Being able to feel a lump in the throat is a common symptom that patients seek an opinion with ear, nose and throat specialists. In this article, Mr Wale Olarinde (consultant ear, nose, throat/head & neck surgeon) discusses the problem of lumps in the throat that cannot be physically felt with the fingers rather than a neck lump, which can be felt with the fingers.
Symptoms of feeling a lump in the throat
People usually complain of a wide variety of symptoms such as:
- a hair or tickly feeling or lump in the throat
- sensation of something stuck in the throat
- phlegm or mucus in the throat
- repeated throat clearing
- feeling of wanting to pull something out of the throat
- feeling of tightness or constriction in the throat.
The feeling of a lump in the throat can itself be due to many things. The common causes of this symptom include laryngopharyngeal reflux (LPR) of acid in to the throat, Globus pharyngeus, or very rarely throat cancer.
Reflux and the sensation of a lump in the throat
Often people do not have the typical symptoms of acid reflux, such as heartburn, and so it comes as a surprise when they are told by a specialist that they have a type of reflux known as silent reflux, where acid is literally sprayed in to the throat from the stomach. This can be caused by a variety of factors including: smoking, excess alcohol, obesity, late meals, spicy or fatty foods and fizzy drinks.
Globus Pharyngeus and feeling a lump in the throat
Another common cause of feeling something stuck in the throat is a globus feeling, sometimes referred to medically as globus pharyngeus. This is a sensation of something in the throat when nothing can be found to explain the feeling. It is common in mid-life and several suggestions have been proposed, although none are completely plausible. There is no known proven cause for it and it is known to sometimes resolve on its own. Usually it is not a constant sensation. Globus pharyngeus is a diagnosis of exclusion. This means that your specialist will be reasonably convinced there is nothing else causing your symptoms before deciding it is a globus feeling. Sometimes further investigations are required before concluding symptoms are due to globus pharyngeus.
Cancer of the throat and the sensation of a lump in the throat
Cancer of the throat is also a possible cause for feeling something in the throat. In this case, the sensation is more likely to be persistent and may be associated with other symptoms such as a constant sore throat, unexplained earache, difficulty swallowing, voice change or a neck lump that can be felt with the fingers. Throat cancers are commoner in smokers and people who drink a lot of alcohol, although there is now a well recognised association between throat cancers and the human papilloma virus which is transmitted sexually. This is not an uncommon condition in people who have never smoked. Throat cancers are, fortunately, less common than cancer of the breast, bowel, lung, prostate or even lymphomas.
Diagnosing the feeling of a lump in the throat
Your specialist will want to ask you some questions about your swallowing, voice and any other symptoms that could be from a problem in your throat. You may also be given a questionnaire to fill out to provide more clarification about your symptoms.
An examination of the neck, mouth and throat will then be carried out. The examination will almost certainly include a camera examination (flexible nasoendoscopy) of your throat and voice box. Sometimes the upper part of the gullet can be visualised by this means. The camera examination involves a flexible telescope (usually about the width of a mobile phone charger cable) going through your nose. The examination usually lasts about one to two minutes. You may be offered a local anaesthetic spray for your nose before the procedure but most of the anaesthetic sprays on the market have a bad taste that many people do not like.
Your specialist may decide you need further investigations although this is usually decided on a case by case basis in people with a feeling of a lump in the throat.