Patients with GH report a sensation of a lump or a foreign body in the throat. These symptoms are not associated with pain, dysphagia, or food sticking in the throat.

Worrisome features that are indicative of serious disorders include onset after the age of 50 years, concomitant weight loss, pain, palpable neck mass, dysphagia, regurgitation, muscle weakness, and worsening of symptoms.

Physical exam

There are no notable findings in GH.

• Pain

  pain with palpitation, epigastric pain due to seven emotions, cough and dyspnea due to disorder of Gi, and six kinds of stagnations. [kpubs.org]

  […] her throat” that made it difficult and painful for her to swallow. [mdedge.com]

  Its frequent symptoms are: throat ache, globus pharyngeus, hawking, dysphonia, dry cough, laryngospasm fits, together or not with symptoms such as heartburn, upper gastric pain, retrosternal pain. [tr-ex.me]

  One may also feel mild chest pain or even severe pain with a clicking sensation when swallowing. [educalingo.com]

• Swelling

  These include: Acid reflux Stress and anxiety Fragment of bone trapped within tissues which has caused a swelling. [medic8.com]

  But the throat is not marked with redness and swelling. [kpubs.org]

  Examination should include: Examination of the neck - lumps, thyroid swelling, lymphadenopathy. Examination of the oropharynx - tongue base, floor of the mouth, mucosa, tonsils. Examination of the nose - hypertrophy, polyps, inflammation, discharge. [patient.info]

  A case report in BMJ Journals’ Frontline Gastroenterology lists them: The feeling of a ball-like sensation in the throat Itching Swelling A scratchy sensation like that of a hair in the back of the throat For up to 75% of patients, symptoms can persist [colgate.com]

  Increased stress may cause this muscle to constrict more strongly. 2-Thyroid swelling – Enlargement of thyroid even if it is a minor, can lead to a sensation of lump in the throat. [drpaulose.com]

• Weakness

  Review of systems seeks weight loss (as evidence of a swallowing disorder) and symptoms of muscle weakness. Past medical history should include known neurologic diagnoses, particularly those causing weakness. [msdmanuals.com]

  Heart palpitations Chest pain Dizziness, lightheadedness Numbness and tingling Weakness, weak limbs Asthma symptoms and anxiety Excessive yawning Shooting chest pains Shortness of breath [anxietycentre.com]

• Goiter

  Goiter can be distinguished by the changes in the appearance of neck. Even though the symptoms are similar, globus hystericus is caused by the stagnation of Gi, but the pectorial pain with stuffiness, by the insufficiency of the Heart blood. [kpubs.org]

  Goiter, Nontoxic (Overview) are associated with sometimes immense thyroid hypertrophy, hypothyroidism, and cretinism. [tripdatabase.com]

  Indications to surgery were multinodular goiter or cytologically suspected cancer and the final diagnoses were benign goiter in 72 patients and papillary cancer in 23 patiens. [bmcsurg.biomedcentral.com]

  I have no goiter or any symptoms of Grave's Disease or other thyroid symptoms. Does anyone out there have this Globus thing and if so any advice HELP! [medhelp.org]

• Fishing

  […] chest and abdomen is compared to heaven and earth, the blockage of Gi between heaven and earth is common to the persons with the following charcteristics in Hyungsang; Dam type rather than Bankwang type, Gi type and Shin type rather than deer type and fish [kpubs.org]

  Such lesions may be due to trauma (swallowing a small piece of fish or chicken bone) or ulcer (apthous ulcer of the throat). 7-Cervical osteophytes pressing on the hypopharynx in patients with cervical spondylosis, mainly in older patients.This is not [drpaulose.com]

  One of the most important supplements is Omega 3 fatty acids, either in fish oil or capsules or in flax seed oil. Buy good quality. The clinical dosage is 2-3,000 mg daily. Omega 3 is the main supplement. [justanswer.com]

  […] such as when their great displeasure brought the gods to turn to darkness all that had been light, submerging mountaintops in stormwater, the gods shocked by their own power, and heartsick to watch their once dear people stippling the surf like little fishes [poetryfoundation.org]

• Cough

  Its frequent symptoms are: throat ache, globus pharyngeus, hawking, dysphonia, dry cough, laryngospasm fits, together or not with symptoms such as heartburn, upper gastric pain, retrosternal pain. [tr-ex.me]

  It felt like I couldn’t cough effectively- but I felt like if I coughed too hard, my throat would close up completely. And then it hit me- I am choking to death. [panicfreeme.com]

