesis and therapeutic options.
Post-infectious persistent cough is associated with common colds and upper respiratory tract infections, but current therapeutic options are limited and may cause morbidity.
Sounds of sickness: can people identify infectious disease using sounds of coughs and sneezes?
People overperceive pathogen threats in disgusting sounds, rather than accurately identifying the origins of these sounds.
Observational StudyA 35-year-old male with chronic cough
Chronic cough in a 35-year-old male with no history of upper airway viral infection and no gastro-intestinal symptoms suggests a chronic obstructive airway disease.
Case ReportRigorous JournalPredictive value of clinical features for anti-reflux therapy response in suspected gastroesophageal reflux-induced chronic cough
Over half of suspected GERC patients benefit from anti-reflux therapy, with nasal itching, tickle in the throat, pharyngeal foreign body sensation, and sensitivity to at least one cough trigger being associated with treatment response.
Observational Study