Posted , 21 users are following.
13 May 2012 at 13:38PM
On "globus". Beeing an ENT doctor for 35 years I have met very many patients, whose complaints are: "I feel a lump in my throat". I remember, some time ago, I met 5 patients in the same day, with just this problem. My view is: the very simple cause of the various symtoms is dryness in the throat. There are different reasons for this condition, eg after a throat infektion, caused by medication, or just age. If the mucous membranes in the throat are too dry, you are beginning to "experience" the act of swallowing, and that feels strange. You experience this as something foreign in the throat, which can be called a "safety reflex", and then the trouble starts. You start to hawk, croak, and increase your swalloing frequency (normally you swallow about 1000 times/day, but in these circumstances perhaps up to 2000 times/day!) This increases the feeling of the lump, and now all the muscles around throat begins to get tired, and you get different secondary symtoms from that. Typically, there are no swallowing problems. What can you do about it? Not much I am afraid - but the knowledge helps a lot. Many patients with this problem are very worried and anxious.
4 likes, 15 replies
naveed25504 old_doctor
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Loolabee old_doctor
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old_doctor Loolabee
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reveals rather little) I give my view: what you describe, and what I find
is typical of "globus". You tell me about a feeling of something strange, uncomfortable in the throat, many say it feels like a "lump".
What is important for the diagnosis is that you have no real difficulty
swallowing drink and food. Some people experience when eating short episodes, when they feel the throat "tightens", a short spasm, but most of the time there is no difficulty swallowing, no breathing problems. You know that you hawk and croak a lot (and people around you also notice that), but most people are unaware of an increased swallowing frequency. I refer to the inborn "safety reflex", which alert us when something i stuck in the throat. In this case the safety reflex causes trouble - there is no foreign object in
your throat, but you have that distinct feeling. The hawking, croaking and not least increased swallowing cause a lot of extra muscular activity - every time you swallow 26 small muscles around the throat contract. The deep jaw muscles are involved, every time you swallow
you bite and these and all other muscles are "overworked", get sore, the voice can be affected, and the feeling of something foreign, strange in the throat is increased.
You get very "focused" on the symtoms - you feel them almost all the time! Of course you get worried! Sooner or later you are beginning to
consider - what is this feeling - is it cancer!? If you were focused before, now it gets much worse (especially if you have gone through examinations and been told - it is nothing! Many persons tell me this
and some start to cry). When the feeling is strong you may be afraid to swallow - what if food get stuck! Then the normal, automatic swallowing precess becomes still more disturbed. Not so few start their problems with an episode where food really got stuck in the throat. To "feel" the act of swallowing is disturbing.
The observations I do is typical: I find the mucous membranes in the throat to dry - and there are different causes for that. I tell: "you have lost to much of the good mucous in the throat, what is left is more thick, gluey mucous". Can you change that? No is my answer.
The other findings are signs of increased muscular tension - in the mouth often abraded teeth, pressure marks in the tounge from the
teeth, muscles sore when palpated around the head and neck.
That can be treated by physiotherapi whith the intention that you must daily take a short brake,"feel" your muscles and use a program
to relax. The knowledge that globus is totally harmless also helps a
lot - perhaps that is the most important message.
I have met people from other cultures and have found that all have different sayings: worries, anxiety, stress have a tendency to
be expressed as globus, lump (heart) in the throat. What examinations can you do? You don´t need to do any more examinations! About CBT - I have no knowledge.
Best regards
old doctor
amy75782 old_doctor
Posted
I have found your information very helpful. I myself have suffered from globus for about 18 months. It hasn't been very bad for the last 6 months, but last week I had a throat infection and was prescribed penicillin. The sore throat went the doctor said I had an ulcers down my throat, but not I am left with globus again!! Strange feeling tightness in the throat and also excess phlem.
I do suffer with acid so I think this contributed to the situation. It's such an odd feeling. I went to ENT 2013 and they said everything was normal but I can't help worrying it's something else now, do you think I should ask for an endoscopy?
Thanks
Amy
anyagrace old_doctor
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fung999 old_doctor
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jc2015 old_doctor
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Thank you very much for your insight. Would you be able to tell the difference between this and something like throat cancer? I am having symptoms similar to the ones you describe - noticing swallowing, a very slight throat bleed that has gone away, swallowing a ton now. I think the lymph nodes in my neck are swollen too possibly. It is the middle of winter so dryness or infection make a lot of sense, I'm just trying to rule out something more serious so I can stop freaking out. I am just now turing 36, so middle age seems like it could be a factor. Would there be any more specific indications for something serious like cancer? Thank you for any information you can provide and your time.
1diamond_owl old_doctor
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It relieved me from the discomfort by gargling Apple Cider Vinegar and directly concentrating on the area head facing upwards and tried to swallow a bit amount just to moisten the area but I will spit it.The taste is absolutely revolting but it helped me,Read your posts and said that there's no cure for this but PT to relax the muscles are there any home remedies you could recommend?
Many thanks and more power to you .
sam37528 old_doctor
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judy97374 old_doctor
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irene46269 old_doctor
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katie16755 old_doctor
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Can globus also give you the feeling of something sharp below your Adam's apple? Like a fish bone but no fish bone present?
Guest katie16755
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katie16755 Guest
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Hi candice, unfortunately not 😒😩 nearly a year on and I still have the feeling of phlegm or something similar being stuck, the fish bone feeling only lasted a couple of months though, I also don’t feel like I’m being strangled anymore, I’ve had an endoscopy which showed a very slightly loose sphincter, Barium swallow which apparently is fine and sibo tests which are negative, I’m seeing the gastroenterologist next week and I’ll ask for the ph 24 hour test just to see if the acid is coming up into my oesophagus.
Do you just have that as a symptom or do you have acid?
martin0 old_doctor
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