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What Does It Mean to Feel a Lump in Your Throat?
Interviewer: You feel a lump in your throat. What does that mean? What could it be? Is it a cold? Postnasal drip? Maybe something else? To help us understand what might be causing that feeling and how to find some relief is Dr. Breanne Schiffer. She's an otolaryngologist, or ear, nose, and throat specialist.
Dr. Schiffer, how do patients usually describe the feeling of having a lump in their throat?
Dr. Schiffer: So for a lump in the throat, we also will call this globus sensation in the medical field. But patients will typically describe exactly that. They feel like there's a lump or a golf ball in their throat. It's not always painful, but it can be uncomfortable or they're just very aware of the sensation that something is there.
So oftentimes we would want to actually evaluate whether or not there truly is a lump in the throat. This can oftentimes be done by seeing an otolaryngologist and having a relatively simple in-office procedure with a camera that looks at the back of the throat to confirm that there's no mass present.
Alternatively, when there is no actual lesion there, many people will express or feel a lump in their throat and this can be associated sometimes with anxiety or stress, but also in addition, I sometimes will see this with patients who have reflux or other symptoms that could be irritating the back of their throat as well.
Interviewer: Okay. So a lump in the throat could actually be a lump in the throat or it could just be the sensation of a lump in the throat, it sounds like.
Dr. Schiffer: Correct.
What to Do If You Have a Lump in Your Throat
Interviewer: What could a patient do if they're experiencing a lump in the throat?
Dr. Schiffer: So if somebody is experiencing a lump in the throat, I generally will ask them to consider when they really feel this lump is present. So if this is something that tends to come on when they're feeling emotional or anxious or have increased stress or something along those lines, then they can practice certain relaxation techniques trying to kind of relax the muscles in the neck that may be tensing up and causing that lump in the throat sensation.
But other patients will describe to me that they have a lump in their throat that's present maybe 30 minutes to an hour after a meal, or maybe shortly after eating, or something along those lines. And this makes me a little more suspicious of the possibility of reflux as a cause.
And so, for those individuals, I generally would recommend making either some lifestyle or dietary changes to try to manage reflux. Also, those individuals may potentially use over-the-counter medications to help reduce acid production in the stomach, and they can see if that helps some of their symptoms as well.
When to See a Doctor About a Lump in Your Throat
Interviewer: Correct me if I'm wrong, but it feels like a lump in the throat, when to see a doctor, this one probably you should go see a doctor. I mean, you've got to see if it's an actual lump or not, right? When should a patient see a doctor?
Dr. Schiffer: I think if the symptoms have been there for a few weeks and it's pretty persistent, that would be a time that I would recommend going to see a physician. If it comes and goes, it lasts maybe two weeks, it was really there during a particularly stressful time or maybe you were getting over an upper respiratory infection or something like that, then it's probably not something you'd be super concerned about.
But if it's been there persistently, certainly if it's impacting your swallowing, it's causing pain, you've noticed some voice changes associated with it and it just doesn't seem to go away, I think it's very reasonable and would be recommended, especially for peace of mind, to see a physician who could actually evaluate and discover if there truly is a lump in your throat or not.
Possible Causes for a Lump in the Throat
Interviewer: And what could that possibly mean if there was a lump there?
Dr. Schiffer: So, for some individuals, the lump can be related, like I said, again to reflux or other kind of GI disturbances, so to speak. For other individuals, it can actually be some difficulties with particular swallowing muscles that can cause the sensation of a lump being present. And again, not to harp on this, but of course, we always want to rule out cancer as a possible cause. And so those are the things that I would consider and hopefully would be able to see or evaluate relatively easily in clinic.
Understanding Hoarseness and Voice Changes
Interviewer: Our last throat symptom that somebody might experience is hoarseness or voice changes. I think that's fairly self-explanatory, but how do patients describe this?
Dr. Schiffer: So patients will come in with hoarseness or voice changes quite frequently, and a lot of times I'll try to characterize what exactly about their voice has changed.
