What causes itchy throat allergies

Dry, itchy and sore throats are common symptoms which numerous seasonal allergies sufferers own to endure. They may not be the symptoms which spring to mind when we ponder of allergies, but for those who experience it, they can be some of the most irritating, making it painful to swallow.
Dry throat
We every know that if we hold our nose, we own to breathe through our mouth.

Holding your nose creates a similar effect to that of nasal congestion. If seasonal allergies is causing a blocked nose, you will be forced to use your mouth to breathe.

Your nose is lined with fine hair and mucus, making it more effective at warming air than your mouth. Having a blocked nose means that freezing air is entering your mouth and throat when you breathe, drying out the moisture created by saliva. As the tissue in your throat is more sensitive than your mouth, we tend to notice the effect of dryness in our throats first.

Itchy throat
Your nose is also better at filtering air than your mouth.

This means that it traps pollen particles before they can enter into your system.

What causes itchy throat allergies

However, when you start to breathe through your mouth, the pollen particles own direct access into your body. They land at the back of your throat, irritating the tissue.

Additionally, your body senses the arrival of pollen, and treats it as a potentially threatening foreign body. This triggers the release of the chemical histamine to fight off the invasion. Histamine causes the nerve endings to become more sensitive, resulting in symptoms of itchiness in the throat and soft palate.

Sore throat
The combination of a dry and itchy throat, particularly over a prolonged period of time such as throughout the seasonal allergies season, often causes the throat tissues to become inflamed – this is experienced as a sore throat.

In addition, excess mucus in inflamed nasal passages and sinuses drains to the back of the throat, in a process called post-nasal drip.

This mucus irritates the sensitive tissues of the throat, causing tenderness. This is particularly noticeable when swallowing.


References:

  • Morales-de-Leun G, Lupez-Garcia A, Arana-Muooz O, Carcaoo-Perez Y, Papaqui-Tapia S, Caballero-Lupez CG, et al. [Correlation of cutaneous reactivity between allergenic extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae with Blomis tropicalis in patients with allergic rinitis and asthma]. Rev Alerg Mex. ;59(3) Epub /07/ CorrelaciUn de reactividad entre extractos alergEnicos de Dermatophagoides pteronyssinus y Dermatophagoides farinae, con Blomia tropicalis en pacientes con rinitis alErgica y asma.
  • Vidal C, Boquete O, Gude F, Rey J, Meijide LM, Fernandez-Merino MC, et al.

    High prevalence of storage mite sensitization in a general adult population. Allergy. ;59(4) Epub /03/

  • Fonseca Fonseca L, Diaz AM. IgE reactivity from serum of Blomia tropicalis allergic patients to the recombinant protein Blo t 1. Puerto Rico health sciences journal. ;22(4) Epub /02/
  • Wuthrich B, Schmid-Grendelmeier P, Schindler C, Imboden M, Bircher A, Zemp E, et al. Prevalence of Atopy and Respiratory Allergic Diseases in the Elderly SAPALDIA Population. Int Arch Allergy Immunol. ;(2) Epub /08/
  • Arlian LG, Morgan MS, Neal JS.

    Dust mite allergens: ecology and distribution.

    What causes itchy throat allergies

    Curr Allergy Asthma Rep. ;2(5) Epub /08/

  • Khalil G, Haddad C, Otrock ZK, Jaber F, Farra A. Halzoun, an allergic pharyngitis syndrome in Lebanon: the trematode Dicrocoelium dendriticum as an additional cause. Acta tropica. ;(1) Epub /10/02
  • Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. [A case of parasite in throat with laryngeal itching and cough as the first symptom]. [Article in Chinese] Aug; 46(8)

Desiree Larenas-Linnemann, MD
Clinic of Allergy, Asthma and Pediatrics Hospital Medica Sur
Mexico City, Mexico

Garry Stadtmauer, MD
City Allergy
New York, New York, USA

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Note: Please read disclaimer.

Ask the Expert is for licensed physicians only.

Desiree Larenas-Linnemann, MD
Clinic of Allergy, Asthma and Pediatrics Hospital Medica Sur
Mexico City, Mexico

Garry Stadtmauer, MD
City Allergy
New York, New York, USA

Back to Question & Answer list

Note: Please read disclaimer. Ask the Expert is for licensed physicians only.


Constant Itchy Throat with Cough

Question

I own a case to present.

A lady who is 62 years ancient complained of constant itchy throat for numerous years. She tried numerous kinds of antihistamine drugs without excellent effect. I can't discover any environmental factors influencing her disease. She has been to Australia without a change in symptoms. The SPT showed negative results. I prescribed 1st generation and 2nd generation antihistamines for her without excellent effect. I can't explain it. She does not own asthma nor allergic rhinitis, etc.

