The sensation of one’s throat feeling like it’s closing, yet being able to breathe normally, can be a distressing and puzzling experience. This feeling is often described as “globus sensation” or “globus pharyngis” and can cause anxiety and discomfort. In this article, we will explore what globus sensation is, its potential causes, and how to manage and alleviate this feeling when it occurs.
I. What is Globus Sensation?
Globus sensation is the feeling of a lump, tightness, or constriction in the throat, often just above the level of the Adam’s apple. It can be described as the sensation that the throat is closing or that there is something stuck in the throat. Despite this uncomfortable feeling, individuals experiencing globus sensation can typically breathe normally and do not experience difficulty or obstruction in their airway.
II. Common Causes of Globus Sensation:
Stress and Anxiety: Psychological factors, such as stress and anxiety, are often associated with globus sensation. Increased muscle tension in the throat and neck can contribute to the feeling of constriction.
Gastroesophageal Reflux Disease (GERD): Acid reflux can cause irritation in the esophagus and throat, leading to a sensation of something being stuck or a lump in the throat.
Laryngopharyngeal Reflux (LPR): LPR is a type of acid reflux that specifically affects the larynx and pharynx. It can lead to throat discomfort, hoarseness, and globus sensation.
Muscle Tension and Spasm: Muscle tension or spasms in the throat or neck muscles can cause a feeling of tightness or constriction.
Postnasal Drip: Excessive mucus or postnasal drip from conditions like allergies or sinusitis can lead to throat irritation and the sensation of a lump in the throat.
Thyroid Disorders: Thyroid nodules or thyroid enlargement (goiter) can sometimes cause a sensation of pressure or fullness in the throat.
Psychological Factors: Stress, depression, and other psychological factors can contribute to globus sensation. Some individuals may experience it as a manifestation of somatic symptom disorder.
Globus Hystericus: This term is used when globus sensation is considered primarily psychogenic, meaning it arises from emotional or psychological causes.
III. Diagnosis and Evaluation:
If you are experiencing globus sensation, it is essential to seek medical evaluation to determine the underlying cause and rule out any serious conditions. The following steps are typically involved in the diagnostic process:
Medical History: Your healthcare provider will discuss your symptoms, medical history, and any contributing factors, such as stress, anxiety, or acid reflux.
Physical Examination: A physical examination may include examining the throat, neck, and surrounding structures to check for any abnormalities or signs of inflammation.
Endoscopy: In some cases, an endoscopy may be performed to directly visualize the throat and esophagus. This can help identify any signs of irritation or reflux-related damage.
Imaging: Imaging tests like barium swallow studies or CT scans may be used to evaluate the structure and function of the throat, esophagus, and adjacent areas.
Esophageal pH Monitoring: This test measures acid reflux into the throat and can help diagnose acid reflux-related causes of globus sensation.
IV. Management and Treatment:
The approach to managing and treating globus sensation depends on the underlying cause. Here are some strategies that may help alleviate or manage the sensation:
Lifestyle Modifications: If acid reflux or LPR is a contributing factor, lifestyle changes can be beneficial. This includes avoiding trigger foods, eating smaller meals, not lying down immediately after eating, and elevating the head of the bed during sleep.
Dietary Adjustments: Some individuals find relief by avoiding spicy, acidic, or greasy foods, which can exacerbate throat irritation.
Medications: Your healthcare provider may prescribe medications to reduce stomach acid, such as proton pump inhibitors (PPIs) or H2 blockers, in cases of acid reflux.
Stress Management: Techniques like deep breathing exercises, mindfulness, and meditation can help reduce muscle tension and alleviate globus sensation caused by stress or anxiety.
Speech Therapy: In some cases, speech therapy can help individuals learn techniques to relax and manage muscle tension in the throat and neck.
Treatment for Allergies or Sinusitis: If postnasal drip is contributing to globus sensation, addressing underlying allergies or sinusitis can be beneficial.
Psychological Counseling: If psychological factors play a significant role, counseling or psychotherapy may be recommended.
Thyroid Evaluation: If a thyroid disorder is suspected, thyroid function tests and imaging may be performed to diagnose and treat the issue.
Avoiding Excessive Throat Clearing: Frequent throat clearing can exacerbate globus sensation. Try to avoid clearing your throat excessively, as it can irritate the throat.
It’s important to note that the sensation may persist despite treatment, and it can be challenging to address in some cases. Additionally, management may need to address both the physical and psychological aspects of globus sensation.
V. When to Seek Medical Attention:
While globus sensation is often benign and associated with non-serious causes, it is essential to seek medical attention if you experience persistent or worsening symptoms, especially if they are accompanied by other concerning signs. These signs might include:
Difficulty swallowing or painful swallowing
Unexplained weight loss
Hoarseness or voice changes
A persistent cough
Blood in your sputum or phlegm
A lump or mass in the neck
These symptoms may indicate underlying medical conditions that require thorough evaluation and appropriate treatment.
Globus sensation, or the feeling of one’s throat closing while still being able to breathe, can be a discomforting experience with a variety of potential causes. Understanding the underlying factors and seeking medical evaluation is crucial for appropriate management. Whether the cause is stress, acid reflux, muscle tension, or a combination of factors, effective treatment options are available to alleviate the sensation and improve overall well-being. If you are experiencing globus sensation, consult a healthcare provider to determine the underlying cause and develop a personalized treatment plan.