  […] sensation as of a ball in the throat or as if the throat were compressed; a symptom of conversion disorder. globus hystericus [glō′bus] Etymology: L, small ball; Gk, hystera, womb a transitory sensation of a lump in the throat that cannot be swallowed or coughed [medical-dictionary.thefreedictionary.com]

  The nights spent awake trying to cough up an imaginary hair then feeling a lump was blocking my throat. It didn't help that I used to cough all the time with it and irritated my throat so it felt even worse. [mumsnet.com]

• Postnasal Drip

  Occasionally mucus dripping down the back of the nose (also called a postnasal drip) can cause these symptoms. Postnasal drip can be due to inflammation of the sinuses, although there are several other causes of this symptom. [julianhamann.com]

• Sore Throat

  Yes, STDs do occur in the throat — most commonly gonorrhea. Symptoms of gonorrhea can include severe sore throat; red, swollen tonsils; and sores of the mouth. Another possibility is a herpes infection of the mouth and throat. [gohealthuc.com]

  She noted it was worse with dry swallows when she felt like a tablet was stuck in her throat. The sensation had become more persistent in recent weeks leading her to worry that she had cancer. She had no cough, sore throat or hoarseness. [fg.bmj.com]

  Other symptoms include: Dry and/or sore throat Hoarseness This does not usually cause a problem with swallowing although some people find that they have to swallow more often than normal. [medic8.com]

  Muscular – myasthenia gravis, myotonic dystrophy, polymyositis Benign or malignant tumor in the neck or mediastinum Upper respiratory tract infections Xerostomia – dry mouth Also refer to the causes of oropharyngeal dysphagia and a chronic sore throat [healthhype.com]

• Dyspnea

  Symptoms Sensation of lump in throat (Cervical Dysphagia) Intermittent fear of Choking with Dyspnea III. Associated conditions IV. [fpnotebook.com]

  […] hystericus is usually followed by Seven Gi injuries, Pain and depressive syndrome due to disorder of Gi, palpitation due to fright, continuous violent palpitation, Gi phlegm, precordial pain with palpitation, epigastric pain due to seven emotions, cough and dyspnea [kpubs.org]

  In both groups we first did an interview, which aim was to assess gender, age, proton pump inhibitors PPI, smoking/smoking load and the presence of laryngeal symptoms in general, such as cough, dyspnea, hawking, globuspharyngeus, throat pain or irritation [tr-ex.me]

  719.7 hysterical 300.11 Dysesthesia 782.0 hysterical 300.11 Dyskinesia 781.3 hysterical 300.11 Dysorexia 783.0 hysterical 300.11 Dysphagia 787.20 functional 300.11 hysterical 300.11 nervous 300.11 Dysphonia 784.42 functional 300.11 hysterical 300.11 Dyspnea [icd9data.com]

• Throat Irritation

  Chronic throat irritation, a permanent globus sensation, a sore or dry sensation in the throat are common symptoms, which are often trivialised and wrongly attributed to gastro-esophageal reflux disease. [sciencedaily.com]

  Globus may be associated with throat irritation, soreness, dryness, catarrh, or constant throat clearing. It forms a large part of ENT practice and may account for about 4% of referrals to our outpatient clinics [3]. [hindawi.com]

• Dysphagia

  (C1955519) Concepts Disease or Syndrome ( T047 ) ICD10 R13.19 English cervical dysphagia, cervical dysphagia (diagnosis), Cervical dysphagia [fpnotebook.com]

  Differential diagnosis The differential diagnoses are the causes of true dysphagia. See separate article Dysphagia for further details. [patient.info]

  Submucosal Bulge in the Hypopharynx Causing Dysphagia. Dysphagia, Vol. 29, Issue. 5, p. 629. CrossRef Google Scholar Karaman, Emin Saritzali, Gkioukxel Albayram, Sait and Kara, Batuhan 2011. [doi.org]

• Choking

  It can also lead to significant health anxiety, since people with this sensation may worry they are choking or about to choke. In this article, we take a look at this sensation, its causes, and when people should see a doctor about it. [medicalnewstoday.com]

  I was too preoccupied with my breathing and choking and gasping for air and impending death. Voice of Reason: Jill, this is just anxiety. Scared Jill: Well maybe but I really think I’m choking to death. Voice of Reason: We’ve done this before. [panicfreeme.com]

  The patient was a non-mentally retarded 12-year-old female who refused to swallow solids because she thought that her throat muscles would involuntarily constrict and result in choking. [ncbi.nlm.nih.gov]

