A lump in your throat

A lump, in medical terms a globus feeling (globus nervosus), is common. It then seems as if something is stuck in your throat at the height of the larynx. And no matter how often you cough, swallow or clear your throat; it doesn’t disappear. Often it is harmless, but not always.

Causes

When swallowing, but also when scraping and coughing, you tense your throat and neck muscles. Do those muscles remain tense, for example by stress, you will feel it like a lump in your throat. When the tension subsides, the lumpy feeling also disappears. Anxiety, sadness, anger or another strong emotion can also dry out the throat and cause a lump, just like wrong breathing or wrong use of voice. In addition, you may experience the mucus production in the nose and throat as a lump feeling.

Therapy

By reassuring, for example because the ENT doctor has not found any abnormalities, the lump feeling often disappears by itself. This can take several weeks. Sometimes speech therapy helps to combat a lump. You will then be given exercises in which you learn to better relax the throat and neck muscles. If the lump feeling does not disappear or if complaints arise, request a new examination by the ENT specialist. Sometimes a lump feeling has a physical cause. Usually such a deviation is accompanied by other complaints, such as difficulty eating, a sore throat, earache or hoarseness.

To investigate

The ENT doctor can do a number of investigations into the physical cause of a lump in the throat. Throat mirroring, for example. The doctor uses a heated mirror and a forehead lamp to look at the throat and larynx.

In some people, the tendency to gag during the throat mirror examination is too strong. A small fiberscope (laryngoscope) is then used. After numbing the nasal and pharynx, the doctor then looks at the throat and larynx through the nose. Sometimes there are x-rays of the neck and esophagus or paranasal sinuses. Finally, an occasional allergy test done.

When is it not innocent?

A lump in the throat is not harmless if the feeling has a physical cause.

• Disorder of the larynx
  In some people, the vocal cords do not close properly: the voice is not powerful and is easily forced. In addition to a lumpy feeling, there is also hoarseness.
• Allergy
  Allergy to the dust mites usually leads to a stuffy nose but can also cause a lump.
• Angina Pectoris
  Clogging of the coronary arteries causes chest pain during physical exertion. Sometimes this effort makes you feel like a lump.
• Chronic laryngitis
  If the throat mucosa is stimulated for a long time, a chronic throat infection can develop, sometimes with a lump feeling.
• A malignant abnormality (throat cancer)
  If the lump is accompanied by a change in voice, difficulty eating, weight loss and ear pain, an ENT specialist is necessary. Fortunately, a malignant disease of the mucous membrane of the throat, larynx or esophagus is rare.
• sinus infection
  An inflammation of the paranasal sinuses can irritate the throat due to mucus secretion, causing a lump feeling. Complaints are: headache, snot, nasal congestion and loss of smell.
• Wear of the cervical vertebrae
  The edges of the cervical vertebrae become thickened at the front with age. Because the esophagus lies against the front of the cervical vertebrae, this can give a lump feeling.
• Muscle tension of the esophagus entrance
  The esophagus entrance is a sphincter muscle that sometimes has too high a voltage. You can experience this as a lump in the throat. In people with a diaphragm rupture the valve mechanism between esophagus and stomach does not work properly. To prevent the overflow of stomach acid into the larynx and trachea, a higher tension is created in the sphincter muscle of the esophagus, resulting in the lump feeling.
• Muscle tension of the larynx
  Muscles run in and around the larynx, including those of the vocal cords. If the voice is used incorrectly, they are used too intensively. This can give you a lumpy feeling.
• Enlarged or inflamed almonds
  An enlarged or chronically inflamed tonsil is often accompanied by a sore throat, a bad taste in the mouth, a lump in the throat and fever.
• Enlarged thyroid
  An enlarged thyroid gland can press against the larynx in such a way that it causes a lump feeling. Often there are additional complaints of a thyroid gland that works too slowly or too quickly.
• Zenker’s diverticulum
  A weak spot between the muscles of the esophagus causes a bulge: Zenker’s diverticulum. This causes complaints such as difficulty swallowing, mucus in the throat, weight loss, bad breath, choking and coughing. You can also get a lump in the throat with this.