Being able to feel a lump in the throat is a common symptom that patients discuss with ear, nose and throat specialists. In this article, Mr Wale Olarinde discusses the problem of lumps that cannot be physically felt with the fingers rather than the 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 will include laryngopharyngeal reflux (LPR) of acid into the throat, Globus pharyngeus, or rarely throat cancer.
Reflux and the sensation
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 they have a type of reflux known as silent reflux, where acid is literally sprayed into 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
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 middle 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 disappear on its own. Usually, it is not a constant sensation. It 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.
Cancer of the throat and the sensation
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. Throat cancers are, fortunately, less common than cancer of the breast, bowel, lung, prostate or even lymphomas.
Your specialist will want to ask a few more 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 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 two minutes. You may be offered a local anaesthetic spray for your nose before the procedure but most of the 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.