  Although it isn’t dangerous, a person experiencing a lump in their throat along with anxiety can be quite scary, as they may feel as if they may choke or have greater difficulty swallowing. [belmarrahealth.com]

  It is usually defined as a kind of feeling that there’s a lump in your throat that will let you feel like you are choked. Some people like you who have this problem will feel extreme pain in the chest and throat. [flowpsychology.com]

• Regurgitation

  Helicobacter pylori (+) patients had significantly more heartburn, regurgitation, and inlet patch in upper esophagus than Helicobacter pylori (-) patients. [ncbi.nlm.nih.gov]

  Thereafter, 1 patient admitted to having dysphagia for more solid food and salivary regurgitation. [jamanetwork.com]

  Regurgitation. Systemic symptoms - fever, night sweats. Abnormalities on examination - lumps, lymphadenopathy. Differential diagnosis The differential diagnoses are the causes of true dysphagia. See separate article Dysphagia for further details. [patient.info]

  Worrisome features that are indicative of serious disorders include onset after the age of 50 years, concomitant weight loss, pain, palpable neck mass, dysphagia, regurgitation, muscle weakness, and worsening of symptoms. [symptoma.com]

• Odynophagia

  In practice, it is essential to differentiate globus from dysphagia or odynophagia, because the later entities portend more worrisome pathological processes. [uclahealth.org]

  Case Report First Online: 13 December 2005 Abstract We present a case of a displaced superior cornu of the thyroid cartilage causing odynophagia and a foreign body sensation of the pharynx. [doi.org]

  Globus Hystericus ( C0017650 ) Definition (NCI) Persistent or intermittent non-painful sensation of a lump or foreign body in the throat occurring between meals in the absence of dysphagia, odynophagia, evidence of gastroesophageal acid reflux, or histopathogically [fpnotebook.com]

  There were no precipitating factors and no symptoms of weight loss, dysphagia, odynophagia or change in her voice. She had smoked previously and rarely had heartburn. She had no other anxieties and was not under any unusual stress. [fg.bmj.com]

• Epigastric Pain

  pain with palpitation, epigastric pain due to seven emotions, cough and dyspnea due to disorder of Gi, and six kinds of stagnations. [kpubs.org]

  After the diagnosis of achalasia was made, 2 said they had "gastric cramps" and 1 admitted to having epigastric pain that ceased after self-induced vomiting; the regurgitated food always tasted like the food previously eaten. [jamanetwork.com]

  R30.9 ICD-10-CM Diagnosis Code R30.9 Painful micturition, unspecified 2016 2017 2018 2019 Billable/Specific Code Applicable To Painful urination NOS psychogenic F45.8 Myasthenia G70.9 ICD-10-CM Diagnosis Code G70.9 Myoneural disorder, unspecified 2016 [icd10data.com]

• Palpitations

  Because Gi stagnation due to seven emotions is the main cause, the globs hystericus is usually followed by Seven Gi injuries, Pain and depressive syndrome due to disorder of Gi, palpitation due to fright, continuous violent palpitation, Gi phlegm, precordial [kpubs.org]

  [from 18th c.] 1997, Roy Porter, The Greatest Benefit to Mankind, Folio Society 2016, p. 78: Something which could later be interpreted as hysteria – a disorder marked by palpitations, migratory pain, breathing difficulties and the globus hystericus – [en.wiktionary.org]

  Consider anxiety and ask about symptoms of psychological distress including other physical symptoms such as palpitations, poor sleep, and feelings of panic. [ncbi.nlm.nih.gov]

  Heart palpitations Chest pain Dizziness, lightheadedness Numbness and tingling Weakness, weak limbs Asthma symptoms and anxiety Excessive yawning Shooting chest pains Shortness of breath [anxietycentre.com]

• Foreign Body Sensation

  We present two cases in which the patient had a foreign body sensation in the throat, associated with a dry swallow. [doi.org]

  "Foreign body sensation in the throat due to displacement of the superior cornu of the thyroid cartilage: two cases and a literature review". The Journal of Laryngology and Otology. 120 (7): 608–09. doi:10.1017/S0022215106001125. PMID 16681864. [en.wikipedia.org]

• Erythema

  Typical changes are caused by the reflux of the larynx, as edema and erythema back commissure-posterior laryngitis. In severe forms of LPR compromised quality of life, and to disturb them in their everyday professional and private life. [egms.de]

  The patient with questioned abnormal enhancement of the larynx had a flexible laryngoscopic examination that revealed mild interarytenoid erythema and edema attributed to laryngeoesophageal reflux, for which the patient had already started treatment. [ajnr.org]

