Globusgefühl

Globusgefühl, or globus pharyngis, is a subjective sensation of a lump or tightness in the throat without a physical obstruction. It is a common complaint in ENT and primary care. The symptom is usually non-painful, may be intermittent, and swallowing is typically normal; the oropharyngeal exam is often unremarkable.

Causes are multifactorial. Laryngopharyngeal reflux is frequently implicated, though many cases occur without reflux. Other factors include esophageal motility disorders, pharyngeal hypersensitivity, muscle tension, anxiety, and postnasal drip. Structural neck lesions or thyroid disease are uncommon.

Evaluation aims to exclude red flags such as progressive dysphagia, odynophagia, weight loss, neck mass, hoarseness, or cancer history. If red flags are absent, endoscopy is usually sufficient to rule out structural disease; additional tests (pH monitoring, manometry, videofluoroscopy) are used selectively based on symptoms.

Management emphasizes reassurance and addressing contributing factors. Treat reflux with lifestyle measures and proton pump inhibitors if indicated; address anxiety with cognitive-behavioral therapy; some patients benefit from speech therapy to reduce throat muscle tension. Most cases resolve or improve over time; prognosis is generally favorable.