What is Inducible Laryngeal Obstruction or ILO?

Inducible laryngeal obstruction is a temporary obstruction of the larynx (voice box) which can cause breathlessness. During an episode of ILO, instead of your vocal cords opening when you breathe in, the vocal cords or surrounding structures move closer together when breathing in. This makes breathing in more difficult and often noisy.

Inducible: Symptoms are induced by a specific trigger or irritant.

Laryngeal: In the larynx (voice box)

Obstruction: Airflow is limited, and can feel obstructed, making it more difficult to breathe in. However, oxygen levels remain normal.

ILO symptoms tend to be episodic and often start and cease abruptly. They may be mild or sometimes severe. People are usually symptom free between episodes, although some report anticipatory anxiety (e.g., “I worry about when my next attack will occur”), cough, throat tightness, or voice changes in between more acute episodes of ILO.

What triggers ILO?

Environmental irritants e.g. aerosol, perfumes, cleaning products, vinegar, air fresheners, temperature changes.

Psychosocial responses/feelings– anger, stress, anxiety, emotion

Physical activities – talking, laughing, coughing, walking up an incline, eating and drinking

Medical factors: acid reflux; asthma, dysfunctional breathing, nasal congestion and allergies can exacerbate ILO.

What feelings do people with ILO commonly describe?

I can’t get air in

I feel like my throat is shutting off

I feel like I’m gasping for breath

My inhalers don’t work

I feel like I’m being strangled

I feel like I’m breathing through a straw

Common symptoms of ILO

  • Shortness of breath or difficulty getting air into or out of your lungs
  • Tightness in the throat or chest
  • Frequent cough or throat clearing
  • A feeling of choking or suffocation
  • Noisy breathing (stridor, gasping, raspy sounds)
  • Hoarse voice
  • Sensation of mucus
  • Unable to speak
  • Panic and anxiety

What is speech and Language Therapy for ILO:

Once ILO is suspected/diagnosed you may be referred to a speech and language therapist who is a specialist in treating ILO. Detailed assessment will help identify the triggers for your ILO. The main treatment aim is reducing laryngeal sensitivity and learning techniques that help you control your vocal cords.

  •  Advice for improving hydration and general health of the voice box.
  •  Support and advice for managing acid reflux and post nasal drip or nasal congestion.
  •  Techniques to relax the throat and vocal cord muscles.
  •  Techniques for controlling cough symptoms.
  • Coping strategies to help manage an acute episode of ILO.
  •  Breathing techniques to help force the vocal cords open during an episode of ILO and to keep breathing regulated at rest, when talking and while exercising.
  •  Strategies for managing stress reactions. Discussion about the potential role of talking therapies, psychotherapy, physiotherapy or sports psychology.
  •  If you have a diagnosis of asthma, regular reviews and medication checks are important to keep it under good control.

You may meet with a therapist 3 or 4 times. Learning these new techniques takes regular practice even when you are not having ILO symptoms, so you can be ready to control them before they become severe.


Clinic Locations:

Total Heath West Berkshire, Lower Henwick Farm, Turnpike Road, Thatcham, RG18 3AP – Tuesdays only

The Manor Hospital, Beech Road, Headington, Oxford, OX3 7RP – Thursdays only

Virtual video consultations are also available – Monday and Friday

Therapy prices:

  • Initial assessment and advice session (up to 60 minutes) £125
  • Therapy session (up to 45 minutes).  £75
  • Some patients may have treatment funded by their health insurance. Tor Spence is a registered speech therapy provider for most of the UK’s health insurers. Please confirm with your insurance provider if they will fund your speech therapy and ask them for an authorisation code before booking an appointment with VoiceFit.