Some patients tell me that they would sooner have constant pain than put up with swallowing difficulties. I suppose it's because long-term pain is something the brain can 'tune out' whereas a symptom that occurs in connection with an activity such as swallowing or that comes and goes is less easy to ignore. Also, whatever the cause of pain, the supermarket shelves are stuffed with tablets to help relieve it. You can't say the same about swallowing problems.
Things are made worse when symptoms which occur in many harmless conditions can also be features of cancer.
41-year-old Samantha29269 posted a message on the forum saying that for the last few months she'd had something stuck at the base of her throat, like a lump, that came and went. She'd had no problems swallowing food or drink. Her GP could find nothing of concern but referred her anyway for a routine ear, nose and throat (ENT) clinic check-up. Something in the doctor's letter must have rung alarm bells because the hospital sent her an urgent appointment. Needless to say this freaked her out as her GP had been very reassuring.Swallowing problems
For the last few months I've had a feeling of having something stuck at the base of my throat or like a lump. It's not there all the time and comes and goes.— samantha29269, Feel like something stuck in my throat
The forum moderator suggested globus sensation or globus pharyngeus (pharyngeus referring to the back of the throat). No one is sure what causes this condition but there seems to be some problem with the co-ordination of the muscles at the back of the throat when saliva is swallowed. It used to be called globus hystericus, a rather unkind Victorian term that suggests a psychological disorder. But stress can play a part, though probably more as an aggravating factor than a cause.
Sometimes, once investigations have ruled out serious causes, reassurance is enough and globus symptoms settle eventually. Some people have found physiotherapy to relax the muscles of the throat helpful. If stress is a factor, cognitive behavioural therapy (CBT) or antidepressants (which also treat anxiety) may be useful.
The medical term for difficulty in swallowing is dysphagia. It's normally used when there is difficulty taking down drinks or food. In mild cases, it can just feel as if food is taking longer to pass down the food tube (oesophagus). There may be no problem with liquids. In extreme cases, there is a problem swallowing food and drink, and you may vomit them back up. There can be all variations of severity in between.
It's important to have dysphagia investigated as soon as possible because - although there are many other more common and less harmful causes - cancer of the oesophagus needs to be ruled out. Even more rarely, you can get cancer of the back of the mouth or throat, or thyroid cancer causing pressure on the oesophagus from outside.
The common test for dysphagia is an endoscopy. A thin flexible tube with a tiny video camera and a light is passed into the mouth and down the oesophagus into the stomach. They can spray your throat to make it numb and pass the endoscope while you're awake, or you can be made drowsy with a sedative injection.
Any suspected nasties can be identified and if necessary a biopsy can be taken.
Sometimes a barium swallow is suggested where you swallow some barium liquid and X-rays are taken of your oesophagus.
I'm not a betting man, but I would have wagered on Samatha's endoscopy being normal as she had had no problems swallowing food or drink. It was indeed fine, and the specialist felt her symptoms might be due to acid reflux at the bottom of the oesophagus.
According to other posters on the forum, digestive problems certainly seem to be a common cause of swallowing difficulties. Jammyc1973 said they were getting sore throats followed by bouts of acid reflux and wondered if there was a link between the two. Arsal had a feeling of a lump in the back of the throat for two years and was eventually diagnosed with acid reflux and irritable bowel syndrome.Scratchy throat
I too have this sensation of something lodged within the bottom of my throat. I wake up every morning with a dry and scratchy throat also.— jammyc1973 , Feel like something stuck in my throat
Krista reminded us that the throat is also the crossroads between the digestive and respiratory systems. In her case, the problem seemed to be postnasal drip and was helped by a steroid nasal spray and cetirizine antihistamine tablets.
Allergies certainly seemed to feature widely on this forum page. Livi was prescribed antihistamine tablets from her doctor and AmidalaSKY's husband benefited from anti-allergy injections.
Logically, stopping smoking should help because it irritates the back of the throat and aggravates postnasal drip.
I guess the take home message is that if you feel like something is stuck in your throat but you have no problems swallowing food or liquid, it's very unlikely you have a serious cause. Nevertheless, consult a healthcare professional to make absolutely sure. There can be many causes and many solutions. Our knowledge about this particular problem is expanding daily, as are the available treatment options.
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