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"Help! I've got a lump in my throat!" is something ENTs (ear nose throat doctors) hear frequently. Known as a globus pharyngeus (literally, lump in the throat) or globus hystericus (when it is precipitated by strong emotion or stress), a painful lump that feels like it could be something between the size of pea to the size of a golf ball. This condition is about the sensation of a lump in the throat, not necessarily a palpable physical lump (although sometimes there is an objectively verifiable lump that causes the pain). The feeling of pressure, pain, and obstruction may occur just above or just below the Adam's apple, which is the forward projection of cartilage that surrounds the thyroid gland. This unpleasant sensation usually just doesn't go away. It's not unusual for a lump in the throat to persists for weeks.

On the other hand, there are certain problems that don't usually occur with lumps in the throat. Usually there is no odynophagia, pain during swallowing, and no dysphagia, inability to swallow. The problem is not likely to be achalasia, or spasms of the esophagus. Nor is there likely to be a problem with laryngopharyngeal reflux, flow of stomach acid up into the throat.

Even though the medical literature still refers to "globus hystericus," the emotional state doesn't have a lot to do with origin of the problem. More often lump in the throat is due to:

  • Iron deficiency anemia (which isn't something you should diagnose for yourself, always get iron deficiency confirmed by a blood test).
  • Lingual tonsillar hypertrophy, also known as swollen tonsils.
  • Hypertensive upper esophageal sphincter, or an esophagus that closes too tight.
  • Temporomandibular joint disorder, also known as TMJ, well known for jaw pain and clicking noises.
  • Cervical osteophytes, or bone-making cells from the spine of the neck creating a
  • Scleroderma of the esophagus, a kind of hardening of the lining of the esophagus that it caused by an autoimmune disease.
  • Occasionally the problem follows thyroid disease, and it's not unusual after surgery to remove the thyroid. However, when lump in the throat is a problem before removal of the thyroid gland, the thyroidectomy procedure usually improves it.

Lump in the throat is hardly a rare condition. About half of the general population experiences it at one time or another. It's more common in women than in men, and it's more common in people over the age of 60 than it is in people under the age of 60.

What can be done about lump in the throat?

A remedy that has been around in Traditional Chinese Medicine for nearly 2,000 years is warm apricot juice. Try it. It actually works. 

It can also help for the doctor to reduce the dosage of drugs for depression, Parkinson's disease, bipolar disorder, or ADHD. Sometimes these drugs cause the central nervous system (even outside the brain) to retain too much serotonin, norepinephrine, or dopamine, and there can be effects on the mucles in the throat. Usually when this happens, there are also gastrointestinal problems, especially "nervous stomach" and diarrhea. 

It can also help to avoid bananas, black walnuts, and tomatoes. These plant foods contain actual serotonin, the same molecule made in the human brain, just made in the fruit of the plant (presumably with the advantage to the plant of making animals happy to spread their seeds). 

Just don't expect your doctor to find a physical lump in your throat. Usually lump in the throat is caused by tension on the muscle wall, not something sinister like cancer. However, if you can feel a lump in your throat when you examine it with your fingers, and a friend can, too, see your doctor right away. You may have an entirely different condition that needs urgent treatment.

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