Always swallowing and throat tight? Your need to swallow often, and that tight throat, may be from a medical condition, or, it may be from plain anxiety, says Dr. Jordan S. Josephson, MD, FACS, author of Sinus Relief Now, the director of the New York Nasal and Sinus Center, and a sinus and nasal specialist at Lenox Hill Hospital. 

“There are two major reasons that cause patients to complain about constant swallowing and throat tightness.”


He continues: “Those two major reasons are post-nasal drip and gastroesophageal reflux disease (GERD).”

So though anxiety can cause frequent swallowing and a tight throat, keep open minded about sinus problems and allergies, which can cause the post-nasal drip.

“These two problems are often connected, and when one acts up the other gets worse,” says Dr. Josephson.

Mucus is normally produced in the nose and sinuses. Normally, 1-2 liters of mucus is produced.

It “traps dirt infection and pollution. The mucus drips into your throat and you swallow about 10-12 times per minute.”

Infection, allergy, pollution, tobacco smoke and chemicals can change mucus’s volume, pH and consistency.

“This causes inflammation to the throat, leading to tightness and swelling and the need to swallow more frequently, thus causing discomfort,” explains Dr. Josephson.

GERD can act up from post-nasal drip increase. It’s a nasty cycle because when GERD acts up, “the reflux can cause swelling in the throat, causing the patient to feel tight in the throat, and this causes the patient to swallow more frequently than normal, giving the patient the sensation of constant swallowing.”

The reflux can cause a laryngospasm, “a sudden closure of the voice box which can make the patient feel like they are choking.

“This may spark a panic attack where the patient feels like (s)he cannot breathe. This sudden closure is to protect the lungs, and although scary, will not cause the patient to suffocate.”

Thus, any alarming tightness or frequent, stubborn swallowing does not mean you’re literally having trouble breathing, even though the reflux can actually reach the nose/sinuses, causing further post-nasal drip, increasing swallowing and throat tightness yet.

The more you worry about your problem, the tighter your throat will seem to get, or actually get for real, because it is well-known that enough anxiety will cause tightness, or cause that so-called lump there.

Excessive swallowing, either due to GERD or anxiety, can, in and of itself, lead to the sensation of a tight throat.

So what is the treatment for problems with GERD and post-nasal drip? Dr. Josephson recommends a complete medical history, complete physical and appropriate tests by an ear, nose and throat physician. “An accurate diagnosis with targeted therapy needs to be instituted to resolve the underlying causes for this complex problem to be resolved.