Effects of Globus Sensation (Lump in Throat)
Medically reviewed by Robert Burakoff, MD
A globus sensation is a feeling of having something stuck in your throat. It feels like a lump in the throat, but nothing is actually causing a blockage. Reasons for a globus sensation include emotional issues such as stress and anxiety or a physical issue such as gastroesophageal reflux disease (GERD), a condition in which stomach contents back up into the food tube.
This article discusses the globus sensation and possible causes of a feeling of a lump in your throat.
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How Globus Sensation Feels
The globus sensation feels like a lump or tightness in the throat unrelated to swallowing. It is not caused by an actual blockage in the throat.
A globus sensation might cause a persistent awareness of how the throat feels, with symptoms such as:
A sensation of a lump or fullness in the throat while nothing is present
A feeling of choking or tightness in the throat
A feeling that the throat is swollen or itchy
Symptom Onset and Frequency
The feeling of something in your throat might come on suddenly. If the globus sensation is due to the muscles in the throat being tense or tight, the feeling could last for a while. If the sensation is caused by GERD or another physical disorder, it might also be a longer-lasting feeling.
People may also find that the globus sensation comes on only at certain times. This can include when feeling strong emotions, such as grief or pride. This is usually temporary. Because it goes away, people don't usually feel that they need to see a healthcare provider.
Causes of Globus Sensation
The globus sensation can be associated with emotions or mood, including feelings of anxiety or stress. It's important to note, however, that it is not due to a psychological disorder.
The muscle at the top of the esophagus (upper esophageal sphincter) may experience increased pressure when the globus sensation is felt. When under stress or experiencing anxiety, people may tense their throat or swallow more frequently.
Most people have felt this at one time or another—feeling scared or nervous and then having the need to swallow repeatedly. The throat may feel dry and have a sensation that something is stuck in it. This cause may be considered a disorder of gut-brain interaction (DGBI).
Globus sensation may also be a symptom of a physical disorder. If it's suspected that the tightness in the throat is associated with a condition, it should be discussed with a healthcare provider.
Associated conditions include:
GERD: GERD is the most common cause of globus sensation. The symptoms of GERD may lead to more frequent swallowing and tightness in the throat, which may result in globus.
Chronic inflammation: Inflammation in the throat, sinus (sinusitis), or tonsils may cause irritation that could lead to a globus sensation.
Dysphagia: Dysphagia is difficulty swallowing. It has many causes. Difficulty swallowing could lead to a feeling of pressure or a lump in the throat. People with dysphagia should seek care if they suspect that something like food or medication may be stuck.
Esophageal motility disorders: When the throat muscles are not working correctly, food may not move through the throat as easily as it should. This could lead to a persistent feeling of something being stuck in the throat. However, if you think something could truly be stuck, it's important to see a healthcare provider right away.
Thyroid disease: The thyroid is located near the throat. When the thyroid is enlarged, or there are other symptoms of thyroid disease, such as a swollen lymph gland, it could lead to the feeling of pressure in the throat.
Cancer: People who have globus sensation may be concerned that it is due to a cancerous growth. However, this cause of globus is rare. Symptoms such as pain in the throat or ear, problems swallowing, and voice changes may indicate that the sensations in the throat may be part of a more serious condition.
Neck or spine problems: Although rare, a problem with the bones in the neck or spine from a degenerative condition or an injury could also cause a globus sensation.
How to Relieve Globus Sensation at Home
The globus sensation may be temporary. It may go away when the feelings of stress or anxiety have passed. In this case, there may not be a reason to take much action.
You might first address "voice hygiene" at home. This may include avoiding things that could irritate the throat, such as smoking (cigarettes or cannabis) and drinking alcohol or caffeinated drinks. You might change your diet to avoid anything that sets off symptoms or irritation.
You may try avoiding clearing your throat or excessive swallowing. One tactic is to be aware of how often you do those things and replace them with another behavior, such as taking a sip of water.
Testing to Diagnose Globus Sensation
No single test alone can diagnose an underlying cause of globus sensation. If a person has a known condition, it may be linked to it. Globus also could be short-lived, making it unnecessary to find a cause.
If testing is needed, it could take several forms. Various imaging techniques can examine the internal structures of the head and neck. A thorough personal and family history may provide clues to possible conditions. A healthcare provider might palpate (examine by touch) the throat for anything unusual or pay attention to your throat as you drink water or eat a cracker.
Possible tests to determine the cause of a persistent feeling of a lump in the throat include:
Barium swallow: X-ray imaging allows real-time monitoring while a person swallows a contrast solution (barium).
Videofluoroscopy: A series of X-rays is taken while a person is swallowing barium-containing food and drinks of various textures.
Endoscopy: A thin tube with a light and a camera on the end is used to look inside the mouth and throat for any problems that could be causing symptoms
Manometry: A thin, flexible tube (catheter) is threaded through the nose and into the esophagus (food tube) and stomach. The tube contains sensors that can track pressure.
Multichannel intraluminal impedance. A catheter is inserted into the nose and down to the lower esophagus. It collects data on acidity for 24 hours.
Acid (pH) monitoring: A capsule is inserted into the esophagus and wirelessly transmits the pH level to a receptor worn as a belt for 48 hours.
Globus Sensation Treatment Under ENT Provider
If the globus sensation is associated with a medical condition, the best course of action is to treat the underlying disorder. If the reason is GERD, or thought to be GERD, treatment with a medication that can reduce stomach acid called a proton pump inhibitor might be used for a short time.
People who find the globus sensation persistent and bothersome even when other conditions are well controlled may be referred to specialists for further treatment.
The first step may be an evaluation with an ear, nose, and throat (ENT) provider (otolaryngologist). Support from a mental health care provider may be helpful if the globus sensation comes on during periods of anxiety, panic, or other strong emotions.
Treatment with a speech therapist may be recommended if other therapies fail and no cause can be found. Mental health therapy may be useful.
Complications of Continuous Globus Sensation
Globus sensation doesn't cause pain and isn't associated with physical complications. However, long-term globus sensation can lead to depression.
Globus sensation can affect quality of life. Some people are given a trial of GERD drugs to see if they alleviate the symptoms, but they don't always work. This, in turn, could lead to frustration and a need for further medical care.
Coping With Psychological Effects of Globus Sensation
If a physical cause for your globus sensation cannot be medically determined, you may be referred to a speech therapist or a mental health professional to help alleviate symptoms.
The following measures may further help relieve your symptoms:
Decreasing stress levels
Focusing on a diet that supports health
Getting more quality sleep
Seeking treatment for feelings of depression or anxiety
Summary
Globus sensation may be distracting and a nuisance when no cause is found, but it is not associated with complications. It may occur during a stressful period and improve on its own. An acid reducer may be tried to stop the feeling because GERD is a common reason for globus.
If symptoms such as difficulty swallowing or pain occur, it is important to get evaluated by a healthcare provider to look for an underlying cause.
Read the original article on Verywell Health.
