Causes and risk factors
The exact cause of globus hystericus is unknown. It is due to problems in muscle coordination of the throat which are responsible for swallowing. Many muscles are involved in swallowing. Proper contraction and relaxation of muscle fibers make swallowing possible, but in this condition, muscles do not relax fully giving rise to a sensation of lump in the throat. It is more common in women. Acid reflux from stomach can also cause globus hystericus. It is a psychogenic dysphagia [difficulty in swallowing]. Esophageal motor disease, thyroid disease, or inflammatory condition of throat like pharyngitis and tonsillitis also can cause the condition. Stress, emotions can also trigger the condition. Some diseases that lead to this condition are cancer of esophagus, Parkinson’s disease, stroke, myasthenia gravis, etc.
Clinical presentation
The main symptom is the presence or a feeling of lump in the throat. There is actually no lump when examined. The sensation comes and goes. It is more on swallowing saliva. It doesn’t affect eating and drinking.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Chest x-ray, endoscopy, barium swallow, esophageal manometry, and barium swallow are required. pH monitoring of fluid in the GIT is essential.
Treatment
Treating the underlying cause is helpful. Physiotherapy for muscles of throat; speech and language therapy is needed. Medications such as antacids, anti-anxiety medicines are required.
Other Modes of treatment
The other modes of treatment can also be effective in treating globus hystericus. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating globus hystericus.
