Globus sensation is the term used for the feeling of a lump in the throat when there is no mass occurring in the area. Usually a globus sensation is perceived but no pathology can be seen upon investigation that could be responsible for the ‘lump like’ feeling in the throat. This sensation usually persists and does not ease or become more pronounced with swallowing although the sensation can differ among individuals.
What causes the lump in the throat feeling?
Causes of a Globus Sensation
- One of the most common causes is gastroesophageal reflux (GERD) where the rising gastric acid causes constriction in the throat. GERD during sleep causes gastric acid to remain in the pharynx, back of the throat, for prolonged periods. This causes inflammation that is experienced as a ‘sore throat’ or ‘lump in the throat’ that is pronounced upon waking but often eases during the course of the day.
- Other causes of a globus sensation may be related to stress and anxiety which is the reason why it is often said that ‘I had a lump in my throat’ when describing a stressful incident. This is also known as globus hystericus.
- If the sensation occurs immediately after eating or swallowing, it may be related to a slow esophageal muscle response. The food pipe, espohagus, pushes food down into the stomach by a rhythmic muscular motion known as peristalsis. If there is a delay in the muscles relaxing after propelling the food, the continuous contraction of the muscle may be experienced as a globus sensation.
- Frequent swallowing or mouth dryness may also contribute towards a globus sensation.
- Chronic tonsillitis (enlarged tonsils) will also cause a globus sensation usually with soreness or pain, depending on the severity of the inflammation or if any infection is present. Tonsil stones may also be responsible but usually causes a sensation at the back of the mouth, towards the sides, rather than in the throat.
- Nodules on the vocal cords may also cause a globus sensation although this usually results in pain and affects speech and the sensation is pronounced upon swallowing.
What tests should be done for a lump in the throat feeling?
Diagnostic Investigation for a Globus Sensation
If a neck mass is evident or can be palpated (felt), then this is not a globus sensation and your doctor will consider other diagnostic investigation to exclude more serious causes like a pharyngeal abscess. Always consult with a doctor or otolaryngologist (ENT specialist) if the sensation is causing pain, affecting your speech or causing difficulty in swallowing (dysphagia). An x-ray may be useful in identifying any foreign objects in the throat. In most cases of a persistent or severe globus sensation, your doctor will consider an endoscopy and/or bronchoscope to exclude certain causes of a globus sensation.