A persistent or recurrent sensation of something stuck in the throat is known as globus sensation (globus pharyngeus or globus hystericus). It is a very common complaint in the general population. This bothersome sensation is usually experienced between meals and there is no significant pain associated with it.
This shows the benign nature in most people and that globus sensation resolves spontaneously.
More than 30% of adults have reported to have experienced globus sensation at least once in their lifetime. It is also known that the sensation could be triggered by an emotional event and that it is more common in women (about twice) compared to men. Only a small portion of patients seek medical advice despite a long history of annoying globus sensation.
The cause of globus sensation is unknown but it is found to be accompanying a number of disorders. Gastroesophageal reflux disease (GERD) has been frequently reported to be associated with globus sensation. Some clinicians correlate the globus sensation to an abnormality of the upper esophageal sphincter (UES) which could also be triggered by exposure to gastric acid. Medical evidence is still being collected for these correlations but GERD is a culprit that is investigated in patients complaining of globus sensation.
A number of patients with globus sensation are found to have a hypersensitive esophagus which could be thought of an abnormally reacting esophagus due to an aberrance of central control of esophageal movement coming from the brainstem. So far, the potential reasons discussed to lie behind globus sensation had been associated with esophageal movement and contraction.
Patients with globus sensation have a higher self-reported anxiety and depression feelings. Psychological complaints are more common in women with globus sensation. Hysterical personality is not higher in these patients and "globus hystericus" is a misnomer. The known fact is that patients with globus sensation do report to experience more anxiety but it is not known if the anxiety is a cause or an effect of globus sensation. Some authorities used to think of stress as the cause of globus sensation by influencing the UES pressure yet this theory is disproved by later studies.
Globus sensation could also be the result of some syndromes or vitamin/element deficiencies which are often presented within a group of other symptoms. If globus sensation is accompanied by other signs and symptoms, then it merits further clinical investigations as other causes come into play. These symptoms include but are not limited to coughing, vomiting, weight loss, fever and pain. Clinical investigation, laboratory tests and imaging might be required to study these patients and the treatment is based on identifying the underlying cause. So don't forget to see your doctor if the sensation is persistent or accompanied by other symptoms.
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