• Pruritus

  L29.3 ICD-10-CM Diagnosis Code L29.3 Anogenital pruritus, unspecified 2016 2017 2018 2019 Billable/Specific Code psychogenic F45.8 scroti, scrotum L29.1 ICD-10-CM Diagnosis Code L29.1 Pruritus scroti 2016 2017 2018 2019 Billable/Specific Code Male Dx [icd10data.com]

• Osteophyte

  Xray C-spine – This is a simple Xray of the neck to check for any arthritis of the neck spine (osteophytes). [parkside-hospital.co.uk]

  Some other possible factors include: temporomandibular joint (TMJ) disorders inability to produce enough saliva cervical osteophytes or bone spurs Eagle's syndrome laryngeal and pharyngeal tension Treatment Globus sensation usually cannot be treated directly [medicalnewstoday.com]

  Such lesions may be due to trauma (swallowing a small piece of fish or chicken bone) or ulcer (apthous ulcer of the throat). 7-Cervical osteophytes pressing on the hypopharynx in patients with cervical spondylosis, mainly in older patients.This is not [drpaulose.com]

• Muscle Weakness

  Review of systems seeks weight loss (as evidence of a swallowing disorder) and symptoms of muscle weakness. Past medical history should include known neurologic diagnoses, particularly those causing weakness. [msdmanuals.com]

  Worrisome features that are indicative of serious disorders include onset after the age of 50 years, concomitant weight loss, pain, palpable neck mass, dysphagia, regurgitation, muscle weakness, and worsening of symptoms. [symptoma.com]

• Short Neck

  neck, and signs of stagnation between the eyebrows. [kpubs.org]

• Globus Symptom

  Globus symptom causes a lot of anxiety among patients who are smokers or heavy drinkers. [parkside-hospital.co.uk]

  A prompt response of globus symptom to ECT was observed with 5-year symptom-free follow-up period as long as the patient remained on a maintenance dose of antidepressant. [ncbi.nlm.nih.gov]

  […] was a significant predictor of the globus symptom[ 79 ]. [doi.org]

  The effect of treatment on globus symptoms was assessed 2 to 3 months later in a double-blind study. Binomial tests showed that there was a significant association between the success of occlusal adjustment and disappearance of the globus symptom. [cambridge.org]

• Anxiety Disorder

  Birmingham Simple and fast anxiety disorder recovery with phone, email and mobile access to resources, apps and support NCFE Accredited learning centre - BPS & BACP support Generalized Anxiety - Panic Disorder - Agoraphobia - OCD - PureO - PTSD - Health [lindenmethod.com]

  What we do is called LAR Therapy and it is the only dedicated, accredited anxiety disorder recovery therapy. [thelindencentre.org]

  To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test or Anxiety Disorder Test. [anxietycentre.com]

  People who suffer with high anxiety conditions such as generalized anxiety disorder, panic disorder, agoraphobia, OCD and Pure O, for example, often complain of a sensation of restriction or that they feel like they have a ‘lump in their throat’. [lindenmethodanxietyrecovery.com]

• Fear

  […] the brain switches off anxiety and returns itself to normal fear responses. [thelindencentre.org]

  Symptoms Sensation of lump in throat (Cervical Dysphagia) Intermittent fear of Choking with Dyspnea III. Associated conditions IV. [fpnotebook.com]

• Irritability

  […] as a hysterical condition rooted in anxiety/psychological causes; then, we briefly review the emerging evidence that roots globus pharyngeus sensation within a constellation of pathophysiologies that are related to pharyngoesophageal inflammation and irritation [jhu.pure.elsevier.com]

  Reflux of gastric contents may lead to irritation and inflammation of the laryngopharynx, or increased tone in the upper oesophageal sphincter may be triggered by distention or acid in the distal oesophagus. [patient.info]

  The sensation of a lump in the throat is a real symptom related to an irritative lesion in the foregut in the majority of patients. 8. Relief of the symptom occurs when the primary condition is amenable and responds to treatment. 9. [birpublications.org]

  Swallowing can be performed normally, so it is not a true case of dysphagia, but it can become quite irritating. The discomfort or irritation in the throat can be made worse by repeatedly clearing the throat or the constant action of swallowing. [drpaulose.com]

  L'ingestion peut être effectuée normalement, donc ce n'est pas un cas réel de dysphagie, mais cela peut devenir très irritant. [educalingo.com]

