Globus (aka globus hystericus, globus pharyngeus or globus syndrome) is the sensation of a lump lodged in the throat. However, no difficulty is encountered when swallowing is performed. The sensation is also described as a choking sensation, fullness or swelling in the throat.
Though the mechanism is unclear, it is estimated that stress and anxiety are involved, and may cause a cricopharyngeal spasm. One proposed mechanism is that anxiety precipitates dry throat, which leads to frequent swallowing making it harder to swallow and causing further anxiety, which repeats the cycle. Gastroesophageal reflux disease (GERD) may also be involved. It is also conceivable that an upper respiratory infection leads to awareness of the epiglottis, which is globus.
Usually, treatment involves reassuring the patient and ruling out or treating organic pathologies. Smokers, those with atypical globus, or those who are unresponsive to other management may receive endoscopic investigations to ensure that there are no profound organic etiologies. Because globus is related to anxiety or depression, they should be treated if present.