Medical Articles

Many people complain: "I often feel like something is stuck in my throat, especially when I'm upset." This common complaint usually does not indicate a serious medical condition.

The patient should consult both a gastroenterologist and an ENT specialist. If the examination results are normal which is often the case then the patient can be reassured that it is a common and harmless condition triggered by stress or emotional distress.

However, if an actual condition is found, such as chronic pharyngitis, hiatal hernia, or acid reflux, appropriate treatment should be administered and the patient can rest assured.

But if the sensation appears specifically after eating, it may indicate a more serious underlying issue. Diagnosis can be more difficult in such cases, and specialized swallowing studies like FEES (Fiberoptic Endoscopic Evaluation of Swallowing) or VESS (Video Endoscopic Swallowing Study) should be conducted for accurate diagnosis and treatment.

Persistent and worsening throat lump sensations that are unrelated to emotional stress often indicate a more significant medical condition.

Sometimes a person may feel as though something is choking them, and the harder they try to breathe deeply, the worse it gets—their breath becomes louder and breathing more difficult, even though their pulmonologist confirmed their lungs are healthy and they do not have asthma.

This is likely due to a condition known as laryngeal spasm, which often occurs when a person is emotionally upset, or after choking on food, drink, or even saliva. Often, the exact cause is hard to determine.

If a laryngeal spasm occurs, the patient should breathe in slowly and exhale quickly—slow inhale, fast exhale. This is the opposite of the instinctive deep and fast inhalation that actually worsens the condition due to increased laryngeal closure (based on physics).

The patient should be reassured that this is a generally benign condition and does not lead to actual suffocation. Still, an ENT consultation is recommended to rule out other causes.

Sometimes, the vocal cord becomes paralyzed, causing changes in voice and breathing. The vocal cords serve several vital functions:

• Producing sound: The two true vocal cords come close together and vibrate rapidly (like clapping) to generate sound, which is then transformed into speech by the palate, tongue, and lips.
• Allowing airflow: During breathing, the cords separate to let air in and out.
• Protecting the airway during swallowing: The larynx tightly closes to prevent food and liquids from entering the airway.

If one vocal cord is paralyzed, it remains distant from the other, preventing proper vibration and resulting in:

• Weak or hoarse voice
• Air leakage while speaking
• Choking on liquids due to improper closure during swallowing

If both vocal cords are paralyzed, they stay in contact and cannot separate, causing severe breathing difficulty.

The nerve that controls the vocal cords travels a long path from the brain, down to the chest or lower neck, and back up to the larynx—making it vulnerable to damage from:

• Brain, neck, lung, or thyroid diseases
• Surgeries in those areas
• Infections and neurological disorders

There are also other types of vocal cord paralysis that do not cause typical hoarseness but other voice changes. These require advanced diagnostic expertise.

Treatment varies depending on the underlying cause, and in most cases, can significantly improve the patient's condition.

Many of us are familiar with recommendations for maintaining heart, skin, and digestive health, as these topics are frequently covered in media. However, we rarely hear or read about how to take care of our voice—even though it's our primary tool for communication.

In this article, we aim to highlight the most important recommendations for keeping the vocal cords in good condition.

1. Vocal Rest

Avoiding vocal strain is the first and most important recommendation. Many of us have experienced hoarseness or voice loss after yelling, so it’s crucial to avoid shouting—especially when emotionally agitated or stressed.

But shouting isn’t the only thing that stresses the voice. Any attempt to alter your natural voice tone is also straining. Examples include children mimicking adult voices, men imitating women’s voices, whispering, or mimicking others. Talking in noisy environments, like concerts, weddings, or sports events, is especially harmful because people tend to raise their voices or shout without realizing it.

Those who use the phone for long periods should be careful as well. On the phone, we rely on our voice to express emotions normally conveyed through body language. Many people also change their natural voice when speaking on the phone, which can strain the vocal cords.

2. Avoid Irritants

Irritants can be gases or foods. Gases and strong odors travel through the respiratory tract and hit the vocal cords directly, causing irritation. The biggest offender here is smoking, whose negative impact on the larynx deserves an article of its own.

Other irritants include environmental pollutants, cleaning chemicals, dust, and even some perfumes. As for irritating foods, they include spicy foods, cold drinks, and alcohol.

3. Hydration

Drinking plenty of fluids—especially water—is one of the most vital recommendations for vocal health. A person should drink about 3 liters of fluids per day, with increased intake during hot days or heavy physical activity.

The body secretes a protective oily substance to lubricate the vocal cords, and dehydration reduces this secretion. Note that certain fluids actually dry out the vocal cords, such as tea, coffee, alcohol, and cola—so these should be limited.

Dry air also harms the voice, so it's advised to humidify your environment by using a humidifier or placing a bowl of water on a heater—especially in homes and offices.

4. Additional Tips

• Warm up your voice before using it for long periods (e.g., humming softly before singing or speaking).
• Avoid unnecessary throat clearing. (This includes the mild coughing people do to clear mucus from their throats.)
• If you suffer from acid reflux or heartburn, avoid triggers like eating large meals before bedtime or consuming fatty foods, as acid reflux can damage the vocal cords.
• When experiencing hoarseness or voice loss—such as during a cold or chest infection—avoid talking or even whispering as much as possible.
• If hoarseness lasts more than three weeks, consult a doctor immediately, as it may indicate a more serious condition. Early diagnosis is the key to successful treatment—even for serious conditions like vocal cord tumors.

No-burp syndrome (medical name: Retrograde Cricopharyngeus Dysfunction (R-CPD)) is a condition where a person is unable to burp, even when air builds up in the stomach. This happens because a muscle at the top of the food pipe does not relax properly to allow trapped air to escape.

Although many people may have experienced occasional difficulty burping, individuals with R-CPD are typically unable to burp at all, which can lead to a variety of uncomfortable symptoms.

Common Symptoms

• Feeling bloated or swollen after eating
• Excessive gas (passing wind)
• Gurgling or croaking noises in the throat or chest
• Chest discomfort or upper abdominal pain
• Difficulty vomiting in some individuals

These symptoms can significantly affect daily comfort and quality of life, particularly after meals or when consuming carbonated beverages.

What Causes R-CPD?

R-CPD occurs when the cricopharyngeus muscle, located at the upper end of the esophagus, fails to relax appropriately in response to trapped air. As a result, air remains trapped in the digestive tract instead of being released through burping.

Is It Dangerous?

The good news is that R-CPD is generally not considered a dangerous medical condition. However, the persistent symptoms can be frustrating and may have a considerable impact on a person's physical comfort and social confidence.

Treatment Options

Effective treatments are available for R-CPD. The most common and successful treatment involves a small Botox injection into the affected muscle. The injection helps the muscle relax, allowing trapped air to escape normally and relieving symptoms.

If you suspect you may have R-CPD, consult an ear, nose, and throat (ENT) specialist or a healthcare professional experienced in diagnosing and treating swallowing and upper esophageal disorders.