Have a lump in your throat? Understanding globus pharyngeus

Have you ever felt like there’s a lump or foreign object stuck in your throat, even though there’s nothing physically there? This sensation, known as globus pharyngeus, is surprisingly common and affects many individuals. While it can be distressing, it’s typically not caused by a serious medical condition. In this article, we’ll explore what globus pharyngeus is, its possible causes, and what you can do to alleviate the discomfort.

What is globus pharyngeus?

Globus pharyngeus, often referred to as a ‘lump in the throat’, is a feeling of tightness, pressure, or discomfort in the throat, as though there’s something stuck or obstructing the airway. Unlike choking or difficulty swallowing, globus pharyngeus is a non-painful sensation that doesn’t necessarily interfere with eating or drinking.

Many people experience globus pharyngeus intermittently, while for others, it may persist for weeks or months. The sensation can often be more noticeable during activities like speaking, swallowing, or after eating. Interestingly, this sensation typically doesn’t cause actual difficulty swallowing or breathing, but it can lead to frequent throat clearing, a constant need to swallow, or a dry cough.

What causes globus pharyngeus?

The exact cause of globus pharyngeus is not always clear, but several factors may contribute to the sensation. These include both physical and psychological elements. Here are some of the most common causes:

Muscle tension in the throat: Often, the muscles around the throat may become tense or overactive, leading to a sensation of tightness or a lump in the throat. This is frequently associated with stress, anxiety or vocal strain.

Acid reflux: Gastroesophageal reflux disease (GORD) or/and laryngopharyngeal reflux (LPR) is one of the most common conditions that can lead to globus pharyngeus. When stomach acid rises up into the oesophagus, it can irritate the lining of the throat, causing a sensation of tightness, discomfort or a lump in the throat.

Postnasal drip: Mucus that drips down the back of the throat due to allergies, sinus infections, or colds can irritate the throat, leading to frequent throat clearing and the feeling of something being stuck in the throat.

Throat inflammation: Inflammation due to infections, such as viral or bacterial infections, or even chronic conditions like laryngitis or tonsillitis, can cause swelling and discomfort in the throat, resulting in globus pharyngeus.

Thyroid issues: In rare cases, thyroid disorders (such as thyroid enlargement or a goitre) can cause the sensation of a lump in the throat. An enlarged thyroid can put pressure on the oesophagus or airway, contributing to discomfort.

Psychological factors: Stress and anxiety can play a significant role in triggering or exacerbating the sensation. The feeling may be more pronounced in stressful situations, and individuals with heightened anxiety may be more sensitive to throat sensations.

What are the symptoms of globus pharyngeus?

The primary symptom of globus pharyngeus is the sensation of a lump, or something stuck in the throat. However, the experience can vary from person to person.

Some additional symptoms that may accompany globus pharyngeus include:

• Frequent throat clearing: Many people with globus pharyngeus feel the need to clear their throat often, even though there’s no visible obstruction.
• Sensation of tightness: The feeling of tightness or pressure may be constant or may come and go throughout the day.
• Difficulty swallowing: Though swallowing is usually not impaired, some individuals may feel like they need to swallow more frequently to relieve the sensation.
• Dry cough: A dry, non-productive cough is common in those with globus pharyngeus.
• Increased mucus production: Some individuals may experience postnasal drip or mucus accumulation in the throat.

How is globus pharyngeus diagnosed?

If you are experiencing the sensation of a lump in your throat or persistent throat discomfort, it’s essential to consult an ENT (Ear, Nose, and Throat) specialist for an accurate diagnosis. Your doctor will typically perform the following steps:

Detailed medical history: The doctor will ask about your symptoms, including when they started, how often they occur, and any potential triggers (such as stress, diet, or recent illnesses).

Physical examination: A thorough examination of the throat, including checking for signs of inflammation, swelling, or signs of reflux.

Endoscopy: In some cases, a flexible tube with a camera (known as a laryngoscope) may be inserted through the nose to examine the back of the throat and the larynx (voice box) for any abnormalities.

Tests for GORD or allergies: If acid reflux or allergies are suspected, further tests such as pH monitoring of the oesophagus or allergy testing may be recommended.

What are the treatment options for globus pharyngeus?

Treatment for globus pharyngeus depends on its underlying cause. While the sensation itself can be troubling, most cases are manageable with lifestyle changes, medication or therapy.

Managing acid reflux (GERD): If GERD is a contributing factor, lifestyle changes such as avoiding acidic foods, eating smaller meals, and not lying down after eating may help. Medications to reduce stomach acid, such as proton pump inhibitors (PPIs) or H2 blockers, may also be prescribed.

Stress management: If stress or anxiety is triggering the sensation, relaxation techniques such as deep breathing exercises, meditation, and cognitive behavioural therapy (CBT) can help reduce tension in the throat muscles.

Hydration and humidification: Staying hydrated and using a humidifier can help if post-nasal drip or dry air is causing irritation. Drinking warm liquids may also soothe the throat.

Voice therapy: For individuals with vocal strain, speech or voice therapy may be recommended to teach proper vocal techniques and reduce strain on the throat.

Allergy management: If allergies are contributing to the sensation, medications such as antihistamines or nasal sprays may help control symptoms.

Surgical intervention: In rare cases, if a thyroid issue or other structural abnormality is identified, surgery may be required to address the underlying problem.

When should I see an ENT specialist about globus pharyngeus?

If you’re experiencing a persistent lump-in-the-throat sensation, it’s important to consult an ENT specialist to rule out any serious underlying conditions. Seek medical attention if you experience any of the following:

• Sudden difficulty swallowing or breathing.
• Persistent or worsening throat discomfort.
• Pain, especially when swallowing.
• Unexplained weight loss or a noticeable lump in the neck.
• Hoarseness that lasts more than a few weeks.

Globus pharyngeus is a common condition that can result from a variety of causes, including muscle tension, acid reflux, allergies or even stress. While it can be an uncomfortable experience, it’s usually not a sign of a serious health problem. With the right diagnosis and treatment plan, most people can find relief and reduce the impact of globus pharyngeus on their daily life.

If you’re experiencing symptoms of globus pharyngeus, don’t hesitate to schedule an appointment with an ENT specialist such as Ms Lentari. Her team can help identify the underlying cause and develop a treatment plan tailored to your needs.