An intentional throat clearing – "ahem" – is like a nudge, a discrete way to get someone's attention, a social cue to back off, a hint to change the subject, or to express doubt. Repetitive, chronic, or excessive throat clearing could be a sign or symptom indicating an underlying condition.

What could be causing my excessive throat clearing?

A common cause of throat clearing is a change to the mucus. If there is too much mucus, if it is too thick, or if it drips back from the nose into the throat, a person will feel a need to clear the mucus. This often happens during a cold, flu, sinusitis, or an allergy flare-up.

Stomach acid due to gastroesophageal reflux (GERD) can flow back up into the throat and cause irritation that triggers throat clearing. Food can sometimes become trapped in a small pouch in the throat (called pharyngeal diverticula) and lead to food regurgitation, bad breath, difficulty swallowing, as well as coughing and repetitive throat clearing. Throat clearing may also be common among those with swallowing problems like dysphagia.

Certain medications may cause cough and repetitive throat clearing, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blocker (ARB), a medication that helps to relax blood vessels and is prescribed for high blood pressure and heart conditions.

In some cases, chronic or excessive throat clearing can be caused by a vocal cord injury or dysfunction, as with benign vocal cord lesions (nodules, polyps, cysts) that develop because of vocal misuse or abuse.

Food allergies or sensitivities to food ingredients can also cause irritation to the lining, causing mucus buildup and throat clearing. You can avoid the problem by avoiding the food that's causing it.

Anatomical causes, such as very large tonsils or a very long uvula, can also trigger irritation and cause throat clearing. You can treat the problem by surgery (removal of tonsils or uvula).

Throat clearing may also be a sign of asthma or a warning of an approaching asthma attack.

For some people, throat clearing may just be a habit.

Should I be worried about my throat clearing?

Excessive, repetitive throat clearing can cause vocal cord trauma and hoarseness. Your vocal cords are two taut bands of muscle that vibrate in order to make sound. When you clear your throat, you cause the vocal cords to slam together.

Seek medical advice if your throat clearing is disruptive to your life. You may be able to track down the root cause or find help to resolve the habit. In some instances, throat clearing may point your doctor toward a diagnosis of an underlying condition.

How can I break the throat clearing habit?

If throat clearing is in fact a habit, you can take steps to break it. Drink plenty of water to keep your vocal cords lubricated. When you feel the urge to clear your throat, take sips of water. In one observational study, ice cold carbonated water was found to be especially effective. Swallow your saliva to flush out mucus. Try a gentle, breathy cough that may be more protective of your vocal cords than the usual clearing. Or try humming, laughing, or talking your way through the moment.