Why do older people get phlegm in their throat?

According to the National Institutes of Health, age-associated changes in the respiratory system can increase susceptibility to respiratory issues. Understanding why do older people get phlegm in their throat is the first step toward effective management and better quality of life for seniors.

Quick Summary

Several factors contribute to increased phlegm and throat clearing in older adults, including age-related changes to the respiratory system and swallowing function, as well as common conditions like postnasal drip, acid reflux, and medication side effects. These issues can disrupt the body's natural mucus-clearing processes, leading to the persistent sensation of phlegm in the throat.

Key Points

• Age-related changes in the respiratory system: Older adults have weakened breathing muscles and less efficient cilia, causing particles and secretions to build up in the lungs and throat.

• Postnasal drip is a leading cause: Excess mucus draining from the sinuses down the back of the throat is a very common trigger for persistent throat clearing and the feeling of phlegm.

• Acid reflux can irritate the throat: Laryngopharyngeal reflux (LPR), where stomach acid reaches the throat, can cause chronic irritation, leading to a constant need to clear the throat.

• Medications can be a contributing factor: Certain drugs, like ACE inhibitors for high blood pressure, can cause a persistent cough or dryness that feels like phlegm.

• Swallowing difficulties can be a sign: Age-related dysphagia, or difficulty swallowing, can result in poor clearance of saliva and mucus, causing a lingering sensation of phlegm.

• Seek medical advice for persistent symptoms: If phlegm is accompanied by fever, chest pain, or is bloody, or if symptoms are severe and chronic, a doctor's evaluation is necessary to rule out more serious issues.

Understanding the Respiratory System in Later Life

As we age, our respiratory system undergoes several natural changes that can make us more susceptible to mucus and phlegm buildup. The bones and muscles of the chest and spine change, which can limit the expansion and contraction of the ribcage during breathing. The diaphragm, the primary muscle for breathing, can also weaken over time, reducing the ability to inhale and exhale deeply. Furthermore, the cilia, tiny hair-like structures that move mucus out of the airways, become less effective, causing particles and secretions to collect in the lungs.

The Role of Postnasal Drip

One of the most common causes of a persistent feeling of phlegm is postnasal drip. This occurs when excess mucus from the nose and sinuses drains down the back of the throat, triggering the need for frequent throat clearing. While this condition affects people of all ages, it can be exacerbated in older adults due to allergies, sinus infections, or simply a change in mucus production over time.

The Link to Gastroesophageal Reflux Disease (GERD)

Acid reflux, specifically laryngopharyngeal reflux (LPR), is another frequent culprit. This happens when stomach acid travels up the esophagus and irritates the sensitive tissues of the throat, causing a feeling of a lump or a need to clear the throat. In many older adults, the lower esophageal sphincter, which keeps acid in the stomach, can weaken, making reflux more likely.

Medications and their Side Effects

As individuals age, they are more likely to be on multiple medications, and some of these can contribute to mucus production or a dry throat sensation that mimics phlegm. For example, certain blood pressure medications, known as ACE inhibitors, are known to cause a chronic cough or postnasal drip. Other medications can cause dryness, making the mucus that is present feel thicker and more difficult to clear.

Age-Related Swallowing Difficulties (Dysphagia)

Swallowing is a complex process that can change with age. Conditions affecting the tongue, throat, and vocal cords can lead to dysphagia, or difficulty swallowing. In some cases, seniors may forget to swallow saliva or may have difficulty clearing food and liquids effectively, which can lead to a buildup of mucus or a feeling of something being stuck in the throat. In more severe cases, this can lead to aspiration, where food or liquid enters the lungs.

Management and Treatment Options for Phlegm

Managing phlegm in older adults often requires a multi-pronged approach tailored to the underlying cause. While it's crucial to consult a healthcare provider for a proper diagnosis, several strategies can provide relief at home.

Hydration and Humidification

• Stay Hydrated: Drinking plenty of fluids, especially warm water, herbal teas, or broths, can help thin mucus and make it easier to clear. Dehydration can cause mucus to become thicker and stickier, worsening the problem.
• Use a Humidifier: Adding moisture to the air with a humidifier can soothe the throat and help loosen phlegm. Regular cleaning of the humidifier is essential to prevent the growth of bacteria or mold.

Dietary and Lifestyle Adjustments

• Dietary Changes: Avoiding foods that can trigger acid reflux, such as spicy or acidic items, may help. Reducing or eliminating dairy can sometimes help for those who find it thickens mucus..
• Elevate the Head of the Bed: For individuals with GERD, elevating the head of the bed can help prevent stomach acid from traveling up the esophagus at night.
• Avoid Irritants: Limiting exposure to cigarette smoke, air pollution, and other environmental irritants can protect the respiratory system.

