Globus sensation: causes, how long it lasts and what helps

East Kent Hospitals' speech and language therapy leaflet says people describe globus differently, and you may have one or more of the following. It adds that the sensation typically improves when you eat and drink. Hull University Teaching Hospitals says it may be associated with hoarseness of voice, and University Hospitals Plymouth says the sensation may vary and there may be periods where the irritation is gone altogether.

• A tightness or a pressure in your throat.

• Catarrh or mucus in your throat that you are unable to clear.

• An area of discomfort in your throat, rather than pain.

• A feeling of something stuck or a lump in your throat.

• Intermittent hoarseness.

• Some people describe a frog in the throat, or the throat feeling tightly constricted.

Globus sensation, also called globus pharyngeus, is the feeling of a lump in the throat where no true lump exists. Hull says it is extremely common, and University Hospitals Plymouth says it is an extremely common diagnosis in ear, nose and throat (ENT) clinics.

East Kent says it occurs when certain muscles in the throat become very tight, mainly the cricopharyngeus and constrictor muscles. It may be intermittent (comes and goes) or persistent (you feel it most of the time), and the symptoms and severity can vary from day to day.

Hull says the exact cause of globus is uncertain and may be different in different individuals. One common link is increased tension in the muscles of the throat, with possible irritation or swelling of the tissues lining the throat or an altered perception of how the throat feels. Plymouth lists excess tension in the muscles of the voice box, irritation or swelling of the lining of the throat, and altered perception of how the throat feels.

The leaflets name the following associations. East Kent also lists cervical spine changes such as osteophytes or cervical spondylosis, and says globus may occur during or after events such as bereavement or a build-up of normal life stresses.

Hull says treatment can be tailored to the individual. Often reassurance that there is no serious underlying problem may be all that is required. It may include relaxation and distraction techniques, because focusing on the symptoms may make them feel worse, stopping smoking, medication if there is evidence of acid reflux or post-nasal drip, and voice therapy with a speech and language therapist if there is associated hoarseness.

Plymouth says that for most people one or two sessions with a voice therapist are all that is required, and strategies include drinking more water or hydrating fluids, continual sipping, avoiding too much caffeine, fizzy or alcoholic drinks, reducing coughing and throat clearing with sips of fluid, and reducing voice strain.

East Kent says the following simple steps often relieve symptoms and commonly the problem disappears. If symptoms have been present for a very long time it can take some months for these remedies to work.

• Manage reflux: if you have symptoms of reflux, indigestion or heartburn, talk to your GP or pharmacist about medication.

• Avoid clearing your throat: it only gives temporary relief and aggravates the throat. East Kent suggests swallowing or sipping water instead, or yawning or a "sniff" then blowing out through pursed lips; the habit can be stopped in 3 or 4 days.

• Release jaw, neck and shoulder tension with regular gentle neck and shoulder exercises, unless you have a medical condition affecting your neck, shoulders or spine, in which case speak to a doctor or physiotherapist first.

• Relax your throat muscles: sip water and swallow, yawn with a good open mouth, and exaggerate chewing movements.

• Learn to relax with exercise, music, meditation or quiet tummy breathing. If you feel tearful, do not stop yourself crying, because holding back tears can cause a lump in the throat feeling.

• Drink enough: Hull suggests one and a half to two litres of water per day, and a gap of 2 or 3 hours between dinner and bed.

Hull says globus is usually diagnosed through discussions with you about your throat symptoms, and it is likely you will have been examined by an ENT specialist to rule out any physical cause. Plymouth says this is done in an ENT clinic by passing a small thin tube with a camera through the nose to view the nasal cavity, mouth and throat. If your doctor has any concerns they may organise additional examinations such as a barium swallow (X-ray of the throat and gullet) or an endoscopy.

East Kent says a speech and language therapist may also help with the diagnosis.

There is no fixed duration in the leaflets. East Kent says it may be intermittent or persistent, symptoms vary from day to day, and following the advice commonly makes the problem disappear, although it can take some months to work if symptoms have been present for a very long time. Plymouth says there may be periods when the irritation is gone altogether.

If, after trying the suggestions, symptoms persist or new symptoms appear, Hull says to contact your GP. East Kent suggests asking the speech and language therapist or ENT doctor you are seeing for advice, or asking your GP to refer you to either service.

Globus differs from dysphagia, which is true difficulty swallowing. The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have difficulty swallowing, cough or choke while eating or drinking, feel like something is stuck in the throat after eating, keep bringing food back up (sometimes through the nose), have a wet, gurgly voice after eating or drinking, are short of breath after eating or drinking, or get lots of chest infections.

The NHS also says that over time dysphagia can cause weight loss, dehydration and repeated chest infections. Plymouth says that if a doctor has any concerns they may organise more tests. A lump in the neck, or symptoms that are getting worse, are reasons to see a GP rather than assume it is globus.

On the NHS, a GP can assess persistent symptoms and refer you to ENT, and speech and language therapy offers voice and relaxation techniques; East Kent notes you can ask your GP to refer you to a speech and language therapist or ENT doctor.

Some people choose to see a private ENT specialist or speech and language therapist to be seen sooner. The same assessment applies: a throat examination to rule out physical causes, reassurance, and advice about reflux, throat clearing and tension.