Globus Sensation

  • Reference Number: HEY-208/2015
  • Departments: ENT

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is Globus Sensation?

Globus sensation is a term used to describe the feeling of a lump in the throat where no true lump exists. It is extremely common and may be associated with hoarseness of voice.

What causes it?

Causes of globus may be different in different individuals. One common cause is increased tension in the muscles of the throat. There may also be irritation or swelling of the tissues lining the throat or an altered perception of how the throat feels. Globus may be associated with:

Stress and Anxiety
Globus can often be experienced by individuals at times of stress or anxiety. It often occurs when holding back strong feelings or emotions.

Acid Reflux
Laryngopharyngeal reflux, also referred to as ‘silent reflux’ is a condition in which the stomach acids travel up the food pipe and into the throat. It can be difficult to detect as individuals often do not get the symptoms of heartburn or indigestion, but it is commonly associated with chronic throat clearing, voice change and globus sensation.

Cervical Spondylitis
Some sufferers of this condition may experience globus due to increased tension in the neck and throat muscles.

Other causes
Other causes can include; medication side effects or other medical problems such as; an enlarged thyroid gland.

How is Globus Sensation diagnosed?

Globus is usually diagnosed through discussions with you about your throat symptoms. These discussions may suggest possible causes of the globus. It is likely that you will have been examined by an Ear Nose and Throat Specialist in order to rule out any physical cause.

What is the treatment for Globus Sensation?

The treatment can be tailored specifically to the individual who is experiencing these symptoms and may include the following:

  • Reassurance that there is no underlying disease
  •  Vocal hygiene advice
  •  Medication may be advised if there is evidence of acid reflux
  •  Voice therapy with a Speech and Language Therapist may be recommended, if there is an associated hoarseness of voice

What can I do to help ease my symptoms?

Vocal hygiene

  1.  Drink more water, a minimum of 1.5 litres (3 pints) per day in addition to any tea/coffee/cola. Flavouring water with cordial may help you increase your intake. Continual sipping is most beneficial, because swallowing helps to relax the throat.
  2. Avoid drinking more than 4 cups of coffee/tea/cola per day. Not only do these drinks have a drying effect on the throat, but they can act as a diuretic, causing extra water loss from your body via your urine.
  3.  Stop any bad habits, such as shouting, raising your voice or throat clearing (swallow instead). These behaviours create unnecessary tension in the throat and can lead to globus sensation.

Anti-reflux treatment

Take the appropriate anti-reflux treatment for gastric reflux, if this has been identified as a cause of your problem.

Managing stress

Examine ways in which you could achieve this. Do your symptoms worsen in specific situations or at specific times of the day? Take time out to work specifically on relaxation.

Specific exercises

You may find the following beneficial provided you have no medical condition affecting the neck, shoulders or spine. If so, you should consult your doctor or physiotherapist first:

Exercise 1 – Neck and Shoulders

  •  Drop your chin down towards your chest; hold it there for about 10 seconds before raising back to centre.
  •  Drop your head sideways towards your shoulder, keeping your shoulders straight. Hold it for 10 seconds before raising back to centre. Repeat on the opposite side.
  •  Shrug your shoulders up to your ears. Hold the position for a few seconds and then relax, dropping your shoulders to their resting position. Repeat this 5 times.
  •  Hold your arms out in front of you, as if you are pushing something away from you. Stretch out as far as you can. Gently drop your arms to your sides as you relax. Repeat this 3 times.
  •  Push your shoulders forwards as if attempting to make them meet at the front. Push your shoulder blades backwards as if attempting to make them meet at the back. Relax and repeat 5 times.

Exercise 2 – Abdominal Breathing

  • Sit comfortably in a chair and place your hands on your tummy.
  • Blow out sharply, as if blowing up a balloon. As you blow out, your tummy and hands should move in.
  • Your shoulders and upper chest should be still and relaxed. At the end of the breath out, relax your tummy; it should expand naturally, allowing your lungs to re-inflate.
  • When you feel comfortable with this technique, produce a soft /sss/ sound on the out-breath.

Exercise 3 – Laugh/Giggle

Laughing and giggling is a natural way to lose tension in the throat by widening the area where you may feel tightness or a ‘lump’.

Exercise 4 – Yawn / Sigh

Yawning is a very good technique for relaxing the muscles in the throat. As the name suggests, you yawn on an in-breath and softly release a sigh on an out-breath. In social situations, this exercise can be adapted to a half yawn into the back of the throat with lips closed.

Exercise 5 – Swallow hard

Swallowing hard on saliva or water helps to stretch the sphincter muscle (muscular valve) that lets food and drink pass down your gullet (food pipe). Stretching this muscle also opens the back of the throat around the area where some people can feel ‘a lump’ or something getting stuck.

Exercise 6 – Chewing method

This technique is used to relax tight jaws or tongues. Imagine you are chewing a toffee by moving your lips, tongue and jaw in a smooth, circular motion. Imagine the toffee is getting bigger and bigger so the movements in your mouth will need to get bigger and bigger.

Exercise 7 – Tongue movement

Moving your tongue slowly around the outside of your teeth with your lips closed also helps to get rid of tension from the larynx (voice box). Do this 10 times one way, then 10 times the other for one minute several times per day.

If, after trying these suggestions, your symptoms persist or new symptoms appear, please contact your GP

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

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