Globus (Latin for globe or ball) is the sensation of a lump or ball in the throat, typically felt in the throat at the level of the Adam’s apple. It is commonly experienced with an intense emotional experience such as stress. The “globus response” is a common human experience. It seems equally prevalent in men and women.
It seems likely that most people experience this sensation at some point in our lives. However, no cause has been demonstrated and there are no serious consequences. Despite anecdotal reports and observations, there appears to be no association with other gastrointestinal disorders such as heartburn or irritable bowel syndrome. Reported associations with headache or other conditions likely result from referral bias – that is, observations of patients sent to specialists.
Globus, like tears, may express an emotion. Its apparent relationship to emotion means some people will be unnecessarily troubled by the symptom. Those with anxiety, depression, panic, or other emotional distress may benefit from treatment or advice concerning these other conditions.
Causes
As with all the functional gastrointestinal disorders, the cause of the globus sensation is unknown. Hypersensitivity of the upper esophagus is suspected. One observer suggested that nervousness leads to a dry mouth, repeated swallowing, and enhanced awareness of the throat.
Several attempts to demonstrate alteration in the contraction of the muscles of the upper esophageal sphincter have garnered inconsistent results, and no related anatomical abnormalities have been observed in the throat and larynx. Nevertheless, a troubled patient may be greatly reassured by an ear, nose, and throat specialist examination.
Distinguishing Globus from Other Conditions
From a medical point of view, it is important to distinguish the globus sensation from dysphagia, or difficulty swallowing. Unlike globus, dysphagia usually indicates a demonstrable cause, and mandates investigation of the esophagus. Heartburn commonly occurs with globus, as it does in people generally. However, the two conditions do not appear to be causally related, and treatment of heartburn does not reliably benefit the globus.
Globus uniquely occurs between meals, and is somewhat relieved by swallowing something, often a glass of water. On the other hand, dysphagia occurs during the swallowing of food or sometimes liquids. It gives the sensation that something is stuck in the gullet – often below the throat. An attempt to swallow in this situation seems to make things worse.
“Red Flag” Alarm Signs and Symptoms that may indicate a More Serious Disorder
The following list is “alarm symptoms” that are not explained by any functional disorder, and therefore demand further inquiry.
- Neck or throat pain
- Bleeding from the mouth or throat
- Weight loss
- Pain or difficulty on swallowing
- Muscle weakness
- Mass in the throat or mouth confirmed by a doctor’s examination
- Progressive worsening of the symptom
Treatment
By itself, globus seldom indicates a structural disease, that is a disease where damage to the body can be demonstrated. Nevertheless, any accompanying symptom must be investigated as indicated.
There is no specific treatment for globus beyond the assurance that it isn’t the sign of a serious disease.
