What is Globus Hystericus?

A normal person can experience the feeling of a lump in their throat briefly when they’re anxious or under stress, but a small percentage of people have this sensation all the time. When this symptom is chronic, it’s called globus hystericus or globus pharyngis. What is globus hystericus – and why is it significant?

What is Globus Hystericus?

Globus hystericus is the persistent feeling of a lump in the throat. Some people describe this annoying sensation as throat tightness – or as a feeling of having phlegm stuck in their throat that they’re unable to clear. Despite these disturbing symptoms, people with globus hystericus are usually able to swallow food and drink liquids normally.

Is Globus Hystericus Always a Psychological Problem?

There are physical conditions that can cause the feeling of a lump in the throat – and it’s important to rule them out before assuming the symptoms are psychological or related to stress. Any kind of obstruction in the throat, esophagus, or larynx by a tumor or a stricture can cause a sensation of tightness or a lump in the throat.

It’s not uncommon for gastroesophageal reflux disease or GERD to give a sensation of a lump in the throat. GERD is a condition where acid enters the esophagus from the stomach due to weakness in the flap that separates the two organs. This type of throat tightness usually responds to antacids or prescriptions that decrease acid production.

Less commonly, people with a lump in the throat may have chronic allergies that cause persistent post-nasal drainage that irritates and blocks the throat and nasal passages, especially when they lie down at night. This usually responds to decongestants and nasal steroid sprays.

To rule out physical causes of a lump in the throat, a person with throat tightness needs to get a thorough examination by an ENT (ear, nose, and throat) specialist. Once structural problems and allergies are ruled out, it may be worth trying antacids to see if they improve the symptoms.

What if the Symptoms of Globus Hystericus Don’t Improve?

When doctors can find no structural cause and GERD isn’t the problem, symptoms of globus hystericus may be related to anxiety, depression, or chronic stress. Some people suffer with this condition for many decades – often along with symptoms of anxiety or depression. If this is the case, the best treatment for globus hystericus is to treat the underlying anxiety and depression.

Some doctors recommend anti-depressants or anti-anxiety medications to treat globus hystericus, but the best solution is to learn more effective ways to deal with stress through counseling – or other means. If the underlying stress issues aren’t dealt with, the problem will come back once the medications are stopped. Some people get short-term relief from the throat tightness by gently massaging the muscles along the sides of the neck and throat and doing gentle head rolls to relieve tight neck muscles.

What is Globus Hystericus: The Bottom Line?

This is a condition that needs a thorough work-up to rule out structural problems, as well as GERD, before assuming the symptoms are due to stress. Once these have been ruled out, short-term counseling can help a person with persistent throat tightness get some relief.

References:

Psychosomatic Medicine. 59: 67-69. (1997)
Merck Manual. Eighteenth Edition. 2006.