Lump in the Throat (Globus Sensation): What Does It Mean?

The presence of a lump in the throat is medically referred to as a globus sensation. It's extremely common and makes up 5% of all ENT referrals.

A physical examination would help in revealing whether or not there is any actual object or lump present in the throat, but this typically isn't the case. For most, this sensation is painless, but can be annoying. Most of the time, eating or drinking provides relief, whether temporary or permanent.

The history behind the name

The first case of globus sensation was recorded around 2500 years ago, but it was not until the year 1707 that John Purcell had described this condition as a pressure put on the thyroid cartilage caused due to the contraction of the strap muscles in the neck. At that time, doctors mistook this condition for hysteria. The term was also known as 'globus hystericus' for this reason, especially in women. It was linked to menopause. 

But in the year 1968, the globus sensation was no longer associated with any hysterical symptoms, and was then renamed to globus pharyngeus.

It is not easy to identify and treat this condition since there are a host of other possible causes that can lead to it, including non-physical conditions such as anxiety and stress. 

This condition affects both men and women, but may be more common in middle-aged adults than younger adults and children.

Symptoms of globus sensation

The main symptom is that feeling of a lump in the throat which may come and go. It usually occurs in the front of the neck, and it can move around, mostly up and down. These symptoms might subside while swallowing, eating, or drinking, but they may return. Most of the time, there is no pain associated with this condition.

When to visit the doctor

Usually, this sensation goes away without any intervention.

But in certain cases, where it does not go away, it would be better to visit the doctor in case there is an underlying condition, such as GERD or a thyroid disorder.

Of course, if you suspect there is an actual object or piece of material stuck in your throat, visit your doctor immediately to make sure your airways are clear.

Causes

There are multiple potential causes that can lead to globus sensation:

Conditions associated with the pharynx

These conditions can lead to inflammation as well as irritation of the pharynx. They can include pharyngitis, tonsillitis, or chronic case of sinusitis with post-nasal drip. These conditions can cause an increase in the sensitivity present in the throat as well as occurrence of globus sensation.

Stress and anxiety

Psychological distress and health-related anxiety are known to be associated with an increase in the occurrence of globus sensation. Traumatic or stressful life events can also trigger globus sensation or worsen the symptoms. Of course, further research is still required to determine the exact link between psychological triggers and globus sensation.

Gastroesophageal reflux disease

This is also referred to as GERD and can at times trigger globus sensation. It's estimated that up to 70% of all instances of globus sensation are due to symptoms of GERD or acid reflux.

Tumors

In very rare cases, globus sensation can also occur due to a tumor that is present in the throat, for example: oropharyngeal metastasis of the merkel cell carcinoma.

Abnormal upper esophageal sphincter function

Abnormal UES function is known to occur when the flap that controls airflow via the windpipe is no longer operating normally. The UES is said to account for a few globus sensation cases. This is usually treated with the help of injections.

Thyroid functioning issues

This is known to occur in those with both active abnormality as well as a post-thyroidectomy (when the thyroid has been either completely or partially removed). The exact correlation in between the thyroid abnormalities and globus sensation is still unclear, but thyroidectomy provides relief from symptoms in certain cases.

Other causes

Other possible causes may include Eagle’s syndrome, temporomandibular joint disorder or TMJ, inablity to produce saliva, laryngeal and the pharyngeal tension, and cervical osteophytes or bone spurs.

Treatment

There is no one single form of treatment that would help in all cases of globus sensation. Treatment depends on the cause and can include the following.

Muscle therapy

If muscle tension is the cause of this issue then the individual would be referred to an ENT specialist or a speech therapist to learn how to ease the tightness when it starts to occur.

Therapy

Since grief, anxiety, depression, or any other mental health issues can lead to globus sensation, treating this underlying condition with therapy will likely improve the occurrence of globus sensation.