(Globus sensation)

As a lump in the throat (globus sensation, Globe hystericus) refers to the independent from swallowing subjective feeling of a lump or mass in the throat (if not objectively existing mass). (See mass in the neck when a lesion is present.) A specific etiology etiology or a physiological mechanism is unknown. suggest some studies that increased Krikopharyngealdruck (upper esophageal sphincter) or an abnormal Hypopharynxmotilität there during the occurrence of symptoms. The feeling is also in the gastroesophageal reflux disease (GERD) or occur with frequent swallowing or parched throat such. As in anxiety, or other emotional exceptional situations. Although not associated with stress factors or specific psychiatric diseases, the globus sensation can be a symptom of certain mental states (e.g. B. Kummer, pride.); some patients obviously have a disposition to this reaction. Diseases that can be confused with a globus sensation, are cricopharyngeal (upper oesophageal) membrane, symptomatic diffuse esophageal spasm, GERD, skeletal muscle diseases (e.g., as myasthenia gravis, Myotonia dystrophica, polymyositis) or space-occupying lesions in the neck or mediastinum, the compression of the esophagus cause. Clarification The main goal is to distinguish the globus sensation from true dysphagia, which suggests a structural or motor disorder of the throat or esophagus. History The history of existing disease should include a clear description of the symptoms, especially if there is pain when swallowing or dysphagia (including the sensation of sticking of food particles). The timing of the symptoms is important, especially if the globus sensation occurs or when eating or drinking is independent of such activities; an association with emotional events should be specifically requested. An examination of the body systems is searching for a weight loss (as evidence of a swallowing disorder) and for symptoms of muscle weakness. The history should sampled known neurological diagnoses, especially those that lead to weakness, einschließen.Körperliche investigation neck and floor of the mouth are to masses. The oropharynx is inspected (by direct laryngoscopy). Swallowing (of water and solid foods such as cookies) can be observed. A neurological examination with particular attention to the motor function is wichtig.Warnhinweise The following findings are particularly important: the neck or neck pain, weight loss Sudden onset after age 50 pain, shortness of breath or difficulty swallowing regurgitation of food muscle weakness Palpable or visible mass Progressive worsening of symptoms interpretation of the findings in a patient with normal examination findings have symptoms unrelated to swallowing include, without pain or difficulty swallowing or the sensation that food components get stuck in the throat, the globus sensation. Any suspicious findings or abnormal findings in the study suggest a mechanical or motor disorder of swallowing. Chronic symptoms that result from undissolved or pathological grief and get better by crying and screaming, giving reason to suspect the Globusgefühl.Testsverfahren In patients with typical findings of the globe feeling no test procedures are necessary. If the diagnosis is unclear or the clinician can not see adequately the pharynx, an investigation is carried out as a dysphagia. Typical tests are direct or Videoösophagographie, measurement of the absorption time, chest x-ray and esophageal manometry. Therapy Treatment of a dumpling in my throat includes the calming effect and a sympathetic understanding. No drug has proven benefits. Underlying depression, anxiety or behavioral disorders should be, if necessary, treated in supportive manner with psychiatric help. Sometimes it may be useful to inform the patient on the relationship between symptoms and state of mind. Important points symptoms of the globe feeling have no relation to swallowing. Tests are not necessary unless the symptoms are related to swallowing, the findings are striking or there are suspicious findings ago.


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