What is a swollen throat?
A swollen throat can be uncomfortable, causing a sore throat or tightness. Often, a swollen throat is caused by an infection, like a cold, flu, or strep throat.
When you have an infection, white blood cells and other substances made by your immune system flood the area. This increases blood flow to the area, causing swelling. The irritation and swelling can make swallowing very painful.
But it can also feel like your throat is closing or narrowing or cause difficulty breathing and swallowing. This could be from an allergic reaction and may be an emergency.
Other conditions like gastroesophageal reflux can irritate your throat, and a goiter can cause your throat to feel tight or swollen.
Your doctor can help you figure out the cause and manage your symptoms with over-the-counter pain relievers and other medications.
Most people don't realize how many different structures pass through the area of your throat, including body parts that are involved with breathing, digestion, blood flow, and hormonal control of your body. —Dr. Leila Mufdi
1. Gastroesophageal reflux disease (GERD)
- Burning sensation in throat
- Tightness in your throat and chest
- Chronic cough
Gastroesophageal reflux disease (GERD) is when acid from your stomach moves backward into the esophagus, the tube between your mouth and stomach. The throat becomes irritated and may feel tight. You may also feel like something is stuck in your throat. Reflux is very common, with more than 20% of Americans having occasional symptoms.
You can help control your symptoms by avoiding spicy or acidic foods, eating smaller meals, and not eating right before going to bed. Weight loss and sleeping with your head elevated may also help. Antacids and medications that decrease the amount of acid your stomach makes, such as Pepcid and Protonix, may help reduce symptoms.
It may take some time and a trial of different therapies to find out what works best to get you feeling better. —Dr. Mufdi
2. Allergic reaction
Allergic reactions may cause a swollen throat, itching, and irritation. You may also have hives or a rash, or swelling of your face and mouth. If your throat is swelling, you may be at risk of a severe reaction, called anaphylaxis, which can cause trouble breathing and swallowing.
An allergic reaction is triggered by exposure to an allergen. The most common triggers of anaphylaxis are foods, insect stings, and medications.
Angioedema is swelling of the tissues of the throat, face, and mouth. It can be related to an allergic reaction. Angioedema can cause you to have difficulty breathing and swallowing. If your throat is swelling from an allergic reaction, you should go to the ER, because it may worsen quickly.
If you are having trouble breathing or swallowing, also go to the ER. It means you are having an anaphylactic reaction.
Treating allergic reactions
For anaphylaxis, the most important treatment is epinephrine (EpiPen). If you have an EpiPen, you should use it and then still go to the ER for monitoring since your allergic symptoms can return after initially improving.
Treatment for allergic reactions may include medications that can decrease the severity of the immune system response including antihistamines (Benadryl or Zyrtec) and steroids.
If you have had a strong allergic reaction in the past, you need to avoid any known triggers and keep your EpiPen with you at all times. You should also see an allergist who can help you figure out your triggers to avoid future reactions.
Throat infections can lead to a sore throat, itching, and swelling. You may also have a fever, runny nose, and cough. You may notice white spots or swelling when you look at the back of your throat, and swollen glands in your throat.
The most common causes of throat infections are cold viruses. Other viral infections include herpes, Covid-19, and the virus that causes mononucleosis. Bacteria such as strep can also cause a throat infection.
For cold viruses and mononucleosis, you can take over-the-counter pain medications. Tea with honey and saltwater gargles can also relieve throat pain and irritation.
For strep throat, your doctor will prescribe an antibiotic. If you have a lot of swelling, your doctor may treat you with a one-time dose of steroids. Herpes is treated with an antiviral medication.
- Throat tightness
- Hoarse voice
A goiter is an enlargement of the thyroid gland. The thyroid gland makes hormones that help regulate growth and metabolism. A goiter can be caused by issues with your immune system, an infection of your thyroid, or tumors.
The size of the goiter usually increases gradually over time. Sometimes, the area of your thyroid may be tender or you may have pain with swallowing. You may also notice a cough or a choking sensation. As the thyroid grows, you may have changes in the amount of hormones the thyroid gland produces. It can lead to weight changes, a racing heart, and changes in skin and hair.
Treatment may include taking iodine or medications that help normalize thyroid hormone production. If the goiter becomes very large, it may compress other structures, causing difficulty breathing and swallowing. In these cases, surgery may be necessary.
There are other less typical causes of throat swelling and tightening.
- Pain that is referred from other body parts such as your heart
- A tumor
- Problems with the salivary glands
- Food that gets stuck in your esophagus, causing a feeling of fullness in your throat, drooling, and difficulty swallowing.
When to call the doctor
Call your doctor in the following situations:
- Your pain and swelling lasts more than several days.
- Concern for a mass or abnormal growth on your neck
Should I go to the ER?
You should go to the emergency department if you have these signs of a more serious problem.
- Difficulty breathing or swallowing
- Throat swelling with other symptoms of an allergic reaction
- Use of your EpiPen due to a severe allergic reaction
- Problems moving your neck
Once you have worked with your doctor to figure out what is causing your throat swelling, most of the causes are easily treatable. Sometimes only minimal changes in your lifestyle or diet are enough to avoid future issues. —Dr. Mufdi
- Changes in lifestyle to avoid allergic triggers or foods that increase reflux
- Over-the-counter pain medications (Tylenol, Motrin)
- Saltwater gargles
- Tea with honey
Other treatment options
- Dietary changes
- Prescription medications that affect your thyroid function
Dr. Mufdi is a board-certified emergency medicine physician. She obtained her undergraduate degree in neurobiological sciences at the University of Florida. She attended Chicago College of Osteopathic Medicine and completed an emergency medicine residency at Albert Einstein Medical Center in Philadelphia. Recognizing the value of health literacy, she is happy to have joined Buoy Health in 2021.