A Lump in the Throat: Why Does It Occur?
The sensation of a lump in the throat is a very annoying and frequent perception. Most people who experience it feel that their throat is going to close and that they can’t breathe.
The truth is that this discomfort may be related to different health problems. However, one of the main causes is anxiety. In these cases, it’s usually called globus hystericus, although it’s important to emphasize that it has nothing to do with hysteria itself.
It’s important to recognize the symptoms that accompany this problem in order to differentiate what’s causing it. Therefore, in this article, we’ll explain everything you need to know about the feeling of a lump in the throat.
Why do we get a lump in the throat?
The feeling of a lump in the throat is a symptom that can have numerous origins. In most cases, finding an exact diagnosis is quite complicated for a physician.
The problem lies in the fact that the discomfort is a frequent manifestation of an underlying anxiety problem. This means that in many patients a physical cause isn’t found and there’s a tendency to request different complementary examinations that delay the appropriate treatment.
This sensation of a lump in the throat is referred to as globus hystericus when the cause is anxiety. The mechanism by which it’s produced is still unknown.
According to the MSD Manual, it could be because the muscles that make up the throat contract. Another hypothesis is that it is due to gastroesophageal reflux, which is a disease also frequently associated with stress and anxiety gastritis.
Find out more: A Sore Throat When Swallowing: Causes and How to Relieve It
What can hysterical globus be confused with?
Distinguishing whether the cause is anxiety or another reason can be complicated, as we have already mentioned. Hysterical ballooning is sometimes confused with disorders affecting the esophagus or thorax.
For example, it can be confused with esophageal spasm, or tumors in the neck or rib cage. These diseases are also often accompanied by the sensation of a lump in the throat, in addition to difficulty swallowing (dysphagia) or even breathing.
Other less frequent causes of a lump in the throat are the following:
- Myasthenia gravis
- Myotonic dystrophy
- Autoimmune myositis
Characteristics of a lump in the throat
When a lump in the throat is caused by anxiety, it usually has some characteristic features. Contrary to what one might suppose, this sensation doesn’t appear at times when stress is experienced most.
In fact, the opposite is true. It’s more frequent for it to form in moments of calmness, which makes it more complex to associate it with nervousness.
Another characteristic is that it usually alters speech. This is because the choking sensation and the tension in the throat, where the vocal cords are located, prevent natural speech.
How to deal with the feeling of a lump in the throat?
When this discomfort appears, the first thing to do is to analyze if there are other accompanying symptoms or signs. In the same way, it’s necessary to try to understand if the cause is stress, nervousness, or anxiety. However, this can be complex.
Alarm signs
There are a number of signs and symptoms that suggest that behind this annoyance hides a pathology other than anxiety. For example, that the area of the neck is sore or that it’s really difficult to swallow solids or liquids.
If a lump is noticed in the neck, there’s loss of weight and the lump in the throat appears suddenly, it could be a tumor (such as the cancer of the esophagus). Other symptoms that may occur, as explained by the American Cancer Society, are muscle weakness and constant regurgitation of food.
Above all, this is a valid suspicion in those who are over 50 years old. According to information from the Mayo Clinic, the following are risk factors for esophageal cancer:
- Obesity
- Smoking
- Insufficient intake of fruits and vegetables
- Excessive consumption of alcoholic beverages
Find out more: Symptoms of the Most Significant Esophagus Diseases
When should you see a doctor?
If other pathologies are ruled out and it’s confirmed that the cause is an anxiety problem, the most important thing will be to look for stress management. In these cases, although it isn’t an emergency situation, it’s just as important to achieve an appropriate approach to improve the quality of life.
Psychological therapy is usually performed to help to better cope with emotions.
In order to rule out different diagnosis, doctors have a variety of tests available. According to the Diagnostic Protocol for Esophageal Balloon Sensation, the most commonly used are the following:
- Phmetry
- Nasofibroscopy
- Esophageal manometry
- Upper gastrointestinal endoscopy
- Swallowing time measurement
The truth is that, if you have any discomfort or questions, it’s always better to go to the doctor. However, in the event that any of the above-mentioned warning signs appear, the appointment should be sought rapidly. The sooner the cause is ascertained, the better the chances of an adequate approach.
All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.
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- Olmos-Martínez, J. M., & Domínguez-Muñoz, J. E. (2020). Diagnostic protocol for the sensation of oesophageal food bolus obstruction. Medicine (Spain), 13(7), 409–412. https://doi.org/10.1016/j.med.2020.05.007.
- Valentino, W. L., & Sharifi-Amina, S. (2022). Esophageal Food Impaction. Radiology Case Reports, 17(9), 2979-2982. https://www.sciencedirect.com/science/article/pii/S1930043322003934
