Lump in Throat

One of the commonest conditions seen by ENT surgeons is globus sensation. This is where a person is aware of a sensation, lump or tickle in the throat. There is no lump to feel from the outside but the affected individual feels something on the inside.

Classically, the lump is felt inside the centre of the throat quite low down ( below the adam's apple), it is not painful and swallowing should not be affected, in many cases the feeling of the lump actually disappears when swallowing food or fluids, only to return later. Often people with this condition regularly clear their throats and repeatedly 'dry swallow' ie try and swallow the lump down. The voice is usually not affected and the symptoms change in severity over time, often worsening in stressful situations.

Patients with globus sensation should not have difficulty swallowing, and should not have pain. These symptoms are serious and should be fully investigated!!

What Causes Globus Sensation?

The true answer is that despite a lot of research we still do not fully understand why some patients get globus sensation, or even what is happening.

It is felt that it may be due to contraction of the muscle at the top of the oesophagus (gullet), which the individual affected becomes aware of and experiences a lump sensation. This does make sense as the muscle is designed to open only when food or drink is being swallowed, and this may explain why the feeling disappears when a person eats or drinks.

The other possible cause for the problem is thought to be acid reflux coming up from the stomach into the oesophagus making the muscle contract harder than usual to ensure that acid does not enter the delicate lining of the larynx and trachea. This is why many physicians will give a trial of an antacid medication which certainly seems to work in some patients. Scientifically, we are still unsure of the relevance of acid reflux as a cause, as medical trials have failed so far to prove a definite link.

Often a simple out-patient endoscopic examination is enough to reassure patients that there is nothing more to worry about and in many cases the symptoms resolve.