A tight feeling in your throat may be caused by heartburn, infection, allergic reaction (anaphylaxis), anxiety, or other conditions. If you suspect anaphylaxis, seek immediate emergency treatment.

If you have tightness in your throat, you may wonder what’s causing it. The cause of the tightness can range from an infection such as strep throat to a more serious allergic reaction.

If you have other symptoms along with throat tightness, such as trouble swallowing or trouble breathing, you need immediate medical treatment.

Read on to learn more about possible causes for tightness in your throat and how you can manage this symptom.

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A few conditions can cause a tight feeling in your throat.

Heartburn or GERD

Acid reflux occurs when the band of muscles between your esophagus and stomach doesn’t tighten properly, allowing acid from your stomach to flow into your esophagus. This often creates a burning sensation, which you may know as heartburn.

However, acid reflux does not always lead to heartburn and can instead cause regurgitation, a feeling like something is stuck in your throat (globus sensation), or even no symptoms at all (silent reflux).

Persistent acid reflux is known as gastroesophageal reflux disease (GERD). Heartburn and GERD can make your throat feel tight and make swallowing difficult.

Infection

Infections such as tonsillitis and strep throat can cause a feeling of tightness or soreness in your throat. This may be due to inflammation in your airways as your body fights the infection.

Allergic reaction

An allergic reaction happens when your immune system misidentifies something harmless as a dangerous foreign substance and launches a defensive response. The most serious type of allergic reaction is called anaphylaxis.

The chemicals released during anaphylaxis cause inflammation, which makes your throat and airways swell up and tighten. The most common causes of anaphylaxis are:

Other symptoms of anaphylaxis include:

Anxiety

Though anxiety is an emotional response, it can produce physical symptoms. During a panic attack, you might feel like your throat is closing and your heart is pounding. These symptoms come on quickly and can resemble symptoms of a heart attack.

Enlarged thyroid (goiter)

The butterfly-shaped thyroid gland in your neck produces hormones that help regulate your body’s metabolism. An enlarged thyroid gland can make your throat feel tight and make it hard to breathe or swallow.

Vocal cord dysfunction

Vocal cord dysfunction, also known as paradoxical vocal cord movement or motion, is when your vocal cords malfunction and close when they should open, such as during a breath.

The closing of your vocal cords can cause throat tightness and significantly affect your breathing.

Anaphylaxis is a medical emergency that needs to be treated immediately. If you have symptoms of a severe allergic reaction, such as trouble breathing or swallowing, call your local emergency services or go to an emergency room right away.

Make an appointment with your doctor if you have symptoms such as:

  • chest pain
  • a fever higher than 103°F (39°C)
  • a sore throat that lasts longer than 48 hours
  • a sore throat and swollen glands
  • a stiff neck

The tests you undergo will depend on the cause of your throat tightness.

Tests for GERD

Doctors can sometimes diagnose GERD based on symptoms alone. You might have to wear a monitor to measure the amount of stomach acid that backs up into your esophagus.

In other cases, medication trials can help doctors find out whether certain medications you take are causing GERD.

Tests for an enlarged thyroid

Your doctor will feel your neck and may order blood tests to check your thyroid hormone levels. They may also use other tests to diagnose an enlarged thyroid gland, including an ultrasound scan as a preferred option and a thyroid scan if necessary.

Other tests

If your doctor suspects that an infection or allergen is causing your throat tightness, they may perform a throat swab to test for strep throat or other infections or a blood or skin test to identify potential allergy triggers.

If you have heartburn, you can help prevent throat tightness and other symptoms by:

  • avoiding overeating
  • avoiding trigger foods and drinks, including spicy foods, citrus fruits and juices, alcohol, and chewing gum
  • taking antacids or acid-blocking medications
  • staying upright after eating to help with digestion

If you have a sore, tight throat due to an infection, pain relievers such as ibuprofen (Advil, Motrin) can ease the discomfort. Resting your voice and using lozenges can also provide short-term relief in mild cases of throat tightness.

Anaphylaxis is treated under close medical supervision, with a shot of epinephrine. Other medications, such as antihistamines and corticosteroids, may be necessary as well.

The treatment depends on what is causing the tightness in your throat.

GERD

Several medications can treat heartburn:

  • Antacids such as Rolaids, Tums, and Maalox neutralize the acid in your stomach.
  • H2 blockers such as cimetidine (Tagamet HB) and famotidine (Pepcid AC) reduce the amount of acid your stomach makes.
  • Proton pump inhibitors such as esomeprazole (Nexium), lansoprazole (Prevacid), and omeprazole (Prilosec) block stomach acid production.

Lifestyle strategies such as the following can also help decrease heartburn symptoms:

  • eating smaller meals, especially before bedtime
  • making efforts to lose weight, if your doctor recommends it
  • quitting smoking, if you smoke

Infections

Doctors can prescribe antibiotics to treat bacterial infections, but many infections go away without treatment. Antibiotics cannot treat viral infections.

Resting and drinking enough fluids can help your body fight infections effectively.

However, in cases of recurrent infection, a surgical procedure such as a tonsillectomy may be necessary.

Practicing good hygiene, such as washing your hands often and maintaining distance from people who are sick, can also help you avoid infections in the future.

Allergic reactions

Anaphylaxis is treated with an injection of epinephrine. If you have severe allergies, doctors may recommend that you carry an auto-injector (Adrenaclick, EpiPen) in case you react to a food, insect sting, or medication.

Anxiety

To prevent panic attacks, your doctor might prescribe a combination of talk therapy and medications such as selective serotonin reuptake inhibitors and benzodiazepines. Relaxation techniques such as yoga and meditation can also sometimes help.

Enlarged thyroid

If you have a very enlarged thyroid gland or a goiter, prescription medications and treatments may help reduce its size. However, in severe cases, surgical removal of some or all of your thyroid may be necessary.

In cases of full thyroid removal, you’ll need to take thyroid hormone afterward to replace what your thyroid gland no longer makes.

There are several potential causes of tightness in your throat, including allergic reactions, infections, thyroid disorders, vocal cord dysfunction, and acid reflux.

The treatment options for throat tightness will depend on its cause. These can range from rest and over-the-counter medications to surgery.