of a lump in the throat, or feeling like something is stuck in the throat,
is called “globus pharyngeus”. Globus means “ball”
and pharyngeus is “throat”, thus “ball in the throat”.
It is not an uncommon condition, as it is the chief complaint in about
5% of patients seen by ear, nose, and throat doctors. It is more commonly
seen in women than men. The cause is unknown; at various times thyroid
conditions, acid reflux from the stomach, or a spastic sphincter muscle
in the upper esophagus have all been suggested as possible causes. However,
research has shown that no one cause can account for the symptom in all
patients, and indeed the cause remains unknown in many patients.
The most important thing to know about globus pharyngeus is that it is
not a sign of throat cancer. The best long-term study of patients with
globus followed more than 70 patients for more than seven years. In no
patient did a cancer, or in fact any other serious illness, ever develop
that was related to their globus sensation. At the end of the seven years,
55% of patients stated their globus sensation had gone away, 25% still
had the sensation but it was better, and 20% had not noticed any change.
Work-up of globus pharyngeus
The work-up of globus is fairly straightforward. It involves taking a
careful history, feeling the outside of the throat for any lumps in the
thyroid or elsewhere, and examining the inside of the throat with a flexible
telescope. If other symptoms are present, a barium swallow or other x-rays
may be recommended.
Treatment of globus pharyngeus
Usually no treatment of globus is necessary. If you have a history or
physical findings that are strongly suggestive of reflux disease, some
sort of anti-reflux therapy may be suggested. If inflammation of the throat
is suspected, a strong anti-inflammatory such as prednisone may be tried
for a week or two. However, for most patients reassurance and close follow-up