Ear, Nose and Throat

Globus sensation: Causes of a lump in the throat

Globus sensation is an overwhelming feeling of a lump or foreign object being lodged in a person’s throat. However, a physical examination will reveal there is no object or lump present.

This article will explore what globus sensation is, along with its possible causes and treatment.

What is globus sensation?

Woman holding her throat, as she experiences a lump in her throat.
Globus sensation is the feeling of having a ‘lump’ in the throat.

Globus sensation is a persistent sensation of a lump in the throat. People report the lump as non-painful but often annoying.

Globus sensation is often difficult to treat, can last a very long time, and will likely recur in the future. Many people experience relief from eating or drinking.

Hippocrates recorded the first known cases of globus sensation around 2,500 years ago. But it was not until 1707 that John Purcell more accurately described the condition as pressure on the thyroid cartilage due to contraction of the strap muscles of the neck.

Still, doctors mistook reports of globus sensation for being associated with fits of hysteria. Globus sensation became known as “globus hystericus,” as it was frequently associated with menopause or other psychological factors in women.

It was not until 1968 that globus sensation was no longer linked with signs of hysterical personality and was renamed “globus pharyngeus.”

Identifying and treating globus sensation is not always easy, as there is a range of possible causes. These include stress and anxiety, so diagnosis based on a physical exam is usually impossible.


Who gets globus sensation?

Globus sensation is a common condition. Reports indicate that globus sensation accounts for approximately 4 percent of all new ear, nose, and throat (ENT) practice’s referrals.

The condition is present equally in men and women. However, it is more likely for a woman to report the symptoms of the condition than men. Also, middle-aged people are more likely to report it than younger individuals.

Causes of a lump in the throat

Man feeling stressed and anxious at work.
Stress and anxiety may cause globus sensation.

There are several potential causes of globus sensation. In all cases, the causes will help define the necessary treatment. Some of the most common causes include:

  • pharyngeal inflammatory conditions
  • gastroesophageal reflux disease
  • psychological factors, such as stress or anxiety
  • abnormal upper esophageal sphincter function
  • rare tumors
  • thyroid disease
  • previously lodged objects

Pharyngeal inflammatory conditions

Pharyngeal inflammatory conditions cause irritation and inflammation of the pharynx. Some of these conditions include:

These conditions may cause an increased sensitivity in the throat and globus sensation.

Gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) can sometimes cause globus sensation. Research indicates that roughly 23 to 68 percent of all people with globus sensation may attribute it to acid reflux or the symptoms of GERD.

Anxiety or stress

There are some links between psychological conditions and globus sensation. Some studies have found that psychological distress, such as stress, depression, and health anxiety, is associated with higher rates of globus sensation.

Also, some studies indicate stressful or traumatic life events can trigger globus sensation or make symptoms worse. Further studies are needed to determine the exact link between psychological factors and globus sensation.

Abnormal upper esophageal sphincter function

Abnormal upper esophageal sphincter (UES) function occurs when the flap that controls airflow through the windpipe does not operate normally.

UES may account for some of the cases of globus sensation. If UES is the cause, the condition can usually be treated with injections designed to help the UES function properly.

Rare tumors

Rarely, globus sensation can be caused by a tumor in the throat. An example of cancer is oropharyngeal metastasis of Merkel cell carcinoma.

Thyroid disease

A person may report symptoms of globus sensation if they have thyroid abnormalities. This can occur in people both with an active abnormality and post-thyroidectomy, which is when the thyroid has been fully or partially removed.

The exact correlation between thyroid disease and globus sensation is unclear, but a thyroidectomy appears to help relieve symptoms in some cases.

Previously lodged object

Sometimes, after an object has been removed from the throat, a small piece may remain. This may cause the feeling of the throat still being blocked.

More importantly, this piece may shift over time and block the airways. In those instances, it is important to seek emergency medical attention to remove the blocking object.

Other factors

Some studies have found links with additional joint or muscular problems. These studies are often isolated, so further research is needed to determine the exact relationship between the conditions and globus sensation.

Some other possible factors include:

  • temporomandibular joint (TMJ) disorders
  • inability to produce enough saliva
  • cervical osteophytes or bone spurs
  • Eagle’s syndrome
  • laryngeal and pharyngeal tension


Treatment

Woman explains throat and neck problems to doctor.
Globus sensation usually cannot be treated directly, so treatment involves addressing the underlying cause.

No single treatment will cure all cases of globus sensation. If the underlying cause is a physical problem, such as GERD, the feeling of a lump in the throat will be reduced or go away once the cause is treated.

However, not all methods work for all people and symptoms may persist even after treatment.

Addressing psychological factors may help a person with globus sensation reduce their discomfort. Taking steps to reduce anxiety or stress can significantly improve a person’s symptoms.

If there is no underlying physical condition or throat obstruction, a doctor may recommend cognitive behavioral therapy (CBT) or other methods to reduce anxiety.


When to see a doctor

A person with globus sensation may never need to see a doctor, as the condition is likely to clear up on its own.

However, in cases of chronic globus sensation, a person may want to speak to a healthcare professional to help identify the cause of the sensation. In those cases, a person may be able to treat the underlying cause and prevent further episodes of globus sensation.

It is essential for people who recently had an object lodged in their throat to seek immediate medical attention if they feel the airways are constricted. In these cases, a small portion of the object may still be present and could block the airways.

Further research is still needed to determine the link between a lump in the throat and the conditions that cause it.

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