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What Causes Sensation Of Lump In Throat?
Question: I have been suffering food stuck in throat, chronic lump in throat, sometimes mild chest and abdominal pain, constant phlegum clearing and even throat pain after talking. For 3 monthes I changed 6 doctor all say LPR and contraloc and motilium but nothing worked even double doses. I did endoscopy and they said no acid reflux but the ENT specialits say there is. I am suffering too much daily and the last month i dont eat expect boiled chicken and potates and contraloc sometimes once others twice with 2 times motilium and zyrtec for nose and phlegum and vitamin A and B and no results. XXXX YYYY@YYYY Male 18 Nexium 40mg. contraloc 40mg sometimes twice. motilium for one week. zyrtec and other allegry drugs. Vitamin A and b12 complex. Diet for a month with also eating before sleeping with 3 hours.
Brief Answer:
Other causes need to be ruled out....
Detailed Answer:
Hi
Thanks for posting the query.
Sensation of lump in the throat could be due to various reasons. To name a few:
1. Siderophenic dysphagia
2. LPR
3. Neuromuscular incoordination
4. Thyroid related issues
5. Concretions in the prevertebral space
7. Excessive intake of antihistamines and decongestants, etc.
After going through the description, I do feel you need to get lateral view of X-ray cervical spine, ultrasound of the neck and a thyroid profile to rule out the other causes.
Also, if you could kindly mention about the dosage of proton pump inhibitors you are taking, it will be of great help. Meanwhile, drink plenty of warm water; avoid chilled food & beverages/coffee/smoking/alcohol if any.
Hope I have answered your query; I'll be available for the follow up queries.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Other causes need to be ruled out....
Detailed Answer:
Hi
Thanks for posting the query.
Sensation of lump in the throat could be due to various reasons. To name a few:
1. Siderophenic dysphagia
2. LPR
3. Neuromuscular incoordination
4. Thyroid related issues
5. Concretions in the prevertebral space
7. Excessive intake of antihistamines and decongestants, etc.
After going through the description, I do feel you need to get lateral view of X-ray cervical spine, ultrasound of the neck and a thyroid profile to rule out the other causes.
Also, if you could kindly mention about the dosage of proton pump inhibitors you are taking, it will be of great help. Meanwhile, drink plenty of warm water; avoid chilled food & beverages/coffee/smoking/alcohol if any.
Hope I have answered your query; I'll be available for the follow up queries.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Yogesh D
Not only lump in the throat, i feel food stuck in the throat while eating. It all started in August when there were some caughing and phlegum while eating. After 1 month of suffering I consulted a doctor and he said problems in throat and gave me antiviral with some antiphlegum. After 10 days I suffered more and more something going up to the throat making me caughinh. I went to other ENT he said LPR and allegry and gave me nexium, cortiosen , zyrtec and rhinocort. After 2 monthes there was little improvement but after 1 month I started suffering chest pain with phlegum also when eating. Went to other ENT specialist said LPR again but gave me B12 complex and motilium with nexium, one week and no improvement. Then I went to digestive system doctor increased dose of PPI to twice and motilium to 3 times and 2 weeks little little improvement, did endoscopy and no signs of reflux expect H pylori infection in pathlogy. Another month later this month still lump in throat and different areas of throat, phlegum when eating and without, throat pain when even talking, food stuck in the throat went to 3rd ENT specialist did endoscopy on throat and nothing appeared.
NOW : I am taking 1 40mg ppi and 2 motlilium and zyrtec but no improvement at all.
Two notices: Even last month when decreased all food and chilis and beverages no improvement + there were something like fungal infection on tongue did not go from diflucan and others for 2 months.
Last note: Blood, kidney, lung functions are good.
Sorry for repeating information but to make the picture more clear :)
Thanks for answering
NOW : I am taking 1 40mg ppi and 2 motlilium and zyrtec but no improvement at all.
Two notices: Even last month when decreased all food and chilis and beverages no improvement + there were something like fungal infection on tongue did not go from diflucan and others for 2 months.
Last note: Blood, kidney, lung functions are good.
Sorry for repeating information but to make the picture more clear :)
Thanks for answering
Brief Answer:
Further investigations are required...
Detailed Answer:
Hi
Thanks for writing back
I have understood your problem thoroughly now and the following are my views.
