Hacking up strange clumps — Why?

Dear Alice,

About every six to twelve months I randomly feel as though I have something caught in my throat. Once I hack it up, I notice that it is a spherical "yellowish" clump with an offensive odor. Hacking up this substance occurs sporadically throughout the day and then does not occur for another six to twelve months. I heard from my mother that this substance is food or bacteria caught in your tonsils that surfaces every once in awhile. However I have been unable to find any articles or material on the Internet which can confirm this. Does Alice know?

Dear Reader,

Holy hacking, Batman! Since it is not too likely that food would remain caught in your tonsils for months at a time, the yellow clumps may be comprised of excess mucus from your sinus and nasal areas. Seasonal allergies may aggravate this odd nuisance.

To be more specific, a condition called post-nasal drip (PND) may be the culprit behind your biannual gagging. Normally, the membranes that line the nose and sinuses produce mucus that help lubricate and clean nasal passages, cleanse inhaled air of foreign objects and toxins, and fight infection. With post-nasal drip, mucus accumulates in the throat and can cause thick secretions in the esophagus, interfering with the swallowing mechanism. It may be that your excess mucus is getting trapped as a symptom of PND, inducing your gag reflex to hack the offending mucus up when needed.

A solid bet is that your sporadic throat emissions are a seasonal affectation. Because you indicate this happens only once or twice a year, in all likelihood taking measures to ameliorate seasonal allergies may help your situation. As the seasons change, try to avoid caffeine and drink lots of water, which will thin mucus secretions. You could also try over-the-counter mucus-thinning medications — ones containing guaifenesin have few side effects and may help to clear your pipes. Nasal irrigations or saline sprays may also alleviate thickened head secretions. For more information on mucus and its function in the body, and how to keep it from overproducing, check out Much ado about mucus in the Go Ask Alice! archives.

It's also possible that you're hacking up tonsilloliths, or tonsil stones, which are formed when debris caught in the tonsils hardens. If you're also experiencing some funky bad breath, ear pain, tonsil swelling, or sore throat, tonsil stones might be the culprit. Gargling with salt water or gently trying to remove the stone might alleviate your symptoms. Your health care provider might prescribe some antibiotics to prevent infection. In some cases when people have repeat episodes of tonsil stones, the tonsils are actually surgically removed.

Since you can't see your mucus membranes and usually can't see tonsil stones, it may be difficult to know exactly when the Attack of the Yellow Throat Clump is coming your way. Experiment with a few different remedies as the seasons change, and hopefully your smelly hocking days are for a limited time only.

Last updated Jun 19, 2014
Originally published May 22, 2009

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