Causes of a Lump in Your Throat
Medically reviewed by Benjamin F. Asher, MD
Feeling a lump in the throat, called globus pharyngeus, can be due to a number of causes. This sense that something is stuck in your throat (even though it seems nothing's there) is different from the swallowing disorder called dysphagia.
It is often diagnosed as a benign condition, with about 45% of adults experiencing an episode of globus in their lifetimes.In many cases, though, it is a symptom linked to another health condition, with gastroesophageal reflux disease (GERD) among the most common. It also can be due to:
Muscle spasms at the top of the esophagus
Bone changes in the neck
Sinusitis and post-nasal drip
Hypopharyngeal cancer (a type of head and neck cancer)
This article discusses globus pharyngeus and the possible causes of feeling a lump in your throat.
Symptoms With Lump in Your Throat
Feeling as though there's a lump in your throat is a common complaint, and this actually accounts for 4% of all new appointments scheduled with an otolaryngologist (an ear, nose, and throat specialist, or ENT). People often complain of symptoms that include:
A throat that feels tight
Pressure or discomfort at your throat
Mucus that's persistent or hard to clear from the airway
You also may experience other symptoms that are specific to an underlying cause of globus. People diagnosed with GERD may complain of indigestion and an acid taste that backs up into the throat. Someone with chronic sinusitis may have symptoms that affect nasal passages, too, while a rare cancer may involve an obvious mass at the throat, unexplained weight loss, pain with swallowing, and more.
What Is Globus Hystericus?
The feeling of having a persistent lump in your throat used to be considered a psychiatric disorder and referred to as globus hystericus (a term that is no longer used). It's now understood to be related to other causes, like GERD. Some people with globus symptoms do benefit from treatment for anxiety and depression, such as selective serotonin reuptake inhibitors, or SSRIs.
Related: What Are Selective Serotonin Reuptake Inhibitors (SSRIs)?
Causes of Lump in Throat
Feeling a lump in your throat may be due to a number of conditions. In some cases, as with dysphagia (difficulty swallowing), it's important to understand the reason because the diagnosis and treatment will be different from globus without other symptoms.
Dysphagia
People with dysphagia sometimes describe the feeling of a lump in the throat. The associated difficulty swallowing can be due to a number of serious medical conditions.
Among them are stroke, Parkinson's disease, and other neurological conditions that can make it hard to swallow. Sometimes, there's no obvious cause of dysphagia but it may be due to muscle tension in the throat.
GERD
Gastroesophageal reflux disease (GERD) is a common diagnosis in people who describe feeling a lump in the throat. Experts estimate that up to 68% of people who experience a globus syndrome have an underlying GERD condition.
Gut-Brain Axis
Earlier studies demonstrated a link between irritable bowel syndrome and globus, but later research arrived at other conclusions. That said, globus is often seen in people with other gastrointestinal (digestive tract) symptoms and conditions.
Some researchers describe this type of lump in the throat as a disorder of gut-brain interaction (DGBI) and continue to study the relationship between globus and other conditions, like irritable bowel syndrome.
Related: The Brain Gut Connection in IBS
Esophagus Problems
Changes in the esophagus, the tube that connects between the mouth and the stomach to move food and drink to it, can lead to globus sensations.
These changes include esophageal motility disorders (problems with how things move in the esophagus) and upper esophageal sphincter dysfunction (pressure changes, for example).
Related: The Upper Esophageal Sphincter
Inflammatory Conditions
People diagnosed with chronic sinusitis, pharyngitis, or tonsillitis often experience the feeling that something is stuck in the throat. It's also common to have a lot of mucus production with some of these conditions. A postnasal drip, for example, can cause irritation that leads to globus sensation.
Bone Structure Changes
Changes that affect bone structure can cause you to feel like you have a lump in your throat. These changes can be due to medical reasons, like a degenerative condition that affects the cervical spine. Or, they can follow trauma to bones in your throat such as the hyoid, placed over your voicebox.
Thyroid Disease
Thyroid disease may be an underlying cause of the sense that you have a lump in your throat. Because the thyroid is located so close to the larynx and other throat structures, lumps or large nodules may affect your sense of swallowing.
Thyroid-related conditions like a goiter or swollen lymph glands can look like lumps, or appear as if your throat is off-center.
Cancer
It's rare, but you may feel as if there's a lump in your throat because of a tumor. Symptoms of a throat cancer also include difficulty swallowing, voice changes, and ear pain.
Hypopharyngeal cancer is possible, but so are benign (noncancerous) tumors. It's important to keep in mind that globus pharyngeus usually doesn't cause throat pain, which can be an important sign that something else needs to be diagnosed.
Diagnosis
There are no specific tests to diagnose a lump in your throat. A healthcare provider will typically evaluate you on the basis of medical history and examination, and then order diagnostic tests to determine or rule out a condition that may be causing your globus sensation.
These diagnostic tests can include:
Barium swallow study
Videofluoroscopy
Manometry
Multichannel intraluminal impedance
Acid (pH) monitoring
Takeaway
Your ENT's primary objective during your visit will be to determine whether you are experiencing dysphagia. Dysphagia and globus are different in that dysphagia is accompanied by a structural or functional problem with your pharynx (throat) or esophagus. Treatment will vary between the two different diagnoses.
Treatment
Because GERD is so common in people complaining of a throat lump, your ENT may simply start you on a short trial of a proton pump inhibitor (PPI) medication to see if this resolves your sensation of a lump in your throat.
If your symptoms resolve, you may simply be referred back to your healthcare provider or a gastroenterologist. If you have a partial resolution of symptoms, your PPI dose may be increased.
However, if you do not have any changes in symptoms, other approaches may be needed. They may include:
Relaxation techniques
Antidepressant trial (takes six weeks before effectiveness can be evaluated)
Speech therapy can teach you techniques to strengthen your swallow and vocal use. This may have varied success rates. Antidepressant use and relaxation techniques have a similar line of rationale.
Prevention
Lifestyle changes may help, since certain factors (smoking, for example) may contribute to globus symptoms. Some of these changes are similar to those recommended when people are diagnosed with GERD. In addition to smoking cessation, you can:
Limit meals or snacks before bedtime
Avoid alcohol or caffeine but drink plenty of water
Lose weight
Globus symptoms may improve on their own, or they may come and go. Be sure to discuss your symptoms and their management with your healthcare provider.
Summary
A lump in your throat can have many benign causes, such as an emotion like pride. But when the sense that something's stuck in your throat doesn't go away, there may be a medical reason that's leading to your globus pharyngeus symptoms.
GERD is among the most common reasons for why people experience the globus sensation and other symptoms will help your healthcare provider to arrive at this or another diagnosis. You also can make lifestyle changes at home to better manage your symptoms as part of your overall treatment plan.
Read the original article on Verywell Health.