1. Most of the symptoms described you are in favor of LPR, but other causes of swallowing problems need to be ruled out.
2. A few other conditions which otolaryngologists should rule out are, increased tone (hypertonicity) in the upper esophageal sphincter, cervical osteophytes impinging on the laryngopharyngeal area. Other issues with stomach emptying and esophageal musculature,” also needs to be ruled out.
Neuromuscular incoordination can also present with similar symptoms. All the above conditions has to be ruled out with following investigations such as esophageal manometry, electroneuronography and CT of the neck. If all of them turn out to be normal, then the LPR remains your diagnosis.
2. My suggestions to you are:
a. Stop zyrtec, this will dry up the throat and increases the swallowing problems.
b. Continue with 40mg PPI (before food) and motilium 10mg, 3 times a day (before food).
c. You may also require anti-anxiety medicine such as Alprazolam (this can be taken after discussing with your doctor).
d. Consult your doctor again and request for all the above investigations.
Hope this clears your doubt.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Further investigations are required...
Detailed Answer:
Hi
Thanks for writing back
I have understood your problem thoroughly now and the following are my views.
1. Most of the symptoms described you are in favor of LPR, but other causes of swallowing problems need to be ruled out.
2. A few other conditions which otolaryngologists should rule out are, increased tone (hypertonicity) in the upper esophageal sphincter, cervical osteophytes impinging on the laryngopharyngeal area. Other issues with stomach emptying and esophageal musculature,” also needs to be ruled out.
Neuromuscular incoordination can also present with similar symptoms. All the above conditions has to be ruled out with following investigations such as esophageal manometry, electroneuronography and CT of the neck. If all of them turn out to be normal, then the LPR remains your diagnosis.
2. My suggestions to you are:
a. Stop zyrtec, this will dry up the throat and increases the swallowing problems.
b. Continue with 40mg PPI (before food) and motilium 10mg, 3 times a day (before food).
c. You may also require anti-anxiety medicine such as Alprazolam (this can be taken after discussing with your doctor).
d. Consult your doctor again and request for all the above investigations.
Hope this clears your doubt.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Sorry for interputiin but i have other questions 1- sometimes lump in throat icrease when moving neck and sometimes not is this also related to lpr ? And fhest pain related ? 2- doctor wrote me medecine containing librax ( chlordiazepoxide and clidinum fir 2 aeeks and no result do you suggest using elabil ? Finally, the only reliefed symptom was the horsness in voice. Thanks alot
Brief Answer:
These are in favor of LPR...
Detailed Answer:
Hi
Welcome back
The sensation of lump in the throat with occasional movement of the throat is typical of LPR. Acid reflux doesn't remain constant it varies with our routine activities. When there is increased physical or mental stress, the reflux increases and thus the sensation of lump.
Chest pain also termed as 'heart burn', is the result of irritation caused by the reflux of acid from the stomach into the esophagus.
I personally prefer alprazolam instead of amytryptylin.
Relief in hoarseness is a positive sign of improvement of the reflux problems. I feel, you should continue the medicines for at least for 3 months, before you notice any significant relief.
I wish you good luck and good health.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
These are in favor of LPR...
Detailed Answer:
Hi
Welcome back
The sensation of lump in the throat with occasional movement of the throat is typical of LPR. Acid reflux doesn't remain constant it varies with our routine activities. When there is increased physical or mental stress, the reflux increases and thus the sensation of lump.
Chest pain also termed as 'heart burn', is the result of irritation caused by the reflux of acid from the stomach into the esophagus.
I personally prefer alprazolam instead of amytryptylin.
Relief in hoarseness is a positive sign of improvement of the reflux problems. I feel, you should continue the medicines for at least for 3 months, before you notice any significant relief.
I wish you good luck and good health.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Hey doctor
I did the manometry and it showed 100% normal.
This is really unique because an endoscopy showed 100% normal also and I am on a restricted diet for 2 months now and contracloc, motilum and even Gaviscon nothing work with the phlegum sticking, throat pain and globus sensation, chest pressure and pain , upper stomach pressure and many other symptoms including headache.
I have been really suffering and hating everything because even eating banana can trigger symptoms !
Is this normal ? 3 months PPI and 1 month mot ilium and 2 months restricted diet, bed elevation and all this is still LPR?
