Globus Pharyngeus
Date issued: July 2019
For review: July 2021
Ref: D?138/S&L/JW/Globus v2
PDF: Globus Pharyngeus [pdf] 189KB
What is Globus?
Globus (or Globus Pharyngeus) is the sensation of a lump or irritation in the throat, when no true lump exists. It is an extremely common diagnosis in ENT clinics, and can also be associated with hoarseness of voice.
What causes Globus?
There are several theories behind what causes Globus. Most commonly globus is caused by:
- Excess muscle tension in the muscles of the voice box (larynx)
- Irritation or swelling of the tissues lining the throat
- Altered perception of how the throat feels
These difficulties can be associated with:
- Laryngopharyngeal reflux: when acid from the stomach back flows up the oesophagus (gullet, food pipe) and into the larynx. This can ‘silent’ and individuals do not always feel symptoms of heartburn or indigestion. It is most often associated with chronic throat clearing, voice quality change and a globus sensation.
- Stress and anxiety: holding back strong feelings or emotions can impact on perception of throat sensation.
The sensation may vary and there may be periods where the irritation is gone altogether.
How is Globus Diagnosed?
Globus is usually diagnosed in an Ear Nose and Throat clinic in order to rule out any physical causes. This is usually done by passing a small thin tube with a camera through your nose to view your nasal cavity, mouth and throat. The vast majority of patients with globus have nothing to worry about; cancer of the throat is not related to globus and is uncommon. However, if your doctor has any concerns they may organise additional examinations such as a barium swallow (X-ray of the throat and oesophagus) or an endoscopy (a look down the throat with anaesthetic).
What is the treatment for Globus?
Treatment may include:
- Reassurance from your doctor and stress management
- Reduction of throat clearing and coughing to minimise irritation
- Medication may be advised if there is evidence of acid reflux
- Medications may also be advised if there is evidence of postnasal drip or nasal allergies
- Voice therapy with a Speech & Language Therapist
If you have been seen by ENT and given a diagnosis of Globus, why not try the app which is available in Android Play Store and the Apple App Store.
How can Voice Therapy help?
The Speech and Language Therapist you will see specialises in treating voice and throat problems. You will be seen on an individual basis in the voice clinic, and sessions can last up to 45 minutes.
We will discuss the nature of Globus, and you will be able to explain how the irritation affects you. We will then discuss strategies that are known to reduce or get rid of Globus.
Strategies that may ease your symptoms include:
- Drinking more water or hydrating fluids (such as diluted cordial). Avoiding too much caffeine, carbonated (fizzy) or alcoholic fluids which are known to have a drying effect on the throat. Continual sipping is the most beneficial as this allows the throat to relax.
- Reduce coughing and throat clearing.
- Reducing voice strain where possible e.g. not shouting or reducing the background noise that you are trying to be heard over.
For most people one or two session with the Voice therapist is all that is required.
