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Topic last updated 12^th October 2017

What is globus sensation?

This is a persistent or on and off sensation of a lump or foreign body stuck in throat. Some others describe it as scratchy, throbbing or tense. It is not painful but it is annoying. The sensation occurs between meals.

A fundamental difference between globus and other throat issues is that there is no difficulty swallowing (dysphagia) or pain on swallowing (odynophagia).

What are the causes?

The diagnosis of globus is usually made after the doctor has found no signs of a lump or another object lodged in the throat. The cause of globus is uncertain; however, it is associated with several conditions.

1. Inflammation-minor inflammation of the throat or back of the mouth is a leading cause of globus.
2. Dry throat-the throat muscles and mucous membranes can feel strained when the throat is dry causing sensation that something is stuck in the throat. Some medications and medical conditions can cause dry throat.
3. Anxiety and stress-frequent swallowing due to anxiety may lead to dry throat. A viscous cycle is set up when the same people respond to globus sensation by swallowing more frequently; anxiety about the globus sensation can make it worse.
4. Reflux-reflux causing stomach contents to travel back up the food pipe and sometimes into the throat may be the culprit. The inflammation from both the acid and the stomach contents cause inflammation leading to globus. The reflux may cause muscle spasms that trigger feelings of an object stuck in the throat. This may occur with or without the classic symptoms of dyspepsia, heartburn or indigestion.
5. Muscle disorders-people with poor muscle tone or power or uncoordinated swallowing mechanism may present with globus sensation.
6. Growth-rarely is the globus sensation associated with an enlarged thyroid gland or a growth in the throat.

Are there tests for globus sensation?

The doctor shall take a history and perform a physical examination which may include an endoscopy to assess for any mucosal lesions or lumps. Occasionally, a barium swallow is requested if uncoordinated swallowing mechanism is suspected.  Rarely are blood tests needed.

When should I see the doctor?

Despite globus been a common condition in the general population, some danger signs to trigger consult of a doctor or further evaluation include:

• Pain in the throat or neck
• Difficulty swallowing
• Pain during swallowing
• Weight loss
• Sudden symptoms after the age of 50
• A mass that can be seen or felt around the neck or throat
• Anaemia (low blood levels)

What are the treatment options?

There are no specific medications or lifestyle changes that are available for treating globus sensation.

When the globus sensation is due to a medical condition, treating the medical condition can remove the globus sensation. For example, antacids, lifestyle remedies may help when globus is due to reflux. Stress and anxiety reduction if that has been suspected as the trigger factor. A psychiatric consultation  if a psychological conditions has been identified. Swallowing exercises or rehabilitation if the cause is poor tone may help with globus sensation.

Disclaimer

The content on the Nairobi ENT website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.

References

1. Kortequee, S. et al. “Management of globus pharyngeus.” International journal of Otolaryngology 2013 (2013): 946780.