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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I have been diagnosed with globus hystericus by my ent

Answered by
Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 3133 Questions

Posted on Sat, 2 Feb 2019 in Ear, Nose and Throat Problems
Question: I have been diagnosed with globus hystericus by my ent dr- the only treatment is something like atavan- don’t want to take- any suggestions?
Answered by Dr. Prasad 1 hour later
Brief Answer:
CBT may be helpful...

Detailed Answer:

I am glad other conditions of lumpy throat are ruled out by scans and barium swallow. In absence of structural defects, the usual cause is anxiety and thus the need for antianxiety drugs (ativan). May I know what medicines were used to treat LPR?

If you do not wish to start antianxiety drugs, the next option to consider is behavioural therapy (CBT). CBT will take time to show results; but with continued sessions, it will make a difference. You can discuss about it with your doctor.

Hope this helps. Let me know if you need clarifications.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Prasad 25 hours later
Thanks for answering my question.

I was on esomeprazole magnesium and when that didn't help, my doctor wanted to rule out any nasal issues so tried Mucinex d- no help. I don't see how this can be anxiety related as I have little stress at this time in my life. I run 3-4 miles 3 days a week as well as walk and I have had meditation practice for 17 yrs. (30 min. twice a day.) I had a lot of anxiety in the past with a stressful teaching job, but I've been retired for 7 years.

Also, what is CBT therapy?
Answered by Dr. Prasad 20 hours later
Brief Answer:
Add prokinetic agent with esomeprazole...

Detailed Answer:

LPR / GERD is one of the common cause of globus and hence treating it is very important. Now I know you been treated with esomeprazole, a proton pump inhibitor (PPI). But I prefer adding a prokinetic agent like domperidone/ondansetron along with PPI for better results. You may discuss with your treating doctor and see if taking PPI with a prokinetic agent makes a difference with the globus sensation.

Anxiety is another condition that is strongly linked to globus hystericus. It doesn't imply that your problem is due to anxiety as you don't report other anxiety symptoms such as nervousness, palpitation and so on. But using anxiolytics has known to improve symptoms of globus even in otherwise normal individuals (those who don't suffer from anxiety). It is an appropriate treatment. But when you don't wish to use anxiolytics CBT is an available option.

CBT refers to cognitive behavioural therapy. It is a talk therapy (session) which will help you understand, change the way you think and behave about the problem. This will help you manage the problem and lead life undisturbed by it.

Hope this answered your question. Let me know if you need more information.


Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

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