Ask a doctor on the topic of General medicine

Phlegm in the throat

March 26, 2014 | 20,00 EUR | answered by Dr. med. Frauke Gehring

Hello,
I have had phlegm in my throat since November. It started with a cough and sore throat. Initially, I was prescribed asthma tablets because I have hay fever and my primary care physician suspected asthma. After that, I had to take Roxi (antibiotics). None of it helped. I then went to an ENT specialist, who suspected silent reflux because the sides of my throat were red, and first prescribed Pantoprazole and then Omeprazole. The sore throat and cough were gone, but not the phlegm. A throat swab also yielded nothing. I also noticed a swollen lymph node on the right side of my neck. My primary care physician and ENT were not concerned about this.
Then I was given several mucolytics and inhalation sprays. The phlegm is still there, but only in the mornings. It's not much, but in the mornings, I have to clear my throat a few times after waking up. The cough is completely gone. My ENT said I should have a gastroscopy, but my primary care physician referred me to a pulmonologist. The appointment is not until May and I am getting really anxious and afraid it could be something serious (lung cancer?).
I am female, 32 years old, and used to smoke occasionally years ago.
PLEASE advise!

Dr. med. Frauke Gehring

Good day,

A lung cancer diagnosis does not fit with this story and your age. I wouldn't worry at all about this!

Your general practitioner referred you to a lung specialist because he suspects asthma. This can be proven or ruled out through some simple tests. An oversensitive bronchial system, which has not yet caused asthma, could be causing this mucus production. One indication of this would be if the symptoms improve with cortisone spray.

The ENT colleague recommends a gastroscopy because reflux of stomach acid can reach the airways and lead to chronic inflammation. If the acid blockers have helped, this would be an indication of this cause.

Both causes lead to inflammation, so the enlarged lymph nodes are actually not a cause for concern.

I would suggest starting with the lung examination due to its simplicity, and then following up with the gastroscopy if necessary. Without fear of cancer!

Warm regards,
Dr. Höllering, Specialist in Internal and General Medicine