Globus pharyngis is the persistent sensation of having a pill, food, or some other obstruction in the throat. This feeling is not usually painful but can be irritating. People often refer to globus as a “lump in the throat.” Other common names for the condition include globus pharyngeus and globus sensation.
Causes
Direct causes of globus pharyngis remain unknown, though many experts propose links to specific conditions. A common theory suggests that stomach acid triggers chronic inflammation that is responsible for the “lump in the throat” sensation. Causes of this include gastroesophageal reflux (GERD) and laryngopharyngeal reflux. Lingual tonsils, sinusitis, post-nasal drip, goiter, and foreign objects can also cause the symptom.
A Rare Cause
Globus pharyngis that manifests with a clicking sensation and pain when swallowing may indicate a rare occurrence where thyroid cartilage is rubbing against the larynx. Because this cause is atypical, doctors often misdiagnose the condition. This type of globus pharyngis responds best to an operation where a surgeon trims the offending thyroid cartilage.
Anxiety, Depression, and Globus Pharyngis
Stressful situations tend to occur prior to the development of globus pharyngis. Additionally, around 96% of people with globus pharyngis say that moments of emotional intensity worsen their symptoms. Experts have also linked globus pharyngis to several psychiatric disorders. Some studies recognize it as a symptom of depression and suggest antidepressants.
When to Visit a Doctor
It is a good idea to tell your doctor about this feeling in the throat, to look for the underlying cause of globus pharyngis. If other symptoms are present or if the condition becomes chronic, medical intervention is necessary; these include pain while swallowing, an inability to swallow, and frequent reflux. If a foreign object becomes lodged in the throat, a piece may remain even after the airway clears. This lingering piece may trigger globus pharyngis.
Diagnosis
Diagnosing globus pharyngis is typically a straightforward procedure because its characteristic symptom is so evident. Doctors usually check for underlying issues like GERD or throat inflammation to confirm the cause. Thyroid exams are common. In certain cases, a CT or MRI scan may be necessary to detect inflammation or atypical laryngeal anatomy.
Differential Diagnosis
Several conditions present with the sensation of a “lump in the throat.” Because of this, medical professionals attempt to rule out other diagnoses, such as Eagle syndrome. Other conditions with this sensation typically cause true dysphagia or difficulty swallowing. They are also painful. Dysphagia and pain are rare in cases of globus pharyngis. Medical imaging may be necessary for doctors to reach the correct diagnosis of the cause.
Treatment
Most people do not require treatment for globus pharyngis, though professional reassurance that the issue is minor can help. Doctors often advise patients with globus pharyngis to avoid dry swallowing or coughing. Targeting the initial cause often resolves the issue, as well. If symptoms indicate acid reflux, proton pump inhibitors or other GERD treatments are beneficial. Psychogenic or mental health-related causes may respond to therapy or medications.
Home Management
When a person experiences globus pharyngis, following a few rules can provide moderate relief. Do not attempt to clear the throat, as this may aggravate the sensation or worsen the inflammation. Experts recommend yawning rather than clearing the throat. Gently swallowing, with or without water, can also help. Drinking fluids and breathing in steam are also effective.
Relief Exercises
Certain jaw, mouth, and neck exercises can also alleviate globus pharyngis:
- Exaggerated chewing movements; imagine chewing on a piece of gum that keeps getting larger
- Shrug both shoulders up to the ears, hold, then release
- Open the mouth, drop the head to the chest, gently roll the head in a circle
- Practice proper posture
Frequency
Studies indicate that globus pharyngis is extremely common, with between 22% and 46% of the population experiencing it at least once. The condition accounts for approximately 4% of new referrals to ear, nose, and throat doctors. Globus pharyngis appears to affect males and females equally, though the latter are more likely to seek treatment.