• Paresthesia

  Paresthesias of the upper respiratory tract. Vestnik otorinolaringologii, p. 76. CrossRef Google Scholar Agarwal, Jay Galati, Lisa and Pinheiro-Neto, Carlos D. 2014. Submucosal Bulge in the Hypopharynx Causing Dysphagia. [doi.org]

• Asthenia

  300.11 Anesthesia, anesthetic 782.0 functional 300.11 hysterical 300.11 Anorexia 783.0 hysterical 300.11 Anosmia (see also Disturbance, sensation) 781.1 hysterical 300.11 Aphonia 784.41 hysterical 300.11 Appetite Astasia (-abasia) 307.9 hysterical 300.11 Asthenia [icd9data.com]

  asthenic R53.1 ICD-10-CM Diagnosis Code R53.1 Weakness 2016 2017 2018 2019 Billable/Specific Code Applicable To Asthenia NOS Type 1 Excludes age-related weakness ( R54 ) muscle weakness ( M62.8- ) sarcopenia ( M62.84 ) senile asthenia ( R54 ) cardiac [icd10data.com]

• Burning Sensation

  This is why GERD is often characterized by the burning sensation known as heartburn. Adults with LPR often complain that the back of their throat has a bitter taste, a sensation of burning, or something “stuck.” [drpaulose.com]

The clinical assessment consists of a full history with details about the symptoms, possible emotional triggers, review of systems, and presence of underlying illnesses. The clinician should identify red flag signs in order to rule out serious differential diagnoses.

Another major component of the workup is the physical exam, which should include palpation of the neck, inspection of the oropharynx, and evaluation of swallowing during eating and drinking. Also, a neurological exam is warranted.

While patients with typical features of GH do not require testing, clinicians may obtain various studies to clarify the diagnosis and exclude other causes. Institutions in the United Kingdom perform barium contrast swallows since they are rapid, safe, and effective [9] [10]. Other modes of investigation such as rigid or flexible esophagoscopy and/or fiberoptic laryngoscopy may be performed to visualize the throat.

Some physicians use the validated Glasgow Edinburgh Throat Score (GETS) to monitor the progression of symptoms [11] .

This condition does not require treatment. However, some clinicians will empirically treat these patients with proton pump inhibitors (PPIs) although GH's relation to GERD is debatable. If symptoms still persist, then clinicians may consider further testing with manometry or pH monitoring.

Coexisting depression or anxiety should be addressed with psychotherapy and antidepressants if needed. Additionally, speech and language therapy may be beneficial.

This benign condition is not associated with negative outcomes or complications.

The etiology of GH has not been clarified although there are possible causes such as severe emotional states, diffuse esophageal spasm, anatomical abnormalities, masses in the neck, or skeletal muscle disorders.

There is a questionable association between gastroesophageal reflux disease (GERD) and GH but the data is conflicting [1] [2]. Also, nonacid reflux (NAR) may play a role [3].

One study noted a prevalence of psychological disorders such as depression and somatization disorder in men with GH [4]. Another investigation reported that significant life events can contribute to the onset or progression of GH [5].

One study evaluated patients who sought care in a general clinic and observed that the prevalence of GH was 6.7 per 100,000 encounters [6]. This is a common condition [7] and is implicated in approximately 4% of otolaryngology referrals [8].

Since the etiology is unknown, the pathophysiology has not been elucidated. Emotional stressors, GERD, mechanical abnormalities, and other conditions have been suspected to play a role.

Preventative strategies include diet modification by reducing consumption of foods that cause GERD. For example, patients should avoid spicy and fatty foods.

Globus hystericus (GH) refers to the sensation of a lump or foreign object in the throat. This is usually diagnosed clinically through a detailed history, throat and neck exam although various institutions will also perform imaging studies. There is no specific treatment.

What is globus hystericus?

This is a condition in which the patient feels as if there is a lump in the throat. The exact causes are not known although some believe it is caused by emotional states, depression or anxiety, gastroesophageal reflux disease (GERD), or mechanical problems in the throat. Patients do not have pain, swallowing, or food sticking.

How is it diagnosed?

The physician will ask important questions about the symptoms, perform a neck and throat exam, and possibly order imaging tests to visualize the throat and airway.

How is it treated?

There is no specific treatment although some doctors will prescribe proton pump inhibitors in case the patient has GERD. Also, patients with psychiatric disorders may require treatment and referral to a psychiatrist.

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11. Ali KH and Wilson JA. What is the severity of globus sensation in individuals who have never sought health care for it? Journal of Laryngology and Otology. 2007; 121(9): 865–8.