Over-the-Counter and Natural Remedies

• Saltwater Gargle: Gargling with warm salt water can help clear phlegm from the throat and soothe irritation.
• Expectorants: Over-the-counter expectorants, like guaifenesin, can thin mucus and make it easier to cough up. Always consult a doctor or pharmacist before starting new medication.

Comparison of Common Phlegm Causes

Cause	Symptoms	Common Treatments	When to See a Doctor
Postnasal Drip	Persistent throat clearing, a feeling of mucus running down the throat, hoarseness.	Hydration, humidification, saline sprays, avoiding allergens.	If symptoms are persistent, or if accompanied by fever or severe sinus pain.
GERD (LPR)	Feeling of a lump in the throat, hoarseness, dry cough, heartburn (not always present with LPR).	Antacids, dietary changes, lifestyle modifications, elevating head while sleeping.	If lifestyle changes are not effective, or for chronic symptoms.
Medication Side Effects	Chronic dry cough, throat irritation, nasal congestion.	Discussing potential medication changes with a doctor.	Anytime you suspect a medication is causing side effects.
Dysphagia	Coughing or choking during/after eating, wet gurgly voice, food sticking in throat.	Swallow therapy with a speech-language pathologist (SLP), dietary modifications.	Immediately, as it can lead to serious complications like aspiration pneumonia.

When to Seek Medical Attention

While occasional throat clearing is normal, persistent or severe symptoms should be evaluated by a healthcare professional. It is essential to consult a doctor if the phlegm is accompanied by fever, chest pain, shortness of breath, or if it is tinged with blood. These signs could indicate a more serious underlying condition that requires medical intervention.

A comprehensive evaluation may involve a family physician, an allergist, or an ear, nose, and throat (ENT) specialist. In cases involving swallowing difficulties, a speech-language pathologist can provide valuable assessment and guidance. Understanding the root cause is critical for creating an effective and personalized treatment plan.

For more information on senior health, a great resource is the National Institute on Aging website.

Conclusion

Increased phlegm and throat clearing in older adults are often complex issues stemming from a combination of natural aging processes and specific health conditions. Factors like changes to the respiratory system, postnasal drip, GERD, and certain medications can all play a role. By addressing the specific cause, seniors can find significant relief and improve their overall comfort and quality of life. Maintaining hydration, adjusting lifestyle habits, and consulting with healthcare professionals when symptoms are persistent are all crucial steps toward effective management.

Frequently Asked Questions

Why do older people have so much phlegm in their throat?

Older people often have more phlegm due to natural changes in the body, such as a weaker immune system, less effective cilia that clear mucus, and weaker breathing muscles. Additionally, common conditions like postnasal drip and acid reflux become more prevalent with age.

What is the best treatment for phlegm in the elderly?

The best treatment depends on the underlying cause. Common strategies include staying well-hydrated, using a humidifier, gargling with salt water, and using over-the-counter expectorants. However, addressing the root cause, such as GERD or allergies, with medical guidance is crucial.

Can certain medications cause phlegm in older people?

Yes, some medications can cause a chronic cough or contribute to the feeling of phlegm. A common example is ACE inhibitors, used for high blood pressure. It is important to discuss any new or worsening symptoms with a healthcare provider.

Is frequent throat clearing a sign of dementia?

While frequent throat clearing can sometimes be a repetitive behavior associated with later stages of dementia, it is more often a symptom of conditions like postnasal drip or reflux. However, issues like forgetting to swallow can also cause throat clearing in those with dementia.

How can I help an older person get rid of phlegm naturally?

To help an older person naturally manage phlegm, encourage them to drink plenty of warm fluids like water and herbal tea, use a humidifier, and try gargling with warm salt water. Adjusting their diet to avoid common irritants like spicy foods can also help.

What is dysphagia and how is it related to phlegm?

Dysphagia is difficulty swallowing, which can be common in older adults. It can be related to phlegm because it can cause poor clearance of saliva, mucus, and food particles, leading to a persistent feeling of something in the throat and the need for frequent clearing.

When should an older person with phlegm see a doctor?

You should seek medical attention if the phlegm is persistent or accompanied by other symptoms like fever, chest pain, bloody mucus, or shortness of breath. A doctor can help determine the underlying cause and recommend an appropriate course of treatment.