Differential Diagnosis for Trouble Swallowing and Constant Throat Clearing
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is characterized by the backflow of stomach acid into the esophagus, leading to symptoms such as trouble swallowing (dysphagia) and constant throat clearing due to the irritation of the throat and esophagus by acid.
Other Likely Diagnoses
- Postnasal Drip: Excess mucus from the nose can trickle down the back of the throat, causing a sensation that something is stuck and leading to frequent throat clearing.
- Allergies: Seasonal or environmental allergies can cause postnasal drip and throat irritation, leading to swallowing difficulties and the need to clear the throat frequently.
- Laryngopharyngeal Reflux (LPR): Similar to GERD but involves the backflow of stomach contents into the laryngopharynx, causing throat irritation and clearing.
Do Not Miss Diagnoses
- Esophageal Cancer: Although rare, it can present with progressive dysphagia and should be considered, especially in older adults or those with a history of smoking or alcohol use.
- Streptococcal Pharyngitis: While typically presenting with sore throat, fever, and lymphadenopathy, it can sometimes cause dysphagia and throat clearing.
- Foreign Body: Especially in children, an object lodged in the throat or esophagus can cause sudden onset of dysphagia and attempts to clear the throat.
Rare Diagnoses
- Eosinophilic Esophagitis: A chronic immune system disease in which a type of white blood cell, the eosinophil, builds up in the esophagus in response to an allergen or irritant, leading to dysphagia and food impaction.
- Achalasia: A rare disorder of the esophagus that makes swallowing difficult, leading to dysphagia and regurgitation of food.
- Cricopharyngeal Spasm: A condition where the cricopharyngeus muscle, which is involved in swallowing, goes into spasm, causing difficulty swallowing and throat clearing.