Globus Sensation

What is it?

There are several definitions of a globus sensation, but it is most often described as a persistent or intermittent sensation of a lump or foreign body such as a golf ball in the throat.

Who gets it?

Under the age of 50, it is three times more common in women however, once over the age of 50 there is no difference between the prevalence in men and women.

Why does it happen?

The reason a globus sensation occurs is unknown. It may happen alone but there are also several disorders where it can be associated such as:

Gastroesophageal reflux disease (GERD). It is possible that globus may be an atypical presentation of GERD with acid in the lower esophagus (the tube connecting the mouth to the stomach) causing the upper esophageal sphincter (a band of muscle) to tighten.
Visceral hypersensitivity. Some studies show that patients with globus have abnormal processing of sensations of the esophageal in their brain.
Upper esophageal sphincter. This sphincter can be impacted without the presence of acid and in some patients with globus it is found to be tighter, more forceful with swallowing, or changes more with breathing than those without globus.
Psychologic abnormalities.
Stress.

How is it diagnosed?

A globus sensation is diagnosed based on your symptoms. Further evaluation continues to rule out other conditions. Exams such as a barium swallow may be obtained to exclude mechanical problems with the throat and to look for any obvious issues with movement. Further evaluation may continue with an upper endoscopy, a pH study, videofluroscopy, or manometry. Other evaluations may include an otolaryngology evaluation with an Ear, Nose, and Throat (ENT) doctor.

How is it treated?

If a disorder that provokes symptoms is uncovered this will be treated. Sometimes there are no effective treatments. In these cases talking with a psychiatrist sometimes helps to cope with the persistent symptoms.

Medications that have been used include:

Tricyclic antidepressants
H2 blockers
Proton pump inhibitors
Sucralfate
Antacids
Benzodiazepines