Feeling like something stuck in your throat – Globus pharyngeus

It’s the summer months and as the mercury soars, complaints of “feeling like something is stuck in my throat” are rising. With the COVID-19 raging worldwide, the simplest of symptoms can create panic. So what is this foreign body sensation in the throat? We will discuss it in this blog today.

Frog in throat

This condition has been given a name in the scientific literature – Globus pharyngeus. It is a feeling of something stuck in your throat, a lump in the throat or a choking sensation. It’s seen in almost 4% of the patients that walk into an ENT Clinic in a year. It can be a very persistent and tiresome sensation for the patient. Many would have sought attention of multiple doctors to no or limited relief.

Etiology of Globus Pharyngeus

Exact cause of globus is not known, multiple factors have been connected to it. These include the following:

  • Post nasal drip
  • Gastro-esophageal reflux
  • Lingual tonsils
  • Cricopharyngeal spasm
  • Enlarged thyroid
  • Hiatus hernia
  • Chronic sinusitis
  • Cervical osteophytes
  • Foreign body such as fish/chicken bone
  • Laryngo-pharyngeal cancer
  • Anxiety

Globus pharyngeus can often be confused with dysphagia or odynophagia. Dysphagia is difficulty in swallowing whereas odynophagia is painful swallowing.

Examination and tests involved in diagnosis of globus

When you tell an ENT doctor that there is a feeling of something stuck in your throat, the doctor is going to take a detailed medical and personal history. This includes your dietary habits, sleep schedule, history of smoking and alcohol intake and any recent stressors in your life. Once the history is complete, the next step is a physical examination. This includes a general physical examination, detailed evaluation of ear, nose and throat. Once clinical examination is over, the doctor draws a few differential diagnoses and advises the tests based on these. These may include blood tests, endoscopy, X-rays and ultrasound of the neck initially and CT or MRI scan eventually.

Treatment of globus pharyngeus

Since globus pharyngeus is only a symptom of feeling something stuck in your throat, its treatment is dictated by the diagnosis made by the doctor. Most common causes for globus sensation are gastro-esophageal reflux and post nasal drip. Treatment involves reducing these. Oftentimes, due to the vague nature of this symptom, treatment of the anxiety it induces also becomes necessary. Lifestyle changes and counselling the patient and their family forms a very important part of the treatment. Frequent follow ups help the doctor in assessing the compliance to the prescribed treatment. 

In conclusion, I would like to emphasize that the symptom “Doc, i have something stuck in my throat” is a vague symptom, with multifactorial origin. Its treatment likewise is multifaceted too. It takes time for the symptom to resolve but one should not lose hope.

This article was written by Dr Akanksha Saxena, Consultant ENT, Head & Neck Surgeon, ENT360. She is a practising ENT Specialist in Gurgaon with over 10 years of experience. Read more of her blogs here.