She coughs sometimes because of the nt Itchy Throat with Cough

Answer

By Dr. Desiree Larenas-Linnemann and Dr. Gary Stadtmauer

Reviewing, we own a 62 year-old patient with a chronic complaint of an itchy throat and some cough that does not seem to improve with a change in environment nor with anti-histamines.

There are a few key elements and questions to ponder about regarding this patient's history.

The first is the patient's age which suggests that the problem may not be atopy.

As we know, IgE-mediated allergic diseases decline with age.

What causes itchy throat allergies

On the other hand, the prevalence of allergic conditions in elderly people has been augmenting, and recent estimates are that allergic rhinitis affects up to 15% of persons aged [1]. Although the above information seems to discard allergy as a cause of her symptoms, we would not law out allergy from the beginning. Thus, an element of the history is to know whether the patient has any other nasal symptoms suggestive of allergy or sinus disease. Lastly, we would inquire further as to more details about the itch. Is it truly an itch, or does the patient own more of an irritative sensation in the throat? The cough may or may not be relevant, and further questioning is helpful.

Is the patient intentionally coughing to relieve the throat symptom?

Several additional details might assist us out somewhat further:

  • Where does she normally live? Is her exposure to environmental factors at home extremely diverse from the environment in Australia where she went to?
    • Voice mis-use or over-use (Singing Practice, shouting) — Excessive strain on larynx may happen because of shouting or prolonged singing practice. This may result in itchy throat.
    • In a 62 year ancient patients an itchy throat could be caused by a tumor, however in our case the symptom has been present for years thus indicating that the cause is likely benign.
    • Post-nasal drip is one of the symptoms of allergy, not so simple recognizable but sometimes fairly resistant to systemic anti-histamines.

      A trial with topical anti-histamine in combination with a topical nasal corticosteroid would be worth a attempt to law this out.

    • What anti-histamines, what dose, for how long? Some patients treated with anti-histamines may improve when treated with somewhat higher doses. Other patients do improve while they take anti-histamines, but as they relapse after discontinuing the medication they come to their doctor saying ‘they did not improve at all’, which might be confusing for the treating physician. It is significant to explore this in detail to discover out if it is really true that while taking a potent anti-histamines at the correct dose (or even double dose) the symptoms stay the same.
    • Infection, but because of the prolonged course of the symptoms, this is not extremely probable in our patient.

      Sometimes a sinusitis can give prolonged symptoms, so a sinus CT would be worthwhile checking.

    • Where in Australia did she go, as the Northern part (sub-tropical = mostly mites) is extremely diverse from middle (dry, boiling = pollen/mold) and from the Southern part (more temperate =all)?
    • Irritants that dehydrate the pharyngeal mucosa- Chemical irritants (excessive alcohol intake, industrial chemicals, etc.), polluted air, cigarette smoke (active or passive) may cause local irritation and result in itchy throat.
    • e.g. it has been described as one of the symptoms of Sjögren's syndrome
    • SPT negative results: it is significant the SPT was done with the correct allergens and bought from the correct provider (good potency, to reduce as much as possible untrue negatives).

      That’s why it is mandatory for the emission of excellent advice to know where the patient lives. For example, in the (sub) tropical zones of the far East, dust mites are the most significant allergens. But, not only of the Dermatophagoides family []. As there are other mites also of importance over there, a SPT negative for HDM does not law out the presence of a possible HDM allergy to one of the other mites (Blomia tropicalis, Lepidoglyphus, Acarus siro, etc.) that do cross-react in certain degree, but they do own their own specific allergens as well.

      What causes itchy throat allergies

      [5]

    • Gastro-esophageal Reflux Disease — Heartburns may sometimes result in itchy throat because of reflux of acid up to the throat.
    • Also: “for numerous years” . . . does this mean during the whole year or worse in a certain season?
    • Other Conditions: Then there are the rare causes of an itchy throat:
      1. Halzoun: an allergic pharyngitis following the consumption of raw or undercooked ovine liver [6].
      2. another extremely rarely the cause may be parasitic but it's worth considering depending upon the prevalence of these infections in the patients locale [7.]

    Apart from allergy, itchy throat can be caused by:

  • Infection, but because of the prolonged course of the symptoms, this is not extremely probable in our patient.

    Sometimes a sinusitis can give prolonged symptoms, so a sinus CT would be worthwhile checking.

  • Irritants that dehydrate the pharyngeal mucosa- Chemical irritants (excessive alcohol intake, industrial chemicals, etc.), polluted air, cigarette smoke (active or passive) may cause local irritation and result in itchy throat.
  • Gastro-esophageal Reflux Disease — Heartburns may sometimes result in itchy throat because of reflux of acid up to the throat.
  • Voice mis-use or over-use (Singing Practice, shouting) — Excessive strain on larynx may happen because of shouting or prolonged singing practice.

