What Is Globus Hystericus?

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Among the symptoms of anxiety is a lump-in-the-throat sensation, which feels like a kind of choking. This is a concern of many. One person described it like this:

I feel as if I'm going out of my mind. Is it a normal part of panic/anxiety disorder to not be able to eat? I have had such difficulty swallowing as I feel I'm going to choke on everything I eat. I feel a tight lump sensation in my throat at all times. It even feels as if I could swallow my own tongue sometimes, even though I know this is not possible. Is anyone else experiencing this?

Many people are experiencing this same symptom. Another person explained that she had felt like a lump or knot was in her throat for over six months and was feeling desperate for a solution. Still another said she felt mystery pain in her throat, which felt like sharp splinters of glass.

All of these people have identified their symptom as part of globus hystericus, which is an anxiety-related condition with no apparent medical cause.

What is globus hystericus?

Globus hystericus is the somewhat-dated term to what is more commonly termed globus sensation or globus pharyngis. It literally means "a feeling of having a lump in your throat or some type of obstruction which may feel like you are choking." Other people may feel pain in their throat and chest. When no underlying medical conditions can be found for these sensations, it can be labeled as a psychiatric condition related to anxiety and/or depression. Globus sensation is suspected when there is no mechanical difficulty with the act of swallowing.

What should you do if you are feeling a lump in your throat?

The first step is to see your doctor to rule out any underlying medical conditions that can cause this symptom. Your doctor may conduct the following tests to arrive at an appropriate diagnosis:

  • A physical examination to feel for any masses in the neck and the floor of the mouth. Your doctor may also observe you drink water or eat solid food such as a cracker. Your neurological functioning may be observed with particular attention to motor functioning.

  • If the sensation is causing pain and/or difficulty with swallowing or speaking, you may be referred to an Ear, Nose and Throat (ENT) specialist. The doctor may use an endoscope to check your throat or order a barium-swallow x-ray.

In cases where gastroesophageal reflux disease (GERD) is suspected, you may be referred to a gastroenterologist. Acid reflux can cause difficulty swallowing, heartburn, regurgitation, and a sore throat. Anti-reflux medications may be given to see if there is a reduction in symptoms. In severe cases the doctor may order an esophagogastroduodenoscopy (EGD) to examine the esophagus to look for any damage. A thin tube with a camera on the end is inserted through your mouth and is passed into your esophagus, stomach, and small intestine.

What happens after a diagnosis of globus hystericus?

For some patients, going through the medical testing is reassuring that there is no underlying disease or medical disorder causing the lump-in-the-throat sensation. Sometimes the sensation goes away on its own. There are other things that you can do once you've received a diagnosis.

  • Identify any medications which may be exacerbating the problem.
  • Cut out caffeine and be sure to hydrate, drinking lots of water.
  • Consider getting a Botox injection to relax the throat muscles (check with your doctor on this).
  • Suck on lozenges, especially Fishermen's Friends lozenges made with menthol and eucalyptus oil.
  • Use acid-reflux medications.
  • Chew gum.
  • Get a throat massage.
  • Apply warm compresses on your throat.
  • Use relaxation methods, such as deep breathing exercises.
  • Identify your stress triggers so that you can look for a pattern of when your symptoms are most prevalent. Keep a diary of when you experience the lump-in-your-throat sensation and under which conditions.
  • Have a good cry. SSymptoms of globus sensation can be related to unresolved emotions like grief. Crying may help to release these strong emotions and get rid of the sensation, at least temporarily.
  • See a therapist or psychiatrist. He or she may suggest relaxation techniques, or in some cases, prescribe an anti-anxiety or antidepressant medication. Cognitive behavioral therapy may also be an effective strategy to reduce your symptoms.
  • Try these recommended self-help exercises to help reduce symptoms.

Remember to consult with your doctor about using any medications or supplements to treat your symptoms.

Here are some additional articles related to globus sensation:

When Eating Makes You Anxious

Anxiety Symptoms Series: Gagging