The idiom “lump in the throat” has traditionally been used to refer to the holding back of tears due to overwhelming emotion. While this feeling may indeed seem like a tightness in the back of your throat, it is also possible to feel it in a much more literal way. Such a sensation, the feeling that an object or substance is stuck in the throat even when there isn’t one, is a medical phenomenon known as globus pharyngeus. And while it may not be a serious concern, it can nevertheless be painful or distressing.
What Is Globus Pharyngeus?
Also referred to sometimes as a globus sensation or globus hystericus, globus pharyngeus is characterized by the feeling of a lump or foreign object in the throat, even when there is no physical obstruction present. This sensation of a lump may be dismissed at first, but the discomfort can eventually interfere with normal swallowing and begin to cause psychological distress. Apart from the feeling of the lump itself, there are a number of other symptoms of globus pharyngeus that may also present:
- lump in the throat feeling better after eating
- sore throat
- tightness of the throat muscles
- increased frequency of throat clearing or coughing
- difficulty swallowing (but not true dysphagia)
- repeated efforts to clear the throat can cause irritation
Possible Causes of Globus Sensation
Globus pharyngeus is a common occurrence around the world, and it is estimated that upwards of 40% of the population will experience the sensation at least once in their life. As common as it is, though, the precise cause isn’t always clear. Many factors are thought to contribute to the development of the condition, but below are some of the most common causes:
- Stress and anxiety: Psychological factors like stress and anxiety can trigger or exacerbate the sensation of a lump in the throat. This is primarily because stress can promote muscle tension around the body and specifically in the throat; stress can also generally lead to increased sensory awareness that can cause the feeling to be more prominent.
- GERD: Heartburn, also known as acid reflux, is an all-too-common symptom that presents when stomach acid backs up into the esophagus. What is an occasional annoyance for some, though, can become a chronic condition known as gastroesophageal reflux disease, or GERD. When a person has GERD, their lower esophageal sphincter (where the esophagus meets the stomach) doesn’t function properly and allows stomach contents to back up. In some cases, the stomach acid can back all the way up past the upper esophageal sphincter and into the larynx and pharynx; when this happens, it can sometimes feel like there is a foreign object in the throat.
- Irritants: Many times the cause of the globus sensation is related to a substance that irritates the throat. In common illnesses like a cold or sinusitis, the immune system generates mucus in an attempt to flush out pathogens; but the resulting postnasal drip can actually irritate the throat and make it feel like a lump. It is also possible for spicy food to cause a similar level of irritation.
- Medical conditions: In addition to the esophagus and trachea, the neck contains a number of important structures that can become irritated or swollen. The thyroid gland, for instance, is located in the neck and can develop nodules that might put pressure on the throat. There is a similar concern with lymph nodes and the tonsils (as in tonsillitis); in each case, inflammation or other problems with these structures may feel like an object is lodged in the throat.
- Anatomy: Some people may simply have anatomical abnormalities in the neck area that predispose them to throat problems or the area becoming easily irritated.
How Is Globus Sensation Diagnosed?
The fact that the globus sensation can be mistaken as so many other conditions makes an accurate diagnosis really important. The first steps are usually a medical history and physical exam, but the diagnosis may require a more comprehensive evaluation with the use of endoscopy. Depending on the other possible causes of the symptom, imaging tests like X-ray or CT scan may be needed, though this usually indicates an underlying problem and not simply the feeling of a lump.
Globus Sensation Treatment Options
Regardless of the cause, it’s worth noting that the condition is an issue of perception; in other words, while it feels like there’s something stuck in your throat, there really isn’t. So while it can be an unpleasant thing to experience, it must be differentiated from conditions where there is an actual obstruction or where narrowing of the esophagus can cause a number of more serious problems. For globus pharyngeus, though, it is a benign concern that will either go away on its own or can be treated in several different ways:
- Underlying conditions: In cases where the globus sensation is due to underlying illness or other condition, the most important step is to assess and address the cause. For a person struggling with GERD, for instance, there are medications and dietary changes that are typically recommended. Or if stress is the cause, the most important step is finding ways to destress.
- Lifestyle changes: Since most cases of globus pharyngeus are mild and likely related to an irritant, another important technique is to avoid substances or situations that are likely to trigger irritation. Avoiding spicy or acidic foods and limiting alcohol are all ways to bypass some common triggers.
- Medication: Over-the-counter antacids or prescription reflux medication can help neutralize stomach acid in cases of heartburn. There are also some muscle relaxants that can ease some of the muscle tension that might be involved. For anxiety and stress-related reasons, anti-anxiety meds or antidepressants may also be useful.
- Therapy: In the same vein as antidepressants, talk therapy may be helpful at working through some of the emotional and psychological factors behind globus pharyngeus. Also, speech therapy can provide exercises that ultimately relax the muscles around the throat.
The strategies for treating globus pharyngeus will naturally depend on the particular person and the likely factors contributing to the condition. A gastroenterologist or other healthcare professional should be involved in both the diagnosis and treatment, though, given how easily it can be mistaken for another health problem. For most people, however, the actual treatment process can be managed through home remedies.
Find a Trusted Healthcare Partner
The good news about globus pharyngeus is that it’s not a serious condition; even though feeling a lump in one’s throat can be irritating, the cause can usually be identified and treated. At Cary Gastro, we strive to be your go-to partner for medical advice associated with the digestive system. If you’ve been experiencing the globus sensation or any other gastrointestinal systems, contact us today to request an appointment.