I really got mad.
I did the manometry and it showed 100% normal.
This is really unique because an endoscopy showed 100% normal also and I am on a restricted diet for 2 months now and contracloc, motilum and even Gaviscon nothing work with the phlegum sticking, throat pain and globus sensation, chest pressure and pain , upper stomach pressure and many other symptoms including headache.
I have been really suffering and hating everything because even eating banana can trigger symptoms !
Is this normal ? 3 months PPI and 1 month mot ilium and 2 months restricted diet, bed elevation and all this is still LPR?
I really got mad.
Brief Answer:
Get a CT scan of the neck...
Detailed Answer:
Hi
Thanks for writing back
Its good to know that, your esophageal manometry is normal. This rules out any neuromuscular abnormality. Before labeling it as globus, I would recommend you to try taking alprazolam along with present set of medicines, you will find it more relaxing.
I do understand the concern behind your problems, but the psychological stress will further worsen your present condition. If possible, try to get a CT scan of the neck done, this will be our last attempt to rule out any osteophytes or mass pressing over the esophagus.
I wish you good luck and good health.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Get a CT scan of the neck...
Detailed Answer:
Hi
Thanks for writing back
Its good to know that, your esophageal manometry is normal. This rules out any neuromuscular abnormality. Before labeling it as globus, I would recommend you to try taking alprazolam along with present set of medicines, you will find it more relaxing.
I do understand the concern behind your problems, but the psychological stress will further worsen your present condition. If possible, try to get a CT scan of the neck done, this will be our last attempt to rule out any osteophytes or mass pressing over the esophagus.
I wish you good luck and good health.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Brief Answer:
CT scan will not cause cancer...
Detailed Answer:
Hi
Welcome back
Taking alprazolam for a short period doesn't cause any dependency. it's a powerful antianxiety medicine.
Secondly, taking one CT scan will not cancer. In that case, those technicians working with the CT scan machine would have got cancer.
Please do not worry! This is the only last weapon we have before diagnosing it as globus pharyngis.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
CT scan will not cause cancer...
Detailed Answer:
Hi
Welcome back
Taking alprazolam for a short period doesn't cause any dependency. it's a powerful antianxiety medicine.
Secondly, taking one CT scan will not cancer. In that case, those technicians working with the CT scan machine would have got cancer.
Please do not worry! This is the only last weapon we have before diagnosing it as globus pharyngis.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hey doctor
If I do the CT scan after hearing this I will continue my life fearing of another disease
can i even do MRI ? or any other solution.
My last questions is that, Is it really normal that LPR symptoms come 2-3 hours after eating ? when walking up throat and chest pain while eating before sleeping tuna by 3 hours and elevating the bed and talking all the medicines. I only want to know if this is normal and i want to know a CT scan alternative please. Thank you very much.
If I do the CT scan after hearing this I will continue my life fearing of another disease
can i even do MRI ? or any other solution.
My last questions is that, Is it really normal that LPR symptoms come 2-3 hours after eating ? when walking up throat and chest pain while eating before sleeping tuna by 3 hours and elevating the bed and talking all the medicines. I only want to know if this is normal and i want to know a CT scan alternative please. Thank you very much.
Brief Answer:
You can get an x-ray of cervical spine and MRI...
Detailed Answer:
Hi
Thanks for writing back
I do understand your concern. No problem! If you are reluctant to get a CT scan done, try getting an X-ray of the cervical spine (both AP and Lateral view), followed by MRI of the neck and thorax to rule out any space occupying lesions compressing the food pipe. If these investigations also report as normal, then your condition can be treated as globus pharyngis.
Yes, the LPR symptoms can show-up 2-3 hours after food, when your stomach is empty and full of acid.
Hope this clarifies your doubts. I wish you good health and speedy recovery.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
You can get an x-ray of cervical spine and MRI...
Detailed Answer:
Hi
Thanks for writing back
I do understand your concern. No problem! If you are reluctant to get a CT scan done, try getting an X-ray of the cervical spine (both AP and Lateral view), followed by MRI of the neck and thorax to rule out any space occupying lesions compressing the food pipe. If these investigations also report as normal, then your condition can be treated as globus pharyngis.
Yes, the LPR symptoms can show-up 2-3 hours after food, when your stomach is empty and full of acid.
