The word "ECH" is a tricky one to spell phonetically because it doesn't have a standard english pronunciation. It is often used to represent the sound made when clearing one's throat. In IPA phonetic transcription it is represented as /ɛk/. The "e" sound is pronounced like "eh" as in "bed" and the "k" sound is a hard, abrupt sound like in "kick". As a result of its unique pronunciation, the spelling of "ECH" can vary depending on dialect and personal interpretation.