Globus Pharyngis
Encyclopedia
Globus pharyngis is the persistent sensation of having phlegm
, a pill or some other sort of obstruction in the throat
when there is none. Swallowing can be performed normally, so it is not a true case of dysphagia
, but it can become quite irritating. One may also feel mild chest pain or even severe pain with a clicking sensation when swallowing.
of one or more parts of the throat, such as the larynx
or hypopharynx
, due to Cricopharyngeal Spasm
, gastroesophageal reflux
or oesophageal dysmotility
.
In some cases the cause is unknown and symptoms may be attributed to a psychogenic cause i.e. a somatoform
or anxiety disorder
. It has been recognised as a symptom of depression, which responds to anti-depressive treatment.
A less common cause, distinguished by a "lump in the throat" accompanied with clicking sensation and considerable pain when swallowing, may be due to thyroid-cartilage rubbing against anomalous asymmetrical laryngeal
anatomy e.g. the superior cornu abrading against the thyroid lamina
, surgically trimming the offending thyroid-cartilage provides immediate relief in all cases. However this cause is frequently misdiagnosed, despite requiring a simple clinical examination involving careful palpation of the neck side to side which elicits the same click sensation (laryngeal crepitus) and pain as when swallowing, most cases are due to prior trauma to the neck. High resolution computed tomographic
(CT) or MRI
scan of the larynx is usually required to fully understand the anomalous laryngeal
anatomy. Anterior displacement the thyroid ala on the affected side while swallowing can help resolve symptoms.
in the 1944 film Up in Arms
, a hypochondriac who constantly complained about a "clicking" in his throat, especially when he turned his neck.
Phlegm
Phlegm is a liquid secreted by the mucous membranes of mammalians. Its definition is limited to the mucus produced by the respiratory system, excluding that from the nasal passages, and particularly that which is expelled by coughing . Phlegm is in essence a water-based gel consisting of...
, a pill or some other sort of obstruction in the throat
Throat
In vertebrate anatomy, the throat is the anterior part of the neck, in front of the vertebral column. It consists of the pharynx and larynx...
when there is none. Swallowing can be performed normally, so it is not a true case of dysphagia
Dysphagia
Dysphagia is the medical term for the symptom of difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, the term is sometimes used as a condition in its own right. Sufferers are sometimes unaware of their dysphagia....
, but it can become quite irritating. One may also feel mild chest pain or even severe pain with a clicking sensation when swallowing.
Causes
The "lump in the throat" sensation that characterizes globus pharyngis is often caused by inflammationInflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of one or more parts of the throat, such as the larynx
Larynx
The larynx , commonly called the voice box, is an organ in the neck of amphibians, reptiles and mammals involved in breathing, sound production, and protecting the trachea against food aspiration. It manipulates pitch and volume...
or hypopharynx
Hypopharynx
In human anatomy, the hypopharynx is the bottom part of the pharynx, and is the part of the throat that connects to the esophagus....
, due to Cricopharyngeal Spasm
Cricopharyngeal Spasm
Cricopharyngeal spasms occur in the cricopharyngeus muscle of the pharynx. These spasms are frequently misunderstood by the patient to be cancer due to the 'lump in the throat' feeling that is symptomatic of this syndrome. In practice, real lumps in the throat, such as a cancer, are generally not...
, gastroesophageal reflux
Gastroesophageal reflux disease
Gastroesophageal reflux disease , gastro-oesophageal reflux disease , gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus...
or oesophageal dysmotility
Dysphagia
Dysphagia is the medical term for the symptom of difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, the term is sometimes used as a condition in its own right. Sufferers are sometimes unaware of their dysphagia....
.
In some cases the cause is unknown and symptoms may be attributed to a psychogenic cause i.e. a somatoform
Somatoform disorder
In psychology, a somatoform disorder is a mental disorder characterized by physical symptoms that suggest physical illness or injury - symptoms that cannot be explained fully by a general medical condition, direct effect of a substance, or attributable to another mental disorder . The symptoms that...
or anxiety disorder
Anxiety disorder
Anxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Conditions now considered anxiety disorders only came under the aegis of psychiatry at the end of the 19th century. Gelder, Mayou & Geddes explains that anxiety disorders are...
. It has been recognised as a symptom of depression, which responds to anti-depressive treatment.
A less common cause, distinguished by a "lump in the throat" accompanied with clicking sensation and considerable pain when swallowing, may be due to thyroid-cartilage rubbing against anomalous asymmetrical laryngeal
Larynx
The larynx , commonly called the voice box, is an organ in the neck of amphibians, reptiles and mammals involved in breathing, sound production, and protecting the trachea against food aspiration. It manipulates pitch and volume...
anatomy e.g. the superior cornu abrading against the thyroid lamina
Cricothyroid muscle
The cricothyroid muscle is the only tensor muscle of the larynx, aiding with phonation. It attaches to the anterolateral aspect of the cricoid and the inferior cornu and lower lamina of the thyroid cartilage, and its action tilts the thyroid forward to help tense the vocal cords...
, surgically trimming the offending thyroid-cartilage provides immediate relief in all cases. However this cause is frequently misdiagnosed, despite requiring a simple clinical examination involving careful palpation of the neck side to side which elicits the same click sensation (laryngeal crepitus) and pain as when swallowing, most cases are due to prior trauma to the neck. High resolution computed tomographic
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
(CT) or MRI
Magnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...
scan of the larynx is usually required to fully understand the anomalous laryngeal
Larynx
The larynx , commonly called the voice box, is an organ in the neck of amphibians, reptiles and mammals involved in breathing, sound production, and protecting the trachea against food aspiration. It manipulates pitch and volume...
anatomy. Anterior displacement the thyroid ala on the affected side while swallowing can help resolve symptoms.
Cultural references
A notable fictional sufferer was Danny WeemsDanny Kaye
Danny Kaye was a celebrated American actor, singer, dancer, and comedian...
in the 1944 film Up in Arms
Up in Arms
Up in Arms is a 1944 film directed by Elliott Nugent. It stars Danny Kaye and Dinah Shore. It was nominated for two Academy Awards in 1945.-Cast:*Danny Kaye as Danny Weems*Dinah Shore as Nurse Lt. Virginia Merrill*Dana Andrews as Joe Nelson...
, a hypochondriac who constantly complained about a "clicking" in his throat, especially when he turned his neck.