What is Globus Pharyngeus?
Globus Pharyngeus is quite a common condition in which a person has a sensation as if there is a lump in the throat or if something is stuck in it. It is a painless condition and the person will feel a choking or tightening feeling. People who clear their throat often are more likely to develop Globus Pharyngeus even though people with chronic cough and hoarseness may also have it. About 4% of all ENT referrals are for Globus Pharyngeus and about 45% of people have experienced it at some point or the other.[1,2,3]
Globus Pharyngeus is a benign condition and does not affect the ability of a person to breathe or swallow. However, the sensation can be quite discomforting or annoying. Some people also get anxious as a result of Globus Pharyngeus as they constantly have a feeling that they are about to choke. The primary difference between Globus Pharyngeus and a genuine throat problem is that in this condition there is no actual lump in the throat and it is just a feeling or sensation.[1,2,3]
Globus Pharyngeus is also different from dysphagia in which a person has difficulty swallowing. In Globus Pharyngeus, it is just the fear of choking that causes people fearful of swallowing. Globus Pharyngeus generally improves after eating or drinking some water. Sometimes anxiety and other psychological problem also can cause Globus Pharyngeus.[1,2,3]
What Causes Globus Pharyngeus?
There is no clear etiology for Globus Pharyngeus. However, some experts believe that certain medical conditions can cause it. These include cricopharyngeal spasm, cervical osteophytosis, hiatal hernia, GERD, sinusitis, and anxiety. In very rare cases Globus Pharyngeus can also be caused by hypopharyngeal cancer.[2]
Experts suggest that acids that are naturally present in the stomach sometimes regurgitate back through the esophagus causing inflammation in the laryngopharynx causing the symptoms seen with Globus Pharyngeus. Studies estimate that about 60% of patients with Globus Pharyngeus have acid reflux. However, researchers also mention that acid reflux may cause Globus Pharyngeus in some cases but not all.[2]
Some studies also reveal that a connection between the upper esophageal sphincter dysfunction with the development of Globus Pharyngeus. It has been seen that about 28% of patients with Globus Pharyngeus have elevated upper esophageal sphincter pressures.[2]
As stated, there are also certain psychological factors that play a role in a person having Globus Pharyngeus. There have been reports of stressful events in life of people before the onset of symptoms of Globus Pharyngeus. Studies also reflect that about 96% of people report that the symptoms of Globus Pharyngeus worsen with any emotional or mental stress.[2]
How Common Is Globus Pharyngeus?
Globus Pharyngeus is quite a common condition with about 4% of people consulting an ENT specialist for this condition. Studies also estimate that about 78% of people visit other physicians for symptoms similar to Globus Pharyngeus. The feeling of something stuck in the throat can be quite scary and leads people to rush to the physician to identify a cause for it and start treatment.[3]
However, in majority of the cases there is no treatment required and the patient is sent home with just plain reassurance from the physician that nothing is wrong with them with regard to their overall health.[3]
How To Deal With Globus Pharyngeus?
Globus Pharyngeus does not require any treatment and there are no medications as such specific for this condition. Also, no lifestyle changes required for it. However, coping with stress and handling stressful situations better may ease out the symptoms of Globus Pharyngeus. Additionally, people with acid reflux should seek treatment for it as it has also been termed as one of the causes for Globus Pharyngeus. It should be noted here that Globus Pharyngeus is recurrent and people who have experienced it once may have it again, particularly in times of stress.[3]
Unless Globus Pharyngeus results in choking it is recommended to wait and watch whether he sensation resolves spontaneously. People who have had experience of Globus Pharyngeus and have consulted a physician need not do it again until the symptoms do not go away or worsen, or change in character.[3]
It is recommended to consult a physician if Globus Pharyngeus is accompanied by throat pain, neck pain, unintentional weight loss, dysphagia, vomiting, pain with swallowing, choking on food, a palpable mass in the throat, symptoms that indicate other medical conditions or infections.[3]
In conclusion, Globus Pharyngeus is a benign and common sensation in which a person feels a lump in the throat or a foreign body sensation. The sensation is quite scary and a person who experiences Globus Pharyngeus may have a fear of swallowing as he or she may feel that they may choke. There is no known cause for this condition but certain factors like acid reflux and elevated upper esophageal sphincter pressures are believed to be a contributing factor.[1,2,3]
It has been observed that Globus Pharyngeus worsens in people during stressful situations. There is no specific treatment for Globus Pharyngeus except for reassurance. However if a person has other symptoms along with Globus Pharyngeus like dysphagia, a palpable mass in the throat, and unintentional weight loss then a consultation with a physician is recommended to identify the cause and start treatment for it. In majority of the cases, Globus Pharyngeus resolves on its own once the contributing factor is taken care of like stress and anxiety.[1,2,3]
Coping with stress is quite important to get rid of Globus Pharyngeus. This needs to be done by adopting a healthy lifestyle, eating a balanced diet, exercising regularly, and doing yoga or meditation. Psychological counseling and psychotherapy has been shown to be quite effective in helping people battle stress as well as anxiety and get rid of the symptoms of Globus Pharyngeus.[1,2,3]
