This is one of the commonest throat symptoms seen in an ENT clinic. The patient is aware of a sensation, lump or tickle in the throat. There is usually no neck swelling but the affected individual feels something inside the throat. The condition is called "globus pharyngeus".
Classically, the lump is felt at the centre of the throat below the Adam's apple. It is not painful and swallowing of food or fluids should not be affected. In fact, the sensation often disappears during a meal, only to return later.
Patients often regularly clear their throats and 'dry swallow' to soothe their throats. The voice is usually normal and the symptoms fluctuate often becoming more noticeable in stressful situations.
Patients with difficulty swallowing, discomfort (especially earache), voice change or neck lumps should be thoroughly investigated.
We do not fully understand why some patients get globus sensation, or even what is happening. It may be due to spasm in the muscle at the top of the oesophagus (gullet) which leads to a lump sensation.
Patients with acid reflux are more likely to be affected and physicians may give a trial of an antacid medication.
Reassurance from a simple out-patient examination is usually enough to exclude other causes of throat symptoms and the sensation often settles very soon after the clinic visit.