Hope this clarifies your doubts. I wish you good health and speedy recovery.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Doctor the hospital wants the details of the MRI
what is the details ? MRI on what specifically and can you write a paper with it.
what is the details ? MRI on what specifically and can you write a paper with it.
Brief Answer:
MRI of the neck and thorax - plain and contrast (if required)
Detailed Answer:
Hi
Thanks for writing back
MRI of the neck and thorax - plain and contrast (if required). This is to rule out any space occupying lesions compressing the food pipe. Plain X-ray of the cervical spine taken in AP and Lateral view to look for cervical spine related issues.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
MRI of the neck and thorax - plain and contrast (if required)
Detailed Answer:
Hi
Thanks for writing back
MRI of the neck and thorax - plain and contrast (if required). This is to rule out any space occupying lesions compressing the food pipe. Plain X-ray of the cervical spine taken in AP and Lateral view to look for cervical spine related issues.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hey doctor
due to midterm exams i postponed the investigations one week.
Sorry for repeating but I have some questions.
1- Why did I felt chest pain after 3 weeks of Nexium and Abdominal pain after 2 months of nexium ( 1 month of contraloc ). Why those symptoms came after taking medicine and was not before.
2- What are all the possibilities remained for food stuck in throat ( I know I must do investigations but I want to discuss it )
3- How this could happens and what are the possibilities: I did endoscopy showed good muscle manometer shows good motility and 3 months of medicine and last week 80mg contraloc, 3 times motilium and gaviscon one before meal and one after, and all food boiled and still having symptoms and even sometimes feeling acidity and sour taste in mouth.
4- Are headaches related to the disease or the medicines ?
5- Are there possible other possibilities for what I am experience other than LPR due to non improvement?
5- Should I go to digestive system doctors?
due to midterm exams i postponed the investigations one week.
Sorry for repeating but I have some questions.
1- Why did I felt chest pain after 3 weeks of Nexium and Abdominal pain after 2 months of nexium ( 1 month of contraloc ). Why those symptoms came after taking medicine and was not before.
2- What are all the possibilities remained for food stuck in throat ( I know I must do investigations but I want to discuss it )
3- How this could happens and what are the possibilities: I did endoscopy showed good muscle manometer shows good motility and 3 months of medicine and last week 80mg contraloc, 3 times motilium and gaviscon one before meal and one after, and all food boiled and still having symptoms and even sometimes feeling acidity and sour taste in mouth.
4- Are headaches related to the disease or the medicines ?
5- Are there possible other possibilities for what I am experience other than LPR due to non improvement?
5- Should I go to digestive system doctors?
Brief Answer:
Abrupt stopping of PPIs can trigger reflux
Detailed Answer:
Hi
Thanks for writing back
1. Abrupt stopping of the proton pump inhibitors (PPI) can trigger the acid secretion and the reflux comes back with vengeance. That was the reason for the chest discomfort too. PPIs should always be gently tapered before stopping.
2. The other possibilities include:
• Esophageal ring - A thin area of narrowing in the lower esophagus can intermittently cause difficulty swallowing solid foods.
• Eosinophilic esophagitis - Is caused by an overpopulation of cells called eosinophils in the esophagus.
• Scleroderma - Development of scar-like tissue, causing stiffening and hardening of tissues, can weaken your lower esophageal sphincter, allowing acid to back up into your esophagus and cause frequent heartburn.
• Neurological disorders - Such as multiple sclerosis, muscular dystrophy and Parkinson's disease — can cause dysphagia.
• Pharyngeal diverticula - A small pouch that forms and collects food particles in your throat.
• Abnormalities in the spine
• Hypersensitive esophagus - An abnormally reacting esophagus due to an aberrance of central control of esophageal movement coming from the brainstem.
• Anxiety and depression
• Syndromes or vitamin/element deficiencies
3. I do understand your concern; I am trying to get into the depth of your problem. I do feel your symptoms are partially related to anxiety. Now, your exams are there and the stress as well as the anxiety levels will increase. Hence, it would be wiser to take some anxiety relievers and do relaxation exercises and meditation. Trust me, with these measures you will definitely feel better.
4. Headache is not related to the medicines. It is more of stress and anxiety related. The possibility of migraine cannot be ruled out.
