A persistent sense that something is lodged in the throat is called globus pharyngeus, or the globus sensation.
Globus pharyngeus does not interfere with swallowing or breathing, but it can become quite annoying. It can also lead to significant health anxiety, since people with this sensation may worry they are choking or about to choke.
In this article, we take a look at this sensation, its causes, and when people should see a doctor about it.
Globus pharyngeus makes the throat feel partly blocked. People experiencing this feeling often refer to a lump in the throat. Some others describe the sensation as scratchy, throbbing, tense, or like they have a pill stuck in their throat.
The sensation is not painful, but it can be annoying. A fundamental difference between globus pharyngeus and other throat issues is that there is no actual lump in the throat when a person experiences the globus sensation.
The globus sensation is different from dysphagia, which is difficulty swallowing. However, some people with globus pharyngeus may report difficulty swallowing or feel anxious that swallowing will cause choking.
Most people with globus pharyngeus find that symptoms temporarily improve after drinking, and sometimes after eating.
Anxiety and psychological symptoms can cause the globus pharyngeus. The condition was once called globus hystericus, and doctors as far back as Hippocrates have assumed that people who experienced this symptom were "hysterical."
Doctors now know that the globus sensation can have both psychological and physical causes and that people are not faking their symptoms - even when there is no physical cause.
A doctor may diagnose globus pharyngeus after they have found no signs of a lump or other object lodged in a person's throat. In many cases, a doctor can find no apparent cause of the sensation. Often, globus pharyngeus is due to minor inflammation in the throat or at the back of the mouth.
The throat muscles and mucous membranes can feel strained when the throat is dry, causing feelings that something is stuck in the throat. Medications and some medical conditions may cause dry throat.
One of the most common causes of a dry throat is frequent swallowing due to anxiety. Since some people respond to the globus sensation by swallowing more frequently, anxiety about the globus sensation can make symptoms worse.
Other potential causes of this inflammation include:
- Gastroesophageal reflux disease (GERD): GERD is a form of acid reflux that causes the stomach's contents to travel back up the food pipe and sometimes into the throat. Inflammation from acid may cause globus pharyngeus. GERD can also cause muscle spasms that trigger feelings of an object caught in the throat.
- Psychological health issues or mood changes: In some people, anxiety disorders and depression trigger the globus sensation. Others may experience a temporary lump in the throat when they experience particular moods.
- Skeletal muscle disorders: People with certain skeletal muscle disorders, such as myasthenia gravis and myotonia, may experience problems in the throat muscles that cause the globus sensation.
- Eosinophilic esophagitis: This is chronic inflammation in the food pipe, normally due to allergies.
- Zenker's diverticulum: This is a balloon of tissue in the wall of the throat.
GERD and anxiety are by far the most common causes of globus pharyngeus. Rarely, a lump in the throat is due to a growth or lesion in the throat. These growths, which are often noncancerous, include:
- a large or swollen thyroid
- a cyst or other benign growth
- a cancerous growth
- a mucosal lesion
Mucosal lesions can be due to trauma, such as swallowing a large object, or due to ulcers at the back of the throat.
A related condition, dysphagia, causes difficulty swallowing. People with dysphagia may have a sensation that there is a lump in their throat, but most of those who experience globus pharyngeus do not have dysphagia.
Odynophagia, the term for painful swallowing, can also cause difficulty swallowing. People with globus pharyngeus do not report pain when they swallow.
Occasionally, individuals who choke or swallow large objects retain a portion of it in their throat; or sometimes, a large object can scrape part of the throat. In either case, people may experience a feeling of fullness at the back of the throat.
Objects that get stuck in the throat after choking can move and make it difficult to breathe, so people who experience globus pharyngeus after choking should seek prompt medical care.
Globus pharyngeus is a common medical symptom, accounting for a significant minority of symptoms reported to an ear, nose, and throat (ENT) specialist.
One estimate suggests that about 4 percent of people seeking care at an ENT clinic have globus symptoms. As many as 78 percent of those seeking care at non-ENT clinics may also have globus pharyngeus.
The feeling that there is a large mass in the body can be frightening, and people with the globus sensation may be more likely to seek prompt medical care than those who have other symptoms. In the overwhelming majority of cases, the cause is not serious, and reassurance is all that is necessary.
Unless globus pharyngeus follows choking, it is safe to wait to see if the sensation disappears on its own.
People who have previously experienced globus pharyngeus and sought treatment do not need to see a doctor unless the symptoms are worse, significantly different, or painful.
People should see a doctor for the globus sensation when it is accompanied by:
- pain in the throat or neck
- weight loss
- sudden symptoms after the age of 50
- difficulty swallowing
- pain during swallowing
- choking when swallowing
- muscle weakness in the throat or elsewhere in the body
- A mass that can be seen or felt in or around the neck or throat
- symptoms that get progressively worse
- symptoms that signal an infection or other serious health issues, such as fever or swollen lymph nodes
There are no specific medications or lifestyle changes available to treat globus pharyngeus. Also, people who have previously experienced globus pharyngeus may experience it again, particularly in times of stress.
When the globus sensation is due to another medical condition, treating that condition can remove globus pharyngeus. For example, antacids and lifestyle remedies may help with globus pharyngeus related to GERD.