What causes throat dryness and how is it treated?

Management of Throat Dryness

Throat dryness should be managed primarily through frequent sips of water, room humidification, and sugar-free lozenges or gum, with pharmacological interventions reserved for more severe cases. 1

Causes of Throat Dryness

Throat dryness can result from various conditions:

1. Atrophic rhinitis - Characterized by progressive atrophy of nasal mucosa, crusting, and dryness due to atrophy of glandular cells 2
2. Medication-induced dryness - Caused by medications such as ACE inhibitors, phosphodiesterase-5 inhibitors, and certain antihypertensives 2
3. Sicca syndrome - Distinct from Sjögren's syndrome, with abrupt onset of dry mouth 2
4. Environmental factors - Low humidity, dehydration, mouth breathing 1
5. Immunotherapy-related toxicity - Can cause oral dryness in cancer patients 2

Treatment Approach Based on Severity

Mild Throat Dryness

• Hydration measures:

  • Frequent sips of water (preferably with neutral or alkaline pH) 1, 3
  • Room humidification 1
  • Avoid carbonated drinks which may worsen symptoms 4

• Stimulate saliva production:

  • Sugar-free chewing gum 1
  • Sugar-free lozenges or candies 1
  • Xylitol-containing products 1

• Avoid irritants:

  • Avoid crunchy, spicy, acidic, or hot food/drinks 2
  • Avoid lemon-glycerin swabs (produce acidic pH, dry oral tissues) 1

Moderate Throat Dryness

• Continue all measures for mild dryness
• Add topical treatments:
  • Oral sprays or gels with neutral pH 1
  • Artificial saliva substitutes 1
  • Nasal saline irrigation for atrophic rhinitis 2

Severe Throat Dryness

• Continue all previous measures
• Pharmacological interventions:
  • Salivary stimulants: pilocarpine (5 mg three to four times daily) or cevimeline (30 mg three times daily) 1
  • For immunotherapy-related dry mouth: prednisone 20-40 mg daily for 2-4 weeks, then taper 2

Special Considerations

For Atrophic Rhinitis

• Continuous nasal hygiene with saline or sodium bicarbonate solution 2
• Periodic debridement of crusts if necessary 2
• Topical and/or systemic antibiotics when purulent secretions or acute infection is present 2

For Medication-Induced Dryness

• Consider medication review and possible alternatives if ACE inhibitors or other medications are causing the symptoms 2

For Chronic Cough with Throat Dryness

• If chronic cough is present, evaluate for underlying causes like post-nasal drip, reflux, or asthma 2
• Intranasal steroids may be effective for cough due to allergic rhinitis 2

Cautions and Pitfalls

1. Water pH matters: Some bottled waters have acidic pH (below 5.5), which can potentially cause enamel erosion. Choose water with neutral or alkaline pH 3

2. Hot vs. cold liquids: Hot fluids (especially hot chicken soup) may temporarily increase nasal mucus velocity and be superior to cold liquids for managing upper respiratory tract symptoms 5

3. Elderly patients require special attention:

   • They are more susceptible to dehydration due to decreased thirst sensation
   • Aim for at least 1.7 liters of fluid intake daily
   • Provide small amounts throughout the day rather than large amounts at once 6

4. Avoid breaking the vicious cycle: For patients with persistent throat clearing due to perceived mucus, sipping ice cold water may help break this cycle 7

By following this approach, most cases of throat dryness can be effectively managed, improving patient comfort and quality of life.