5. Please refer to 3.
6. By all means, you need to consult one who can help you with this problem.
Hope I am able to convince you. Revert back to me if you have any further queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Abrupt stopping of PPIs can trigger reflux
Detailed Answer:
Hi
Thanks for writing back
1. Abrupt stopping of the proton pump inhibitors (PPI) can trigger the acid secretion and the reflux comes back with vengeance. That was the reason for the chest discomfort too. PPIs should always be gently tapered before stopping.
2. The other possibilities include:
• Esophageal ring - A thin area of narrowing in the lower esophagus can intermittently cause difficulty swallowing solid foods.
• Eosinophilic esophagitis - Is caused by an overpopulation of cells called eosinophils in the esophagus.
• Scleroderma - Development of scar-like tissue, causing stiffening and hardening of tissues, can weaken your lower esophageal sphincter, allowing acid to back up into your esophagus and cause frequent heartburn.
• Neurological disorders - Such as multiple sclerosis, muscular dystrophy and Parkinson's disease — can cause dysphagia.
• Pharyngeal diverticula - A small pouch that forms and collects food particles in your throat.
• Abnormalities in the spine
• Hypersensitive esophagus - An abnormally reacting esophagus due to an aberrance of central control of esophageal movement coming from the brainstem.
• Anxiety and depression
• Syndromes or vitamin/element deficiencies
3. I do understand your concern; I am trying to get into the depth of your problem. I do feel your symptoms are partially related to anxiety. Now, your exams are there and the stress as well as the anxiety levels will increase. Hence, it would be wiser to take some anxiety relievers and do relaxation exercises and meditation. Trust me, with these measures you will definitely feel better.
4. Headache is not related to the medicines. It is more of stress and anxiety related. The possibility of migraine cannot be ruled out.
5. Please refer to 3.
6. By all means, you need to consult one who can help you with this problem.
Hope I am able to convince you. Revert back to me if you have any further queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
What dose to take from Elavil or other stress medicines
these days I am really suffering throat and chest pain and I permanently believe there is nothing related to exams.
The problem started in the vacation and increased in best moments so not related at all to anything.
I am really sad that 2 does mg of contraloc before breakfast and dinner. Motilium 3 times before meals. Gaviscon 3 times affter meals and nothing happens. This is really destroying my life.
these days I am really suffering throat and chest pain and I permanently believe there is nothing related to exams.
The problem started in the vacation and increased in best moments so not related at all to anything.
I am really sad that 2 does mg of contraloc before breakfast and dinner. Motilium 3 times before meals. Gaviscon 3 times affter meals and nothing happens. This is really destroying my life.
Brief Answer:
I personally don't advice Amitriptylin...
Detailed Answer:
Hi
Welcome back
1. Practicing in good faith, I personally would not recommend Amitriptylin for people less than 25 years. On the contrary, alprazolam would be a better choice for you. Please check out the following link
http://www.ncbi.nlm.nih.gov/m/pubmed/0000/
2. I do understand your concern and to the best of my potential and knowledge I'll try to help you with this issue.
3. At this young age of yours it is very unusual to have such a severe acid reflux problems. I do feel, we are missing some important clues.
4. As you are unable to go for further medical checkup because of your midterm exams. I would recommend you to take lowest dose of alprazolam after consulting your doctor. This will relieve the anxiety as well as any muscle spasm and the acidity if any. Trust me, in lower doses for a short period this will work wonders.
I wish you good luck for your exams and a speedy recovery.
God bless you.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
I personally don't advice Amitriptylin...
Detailed Answer:
Hi
Welcome back
1. Practicing in good faith, I personally would not recommend Amitriptylin for people less than 25 years. On the contrary, alprazolam would be a better choice for you. Please check out the following link
http://www.ncbi.nlm.nih.gov/m/pubmed/0000/
2. I do understand your concern and to the best of my potential and knowledge I'll try to help you with this issue.
3. At this young age of yours it is very unusual to have such a severe acid reflux problems. I do feel, we are missing some important clues.
4. As you are unable to go for further medical checkup because of your midterm exams. I would recommend you to take lowest dose of alprazolam after consulting your doctor. This will relieve the anxiety as well as any muscle spasm and the acidity if any. Trust me, in lower doses for a short period this will work wonders.
I wish you good luck for your exams and a speedy recovery.
God bless you.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2542 Questions
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