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Lump in Throat Feeling

The lump in the throat feeling is also known as the globus sensation, being described by patients in different ways. It is important to understand that this is literally just a feeling, as there is no actual mass or lump in the throat. According to the specialists in the field, in the situation that the sensation is accompanied by the difficult swallowing (dysphagia), the condition is presented as globus hystericus (no connection to hysteria).


The most essential things to remember is that the lump in the throat feeling is not dangerous. Moreover, there are no complications that can arise from this sensation.

Symptoms of Feeling of Lump in Throat

There can be a number of symptoms that appear in association with the lump in the throat feeling, being suggestive of an additional medical problem that is present. These include:

  • Pain or discomfort at the level of the neck or throat
  • Phlegm or mucus sensation
  • Constant need to clear the throat
  • Lack of appetite
  • Weight loss
  • Difficult swallowing (dysphagia)
  • Painful swallowing
  • The patient chokes when he/she tries to swallow
  • Food regurgitation
  • Heartburn
  • Burping
  • Muscular weakness
  • State of general weakness
  • Visible lump or mass at the level of the neck or throat.

What Causes Lump in Throat Feeling?

At the moment, the exact cause that leads to the appearance of this feeling is not known. Nevertheless, these are the causes that have been considered to be potentially responsible for the lump in throat feeling:

  • Increased tension at the level of the throat muscles (can also be present at the muscles just below the throat, causing similar problems)
  • Gastroesophageal reflux (commonly seen in patients diagnosed with GERD)
  • Intense emotions or anxiety
  • Stress – strong constriction of the muscles
  • Other causes
    • Cricopharyngeal muscle disorders/other pathology of the esophagus
    • Zenker’s diverticulum
    • Inflammation of the esophagus
    • Mucosal lesions at the level of the throat (trauma, ulcers)
    • Actual mass (cancer or enlarged thyroid gland)
    • Neuropathy.

Diagnosis

The differential diagnosis can and should be made with the following medical conditions:

  • Upper esophageal webs
  • Esophageal spasm
  • GERD (gastroesophageal reflux disease)
  • Myasthenia gravis
  • Myotonic dystrophy
  • Polymyositis
  • Parkinson’s disease
  • Stroke
  • Neoplasm (cancer of the gastrointestinal tract, esophageal cancer)
  • Neck/upper chest tumors.

The differential diagnosis is extremely important – even though the lump in the throat feeling poses no threat to one’s health, not to same thing can be said about the above conditions. In making the differential diagnosis, it is important for the physician to notice the other symptoms the patient presents, such as the difficult swallowing (dysphagia).

Apart from the differential diagnosis, these are the methods used for confirming the existence of an underlying disorder:

Medical history of the patient

  • When did the lump in the throat feeling appear for the first time
  • Are there other symptoms associated with it
  • Does crying relieve the sensation (association with grief or other intense emotions)
  • Similar problems in the past
  • Current and past treatments (including surgical interventions)
  • Family medical history (inherited conditions)

Physical examination

  • Physical examination can help the doctor decide whether the patient actually presents difficulties swallowing or just the lump in the throat feeling (or both)
  • Quality of swallowing assessment
  • Physical examination of the mouth and neck
    • Inspection of floor of the mouth
    • Palpation of the neck for mass or lump
    • Inspection of the throat
    • Observation of patient swallowing (liquids and solid food)

Investigations

  • Plain/video esophagography
  • Gastroscopy
  • Measurement of the necessary time to swallow
  • Chest radiography
  • Upper esophageal manometry
  • Endoscopy
  • Barium swallow
  • 24-hour pH probe
  • Multichannel intraluminal impedance testing.

Treatment for Lump in Throat Feeling

If the throat in the throat feeling is not accompanied by other symptoms, no treatment is necessary. No medication can be administered in order to improve the globus sensation. In the situation that the lump in the throat feeling is caused by depression or anxiety, psychological counselling can be of tremendous help. The patient can be taught how to deal with his/her emotions in a more efficient manner. The psychologist can also recommend different techniques to handle one’s emotions, including deep breathing, relaxation and meditation.

The treatment measures for the underlying conditions include:

  • Speech and language therapy
    • The speech therapist can help patients learn how to relax the muscles at the level of the throat
  • Nasal sprays
    • Recommended in patients who experience constant post-nasal drip
    • Should not be used in excessive quantities, as they can lead to the aggravation of the symptoms
  • GERD
    • Proton pump inhibitors
    • Other anti-reflux medication (antacids)
  • Antidepressants
    • Recommended for patients who experience symptoms of severe depression
    • Often used in combination with the psychological counselling (cognitive behavioral therapy)
  • In case of pathology involving the cricopharyngeal muscle
    • Esophageal dilatation
    • Botox injections
    • Cricopharyngeal myotomy
  • In case of an actual mass
    • Surgical removal of the respective mass (if possible)
    • In general, a biopsy is performed at the same time with the excision, for diagnostic purposes.

Self-care measures

It is possible to improve the lump in the throat feeling by taking a few simple yet highly effective self-care measures. For example, you can drink water. It is a known fact that drinking water can eliminate this sensation. On one hand, drinking water has a calming effect, as you are no longer concerned about not being able to swallow. On the other hand, hydration has a generally beneficial effect when it comes to the actual reduction of this sensation.

The same goes for physical movement. Whenever you feel stressed or tensed and the lump in the throat feeling appears, try physical exercise. You do not have to do anything complicated, just as long as you become active. Jogging is often recommended as a physical activity, as it has been known to relax the muscles at the level of the throat. Plus, when you are physically active, endorphins – the happiness hormones – are released at the level of the brain. Last, but not least, you can always try herbal remedies. Both stress and anxiety can be successfully reduced and even eliminated by using herbal remedies, such as valerian, sage or passionflower.

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