Lump in the Throat (Globus Sensation)
The persistent feeling of a lump, tightness or something stuck in the throat, when no actual lump is present, is known as globus sensation. It is a very common and often distressing symptom.
Typically the feeling is in the midline of the throat, is more noticeable when swallowing saliva than when eating or drinking, and may come and go through the day.
While globus is usually harmless, the sensation is real and warrants proper assessment, both to find the cause and to provide reassurance that nothing serious is being missed.
How I assess a lump in the throat
Careful examination is the key both to identifying the cause and to providing genuine reassurance.
I take a detailed history and examine your throat and voice box directly using a thin flexible camera passed gently through the nose (nasendoscopy).
This allows me to inspect the areas that cannot be seen by looking in the mouth, to confirm that there is no concerning lump. For most people, a normal examination is itself an important part of treatment.
What causes a lump in the throat?
Most people who experience the feeling of a lump in the throat do not have an actual lump. In a minority, a specific underlying cause can be found, and in rare cases this can be something serious such as a cancer.
The main purpose of your consultation is therefore to establish one thing: whether a real lump is present or not. Once I am satisfied that there is no lump, the sensation is described as globus. This often settles on its own, or with the supportive treatments described below.
Treatment options
- Throat relaxation and voice therapy – techniques with a speech and language therapist to release muscle tension
- Throat hygiene: Optimal water hydration and avoidance of anything that dehydrates the throat can help in this condition. Avoidance of smoking and vaping is also essential.
- Treating contributing factors – such as nasal and sinus problems or an oversensitive throat. Treatment of gastric reflux (GORD) can be useful in some patients.
- Reassurance and explanation – understanding that the sensation is genuine but not dangerous often reduces the symptom considerably
I will explain what is causing your symptom and put together a plan to relieve it, while making sure that nothing important has been overlooked.
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FAQs
Is a lump in the throat a sign of something serious?
In the great majority of cases, the sensation of a lump is not caused by anything serious. However, because the feeling can occasionally be due to a structural problem, it should be assessed, particularly if it is one-sided, getting worse, associated with pain, weight loss, difficulty swallowing or a hoarse voice. A proper examination identifies the cause and provides reassurance.
What does a globus examination involve?
Assessment centres on a camera examination of the throat and voice box (nasendoscopy), a quick procedure carried out in clinic using a thin flexible scope passed gently through the nose. It allows me to see areas not visible by looking in the mouth and to confirm whether there is any structural cause for the sensation.
Are other investigations needed?
In cases where the sensation of a lump comes and goes and where the endoscopy is normal and there are no risk factors, often no further investigation is required. For persistent cases, sensations on one side of the neck or if there are any other concerns, an MRI or ultrasound of the neck and throat is helpful to exclude a serious cause.
How is globus sensation treated?
Treatment depends on the cause and includes a range of therapies including, voice and throat-relaxation therapy, throat hygiene and treating contributing nasal or throat sensitivity. For many people, a clear explanation and the reassurance of a normal examination significantly reduce the symptom.