Globus: A Feeling of A Lump in The Throat

ENT - Patient information
Globus: a feeling of a lump in the throat

What is globus?
Globus is the medical term for a sensation of a lump in the throat where no true lump
exists. It was once called Globus Hystericus, wrongly suggesting that this is a psychiatric
condition. Globus is sometimes also referred to as Globus pharyngeus (pharyngeus is
simply the medical term for the throat).
What are the usual symptoms in globus?

The main symptom is a feeling of a lump, constriction (tension), or tightness in the throat.
Many patients find that the symptoms vary a good deal and there are often periods when
this feeling goes altogether. Despite the feeling of a difficulty swallowing, patients with
globus do not have problems eating or drinking and usually notice their symptoms most
when swallowing their own saliva. The sensation of a lump sometimes moves up and
down, and occasionally from side to side also, but is usually central at the front of the
neck. It is not uncommon to find minor voice problems such as huskiness, hoarseness or
tiring of the voice in patients with globus.
How common is globus?

Globus is extremely common. Many people suffer with globus from time to time. It is most
common in younger women but can occur at any age and in either sex.
Is there a chance that this could be cancer?

It is not surprising that many patients who seek medical advice about this condition are
worried about their symptoms and are concerned that they may have a growth or cancer.
The vast majority of patients with globus have nothing to worry about; however, if your
doctor has any concerns after a full ENT examination, he may organize some further
investigations, such as a barium swallow (x-ray test) or an endoscopy (a look down the
throat under an anaesthetic). Some patients who do have throat cancer have similar
symptoms but here foods, particularly solids, stick in the gullet, the sensation is nearly
always to one side, the symptoms are constantly present and get progressively worse and
there is often pain which may radiate to the ear.
Globus, June 2019 Page 1 of 3

Patient information – Globus
Where does the globus sensation come from?

There are many theories as to the cause of globus, none of
which has been proven outright. However, most ENT
surgeons now believe that globus arises as a result of muscle
tension or non-coordination in the throat. The swallowing
process is a complex reflex which involves many muscles,
each of which must act in harmony with its neighbours. Some
muscles have to relax, whilst others constrict (tense) in order cricopharyngeus
to swallow correctly. In globus it seems most likely that one
muscle in particular fails to relax properly; this is the cricopharyngeus. It is a circle of
muscle at the bottom of the throat, which surrounds the top end of the gullet (oesophagus)
and acts as a valve or sphincter. It helps to stop stomach contents refluxing back into the
throat. This muscle has to relax to let food pass during normal swallowing. In globus, the
cricopharyngeus muscle fails to relax sufficiently, and so swallowing saliva becomes
difficult; however, when eating, food stimulates the inside of the throat and natural reflexes
allow this muscle to relax correctly and swallowing occurs much more normally.
What triggers globus?

There are many factors which may trigger globus, and in most cases more than one are
relevant, including:
Stress: Nearly all people with globus find that their symptoms are worse when they are
stressed or anxious. This is partly due to the fact that stress causes a general increase in
muscle tension and also that any stress makes us more aware of any problem which we
feel may interfere with our performance or life in general. If you are worried that you may
have a cancer, not surprisingly you become even more stressed and anxious, and the
globus gets worse still.
Tiredness: Often the globus sensation is worse when we are tired, usually at the end of a
busy day, especially if most of the day has been spent talking or on the phone.
Reflux: Many people with globus have reflux of stomach acid into the oesophagus or
throat. Sometimes, this causes few symptoms directly but signs may be visible to your
doctor on examination. The cricopharyngeus does not like acid washing over it, and this is
often a cause of increased tension in this and other muscles in the throat. Stress causes
an increase in stomach acid production as well.
Voice strain: Long periods of talking or use of the phone, presentations, public speaking,
shouting or singing can all lead to overuse or misuse of the voice and throat muscles
leading to increased tension in these muscles and globus.
Smoking: Not all patients with globus smoke but smoking certainly makes globus worse. It
also causes an increase in stomach acid production.

Patient information – Globus
Post nasal drip: This is an excess of nasal mucus which runs down into the throat. This
can make globus worse, partly because of constant swallowing and strain of the muscles
and partly because of the direct effect of the mucus on the lining of the throat.
What can be done to help?

Many patients find that reassurance and explanation of the cause of their problem is all
that is required to treat their globus. However, there are many treatments which are
effective in more difficult cases. Since it is usually a multifactorial problem, it needs a
variety of different treatment strategies. Your doctor will advise you as to the most
appropriate treatments in your case but often this will include anti-reflux medication and
advice, speech therapy (physiotherapy for the muscles of the throat), treatments for nasal
allergy and post nasal drip. If after treatment your problems persist, you should go back to
your doctor and ask to be re-checked.
How to contact us
ENT Department
Tel: 0118 322 7146, Fax: 0118 322 7147
For further information about the Trust, visit www.royalberkshire.nhs.uk
This document can be made available in other languages/formats

upon request.
Written by Mr R J Corbridge 2003, ENT Department

Reviewed: June 2019. Review due: June 2021

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ENT - Patient information

Globus: a feeling of a lump in the throat

What are the usual symptoms in globus?

How common is globus?

Is there a chance that this could be cancer?

Globus, June 2019 Page 1 of 3

Where does the globus sensation come from?

What triggers globus?

Globus, June 2019 Page 2 of 3

What can be done to help?

This document can be made available in other languages/formats

Written by Mr R J Corbridge 2003, ENT Department

Globus, June 2019 Page 3 of 3

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