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Imagine feeling a lump in your throat, experiencing difficulty swallowing, hearing clicks in your throat, perhaps pain in your throat, and constantly worrying not only about the discomfort you’ll go through when you swallow next, but also worrying that something serious might be wrong with you. Yet clinical examination, blood tests, and perhaps even endoscopies, reveal nothing. Next, you may be referred to a psychologist or psychiatrist. So they think it’s all in your head. And still, your symptoms persist, and you’re still worried that your medical team might have missed the signs of something very serious.

Welcome to life with the Globus Sensation, likewise referred to as globus pharyngeus and globus hystericus.

What Is The Globus Sensation, And What Causes It?

Globus Sensation is typically defined as “a persistent or intermittent non-painful sensation of a lump or foreign body in the throat”, though some people diagnoses with it absolutely note pain. It is a condition that is likely ongoing in nature and hard to treat. First discovered by Hippocrates himself, the condition was long thought to be psycho-somantic in nature (as no plausible cause could be identified), hence the label “hystericus”.

The Globus Sensation is not at all an uncommon condition, given that it accounts for as much as four percent of all referrals to ear, nose, and throat specialists, and yet it is still very much shrouded in mystery. Now that we know that most patients suffering from this uncomfortable sensation are far from “hysterical” (unless made so by the frustration of suffering without the ability to gain a diagnosis and treatment), the medical community has been researching potential causes of the Globus Sensation. The list is significant:

  • Gastroesophageal reflux disease

  • Abnormal upper esophageal sphincter function

  • Esophageal motor disorders

  • Thyroid diseases

  • Pharyngitis

  • Laryngopharyngeal tumors

  • Tonsillitis

  • Chronic sinusitis

  • Upper aerodigestive malignancy

  • Hypertrophy of the base of the tongue

  • Retroverted epiglottis

  • Cervical heterotopic gastric mucosa

And last but not least, psychosomatic factors, that is, it really could be “all in your head”. With that list, as well as significant numbers of doctors writing your symptoms off as something you need anxiety medication for right away without digging deeper, it is no wonder that many people suffering from this problem do not achieve satisfactory resolution to their symptoms for a long time.

Potential Treatment For The Globus Sensation

One review of the diagnosis and treatment of Globus Sensation suggests that, as gastroesophageal reflux disease is a major cause of the condition, proton pump inhibitors are a valid first-line treatment. Should this not lead to improvement, other investigations including endoscopies, manometry and pH monitoring can be explored, along with such options as antidepressant medication and cognitive behavioral therapy.

When you’re suffering from a lump in the throat that does not have an obvious physical cause, the road to proper treatment may be long. Advocating for yourself is very likely to be a key part of your journey: remember that even if no physical causes are immediately found, that doesn’t mean there aren’t any, and should your ailment be caused by non-physical factors, you deserve the same adequate treatment as those whose Globus Sensation does have a physical cause.

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