    This may result in itchy throat.

  • In a 62 year ancient patients an itchy throat could be caused by a tumor, however in our case the symptom has been present for years thus indicating that the cause is likely benign.
  • Other Conditions: Then there are the rare causes of an itchy throat:
    1. Halzoun: an allergic pharyngitis following the consumption of raw or undercooked ovine liver [6].
    2. e.g. it has been described as one of the symptoms of Sjögren's syndrome
    3. another extremely rarely the cause may be parasitic but it's worth considering depending upon the prevalence of these infections in the patients locale [7.]

    Concluding, as for the work-up of this patient we would suggest: If correct skin testing with the locally present allergens in correct concentrations is negative and there is no response to oral antihistamines then we would attempt a nasal steroid, nasal antihistamine or combination of the two.

    If this does not assist and a brief burst of prednisone10 days does not relieve symptoms either then it's safe to tell that the origin is not at every allergic. As to the workup, our next procedure would then probably be a rhinolaryngoscopy. It is possible that this patient has chronic rhino-sinusitis manifested solely as an itchy throat with occasional coughing. Another possibility would be laryngo-pharyngeal reflux which may be identified endoscopically. Finally, eventually the extremely rare causes- see above- could be considered.

    Apart from allergy, itchy throat can be caused by:

  • Infection, but because of the prolonged course of the symptoms, this is not extremely probable in our patient.

    Sometimes a sinusitis can give prolonged symptoms, so a sinus CT would be worthwhile checking.

  • Irritants that dehydrate the pharyngeal mucosa- Chemical irritants (excessive alcohol intake, industrial chemicals, etc.), polluted air, cigarette smoke (active or passive) may cause local irritation and result in itchy throat.
  • Gastro-esophageal Reflux Disease — Heartburns may sometimes result in itchy throat because of reflux of acid up to the throat.
  • Voice mis-use or over-use (Singing Practice, shouting) — Excessive strain on larynx may happen because of shouting or prolonged singing practice.

    What causes itchy throat allergies

    This may result in itchy throat.

  • In a 62 year ancient patients an itchy throat could be caused by a tumor, however in our case the symptom has been present for years thus indicating that the cause is likely benign.
  • Other Conditions: Then there are the rare causes of an itchy throat:
    1. Halzoun: an allergic pharyngitis following the consumption of raw or undercooked ovine liver [6].
    2. e.g. it has been described as one of the symptoms of Sjögren's syndrome
    3. another extremely rarely the cause may be parasitic but it's worth considering depending upon the prevalence of these infections in the patients locale [7.]

    Concluding, as for the work-up of this patient we would suggest: If correct skin testing with the locally present allergens in correct concentrations is negative and there is no response to oral antihistamines then we would attempt a nasal steroid, nasal antihistamine or combination of the two.

    If this does not assist and a brief burst of prednisone10 days does not relieve symptoms either then it's safe to tell that the origin is not at every allergic.

    What causes itchy throat allergies

    As to the workup, our next procedure would then probably be a rhinolaryngoscopy. It is possible that this patient has chronic rhino-sinusitis manifested solely as an itchy throat with occasional coughing. Another possibility would be laryngo-pharyngeal reflux which may be identified endoscopically.

    What causes itchy throat allergies

    Finally, eventually the extremely rare causes- see above- could be considered.


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    Table of contents


    Main allergy symptoms

    Common symptoms of an allergic reaction include:

    1. a raised, itchy, red rash (hives)
    2. sneezing and an itchy, runny or blocked nose (allergic rhinitis)
    3. tummy pain, feeling ill, vomiting or diarrhoea
    4. wheezing, chest tightness, shortness of breath and a cough
    5. itchy, red, watering eyes (conjunctivitis)
    6. swollen lips, tongue, eyes or face
    7. dry, red and cracked skin

    The symptoms vary depending on what you’re allergic to and how you come into contact with it.

    For example, you may have a runny nose if exposed to pollen, develop a rash if you own a skin allergy, or feel sick if you eat something you’re allergic to.

    See your GP if you or your kid might own had an allergic reaction to something. They can assist determine whether the symptoms are caused by an allergy or another condition.

    Read more about diagnosing allergies.


    Severe allergic reaction (anaphylaxis)

    In rare cases, an allergy can lead to a severe allergic reaction, called anaphylaxis or anaphylactic shock, which can be life threatening.

    This affects the whole body and usually develops within minutes of exposure to something you’re allergic to.

    Signs of anaphylaxis include any of the symptoms above, as well as:

    Anaphylaxis is a medical emergency that requires immediate treatment.

    Read more about anaphylaxis for information about what to do if it occurs.

    Sheet final reviewed: 22 November
    Next review due: 22 November

    Ask The Expert

    May 5,


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