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Cobblestone throat can occur if there is extra mucus in the throat. Addressing the underlying cause of that extra mucus, such as allergies, can treat cobblestone throat.

Cobblestone throat is a term doctors use to describe an irritated throat with visible bumps and lumps at the back. The bumps are caused by enlarged lymphatic tissue, which are pockets of tissue in the back of your throat.

This tissue often becomes inflamed or irritated in response to extra mucus in the throat. While it can look alarming, cobblestone throat is usually harmless and easy to treat.

Keep reading to learn more about what causes cobblestone throat and how to tell if it could be something more serious.

Cobblestone throat is usually a sign of irritation from postnasal drip, which refers to extra mucus dripping down the back of the throat. The mucus is produced by glands in the nose and throat. It helps moisten dry air, clean nasal passages, trap harmful pathogens, and prevent inhaling foreign materials.

However, some conditions can increase mucus production or make mucus thicker. Postnasal drip occurs when this extra mucus accumulates in the back of the throat, where it can cause irritation and cobblestoning.

It can be caused by:

In addition, cobblestone throat may also appear with a rare but benign disease called tracheobronchopathia osteochondroplastica.

Treating a cobblestone throat involves treating the mucus-producing condition that’s causing it to appear in the first place.

For causes related to allergies or infections, over-the-counter decongestants, such as pseudoephedrine (Sudafed), can help to break up extra mucus. Antihistamines can also help. Just make sure to go for a non-sedating option, such as loratadine (Claritin).

Traditional antihistamines, such as diphenhydramine (Benadryl), can actually make postnasal drip symptoms worse. Your doctor may also suggest using a steroid nasal spray. However, for a bacterial infection like pharyngitis, you’ll also need to take antibiotics for up to 10 days.

For extra mucus related to medication, talk with your doctor. They may be able to change your dosage or swap it out for a different medication that doesn’t have the same side effects.

If your cobblestone throat is related to LPR, you may need to make some lifestyle changes to manage your symptoms, including:

  • losing weight
  • quitting smoking
  • limiting your alcohol consumption
  • avoiding acidic foods, such as citrus, tomatoes, and chocolate

If you’re still having LPR symptoms, you may need to take medication, such as proton pump inhibitors, antacids, or H2 blockers, to reduce stomach acid.

As its name implies, a cobblestone throat has a pebble-like appearance. Depending on what’s causing it, you might also notice:

  • a constant dry cough
  • feeling like you constantly need to clear your throat
  • feeling like something’s caught in your throat
  • a sore throat
  • nausea
  • bad breath

Lumps and bumps that appear anywhere on your body can spark fear of cancer. However, cobblestone throat isn’t usually considered to be a sign of any cancer.

That said, if you also experience swollen lymph nodes, along with symptoms like night sweats, fever, and unexplained weight loss, your doctor may want to rule cancer out as a cause.

If you’re worried about cancer around your throat, tell your doctor if you have any of these symptoms in addition to cobblestone throat.

Learn more: The symptoms of throat cancer.

Should I see an ENT for cobblestone throat?

An ENT stands for ear, nose, and throat specialist. These doctors are also called otolaryngologists. They can examine your throat and determine whether you have a cobblestone throat and what might be causing it. An allergist is another doctor who can examine your throat. Some doctors may have both specialties.

Can you have a cobblestone throat without tonsils?

Yes. This is because many of the conditions that can trigger it can still occur even without tonsils.

Does cobblestone throat smell?

This may depend on the trigger of your cobblestone throat. For example, pharyngitis can occur along with halitosis (bad breath).

Cobblestone throat is almost always a harmless condition caused by extra mucus in your throat. While its bumpy appearance can be worrisome, it’s not associated with any cancer.

Work with your doctor to determine what’s causing the extra mucus to drip down your throat so you can start treating it.