घाँटीमा गाँठो वा केहि अड्किएको अनुभूति

Globus Pharyngeus is a sensation or a feeling of a lump or something stuck in the throat. The most common causes of such symptoms are:

1. Gastric Reflux.
2. Psychogenic cause.
3. Pharyngeal inflammation.
4. Upper aero-digestive tract tumors.
5. Hypertrophied tonsils.
6. Enlarged Thyroid Glands.

In this blog, we will focus on the psychogenic cause for the lump sensation, which in medical terminology is called Globus Pharyngeus or Hystericus Pharyngeus. It is described as “a physical manifestation of suppressed emotion”.

Features:

• These symptoms are more common in females.
• Usually there is a history of stressful life events, such as family tragedy, job termination etc.
• Co-morbidities: Anxiety & Depression
• Patient visits multiple clinics and complains of no improvement in the symptoms.

Symptoms:

• Sensation of lump in throat.
• Frequent swallowing, which leads to inadequate hydration of throat and the symptoms increases.
• Choking sensation
• Feeling of difficulty in breathing
• Overthinking
• Disturbance of sleep
• Symptoms increases when the patient is not busy in activities.
• Symptoms does not increasing while taking meal.
• The patient does not complain of pain on swallowing, nausea, or heartburn.

Clinical findings:

• Physical examination by the doctor reveals no abnormality in the throat.
• Investigations such as Throat endoscopy, USG scan of neck shows normal findings.

Diagnosis:

• Diagnosis is based on history and symptoms, and other causes have been ruled out.

Management:

• Counselling & reassurance
• Medications
• Psychiatrist referral.

Dr J P Pradhananga, Senior Clinician