The sensation of a lump in the esophagus, often described as a “lump in the throat,” is medically known as globus sensation or globus pharyngeus. It presents as a persistent but painless feeling of an obstruction in the throat when no physical blockage exists. This feeling is common, with studies indicating that between 22% and 45% of people experience it at least once in their lifetime. While unsettling, this sensation is frequently benign.
Common Non-Physical Causes
The most frequent reasons for experiencing a lump sensation in the throat are typically not serious and often relate to how the body responds to certain stimuli or emotional states. This sensation often improves when eating or drinking, which distinguishes it from true swallowing difficulties.
Acid reflux, specifically gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR), is a common contributor to globus sensation. When stomach acid flows back into the esophagus and throat, it can irritate the delicate lining, leading to inflammation and a feeling of tightness or a lump. This irritation can trigger muscle tension in the throat, contributing to the sensation.
Anxiety and stress also play a significant role in causing or worsening the lump sensation. Heightened emotional states can lead to increased muscle tension in the neck and throat, particularly in the cricopharyngeal muscle at the top of the esophagus. This tension can create the sensation of an obstruction. Additionally, individuals experiencing anxiety may become more aware of normal bodily sensations, amplifying the perception of a lump.
Physical and Medical Conditions
While often benign, the sensation of a lump in the esophagus can sometimes indicate underlying physical or medical conditions. Esophageal motility disorders, for instance, involve issues with the muscle contractions that move food through the esophagus. Conditions like esophageal spasms, characterized by uncoordinated or forceful muscle contractions, can manifest as chest pain or a lump sensation.
Structural issues within the esophagus can also cause this sensation. Esophageal strictures, narrowings of the esophagus, can make it difficult for food to pass, leading to a lump sensation or food getting stuck. These strictures often result from chronic acid reflux causing scar tissue formation. Similarly, diverticula, small pouches in the esophageal lining, might trap food and create an obstruction sensation.
Conditions affecting surrounding structures can also contribute to the feeling. An enlarged thyroid gland (goiter) in the neck can press on the esophagus, causing a lump sensation or difficulty swallowing. Thyroid nodules, growths on the thyroid, can also exert pressure. Rarely, growths or tumors in the esophagus or adjacent areas can cause this persistent sensation.
When to Consult a Doctor
While the feeling of a lump in the throat is frequently not serious, certain accompanying symptoms warrant medical evaluation. Consult a doctor if the sensation is accompanied by difficulty swallowing (dysphagia). Dysphagia can manifest as problems moving food or liquids from the mouth to the stomach, or a feeling that food is getting stuck.
Other “red flag” symptoms include pain when swallowing (odynophagia), unexplained weight loss, or persistent heartburn not improving with typical remedies. Regurgitation of food or liquids, or a worsening lump sensation, also indicates a need for professional assessment. These symptoms might suggest a more significant underlying condition that requires specific diagnosis and management.
Diagnosis and Management
When a persistent lump sensation prompts a medical visit, a doctor will typically begin with a physical examination and symptom review. To investigate potential causes, several diagnostic procedures may be considered. An endoscopy (EGD) involves inserting a thin, flexible tube with a camera into the esophagus to visualize the lining and identify structural abnormalities or inflammation.
A barium swallow study involves drinking a barium liquid, which coats the esophagus, allowing its shape and function to be observed on X-rays as the patient swallows. Esophageal manometry measures the pressure and coordination of muscle contractions in the esophagus, helping identify motility disorders. These tests help determine if the sensation is due to a physical issue or a functional problem. Management varies based on diagnosis, ranging from lifestyle modifications for reflux (e.g., dietary changes, stress reduction) to medications like proton pump inhibitors. In some cases, speech therapy focusing on throat relaxation or other interventions may be beneficial.