1/12/12

Lump in Throat? Causes & Treatments

If you have the feeling of something stuck in your throat like a lump, this could make you think of ALS or even laryngeal cancer.
If you've been pondering about ALS lately, this likely includes a fear of the Bulbar version.

For this article, I interviewed ear, nose and throat physician, Steven Y. Park, M.D. Dr. Park is Clinical Assistant Professor of Otolaryngology at the New York Medical College, and author of the book, “Sleep, Interrupted: A Physician Reveals The #1 Reason Why So Many of Us Are Sick And Tired.” 

A potential symptom of bulbar-onset ALS is difficulty with swallowing, so thus, people who fear they have this disease often begin "feeling" a lump in their throat, or a feeling that there is something stuck there.

The No. 1 cause for the so-called lump in the throat
 is actually a good dose of anxiety. 
This includes the anxiety that's caused
 by thinking about bulbar-onset ALS.

Haven't you ever had a lump in your throat in the past when you suffered anxiety about, for instance, finances, your job or a relationship? If you currently have a lump in your throat over ALS fear, ask yourself if it feels the same as the sensation you've had in the past over unrelated worries.

JH: Describe why a person would feel a lump in the throat.
Dr. Park: "This a very common problem that I see almost every day. The most common reason for this is due to laryngopharyngeal reflux disease (LPRD), but there can be other reasons such as a foreign body, neurologic conditions and rarely, laryngeal cancer.

"The most common symptoms of LPRD include chronic throat clearing, hoarseness, post-nasal drip, a lump sensation, pain, cough, mucous, burning, tightening or phlegm. You can have one or all of the above.

"The lump sensation is called a globus sensation, or a ball-like feeling. In our field, we treat LPRD with aggressive PPI therapy (such as Prilosec or Nexium) for 1-3 months, but it only works sometimes.

"One of the main reasons for this high rate of failure is that there's something else that suctioning up your stomach contents into your throat. So the acid reflux medications don't really prevent reflux—they only lower the acidity of the stomach juices. You also have bile, digestive enzymes and bacteria that come up and irritate the delicate voice box tissues."

JH: What is it about anxiety that changes how swallowing and the throat feels?
Dr. Park: "If you change your swallowing mechanics due to any reason, whether from allergies, post-nasal drip, a scratch from a bone, or acid reflux, you will feel pain, discomfort or a foreign body sensation.

"Vigorous rubbing of opposing mucous membranes and cartilages can definitely irritate your throat temporarily. This can cause a raw surface on the mucous membranes that takes a few days to heal. 

"The cricopharyngeus muscle (the upper esophageal sphincter) can go into spasm and cause a tightening sensation when under stress. It's also been shown that under stress, due to dysfunction of the upper esophageal sphincter, stomach contents can leak up and cause irritation of the throat structure, aggravating the condition.

"If you have microscopic stomach contents in the throat, the mucous secreting glands in this area try to dilute and clear out this area, so you'll feel mucous, hoarseness, and post-nasal drip. There will be generalized inflammation in the throat, which can also go up into the nose."

Now you know why, when you begin worrying about ALS or other diseases that might affect the throat, you start "feeling" a lump there!

Tongue Cancer 
One possible symptom is "a lump in the back of the throat," according to tonguecancersymptoms.org.

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