So, some individuals, they'll describe that their voice is more gravelly or rough. Other people will describe that their voice sounds softer or weaker or they have to work harder to project their voice. Other people will talk about losing a certain degree of their pitch range, or if they're maybe a more accomplished singer or something like that, noticing pitch breaks or things of that nature.
And so we always try to characterize what types of voice changes they're describing, and then that helps us to delineate potential causes for their symptoms.
Interviewer: When it comes to a hoarseness or voice change, can it occur both very quickly and also over a long period of time? I would imagine a long period of time, somebody might not even notice it or think about it too much.
Dr. Schiffer: Yes. Definitely, voice changes can be quite sudden. I've had some patients who come to me because they woke up one day and their voice was gone or significantly different than it used to be.
Other times I have patients come in who have said, "Oh, I've noticed my voice has been changing over the course of maybe five or six years." It may not be really noticeable to them, but their family members may have remarked, "Oh, it's harder to understand you," or, "It's harder to hear you when we talk on the phone," or things of that nature. So it can be quite acute. It can also be quite chronic.
Causes of Hoarseness: From Infections to Vocal Cord Issues
Interviewer: All right. And what could it possibly mean?
Dr. Schiffer: Hundreds of things that could be the potential cause for voice changes. But definitely, when I'm assessing a patient for voice changes, I want to try to determine the length of time over which they notice those changes. So if it's something very sudden, it could be related to an infection. It could be related to a sudden change to the vocal cord, like, for example, a small vocal cord hemorrhage, which is where a little blood vessel will burst on the surface of the vocal cord.
If it's more of a slow progressive change, maybe over a few weeks or months, we could think about something related to muscle strain or other potential contributions to the use of the vocal cords.
If it's something that has affected your pitch range, maybe people are noticing voice cracks or breaks, they notice that their voice is persistently hoarse or just definitely sounds different all the time throughout the day, then we do think about a possibility of something along the surface of the vocal cord, like a polyp or a cyst or a nodule, or potentially a cancer as well.
When to Seek Medical Attention for Hoarseness
Interviewer: And if somebody is experiencing hoarseness or voice changes, what should they do?
Dr. Schiffer: So in a short period of time, if you notice that your voice is more hoarse or rough or raspy because you've been sick relatively recently, then I would recommend voice rest, hydration, and, in general, pretty conservative measures. Oftentimes you will start to feel better before your voice completely returns to normal, but typically, it would get closer to normal after a few weeks.
If your voice changes have been lasting longer than about four to six weeks, and particularly if they're associated with any throat pain, trouble swallowing, coughing up any blood, ear pain, or any swelling or lumps or bumps in the neck, that would be a reason for you to see a physician.
For some of those more serious symptoms, we do think about the possibility of vocal cord cancer or something along those lines. And even though it's not always cancer, sometimes there could be a polyp, a cyst, a nodule, or some actual lesion on the vocal cord, which would be helpful to identify and then monitor from there.
Importance of Hydration, Monitoring Symptoms, and Seeking Care
Interviewer: I think I noticed a couple of themes here. If symptoms continue for a period of time, that would be a good time to see a doctor. Sounds like hydration is more important than one might imagine. And it seems like we're all super hydrated, but apparently, that's not the case. Other thoughts on that?
Dr. Schiffer: I think that those are some good key takeaway points. The other thing I would recommend is if it is something that you do feel like you've been dealing with for a few weeks, when you have a plan to go see your physician and talk about it, pay attention in those weeks before your visit as to what things do tend to make your symptoms better or what tends to make it worse.
Sometimes that can help us to narrow our differential a little bit quicker or hopefully figure out what type of workup would be the most effective for you. And it can really be helpful in determining what treatments might be the most beneficial.
Interviewer: Right. Come in armed with that information. That really helps providers figure out these mysteries sometimes.
Dr. Schiffer: Yes.
Interviewer: So you are a laryngologist. For any of these throat issues, would they go to their primary care physician first, and then if that primary care physician is having difficulty narrowing down, they would refer? Or what would you recommend?
Dr. Schiffer: Seeing a primary care doctor is very reasonable for an initial visit, especially if it's been just a couple of weeks. Oftentimes it takes a little bit longer, unfortunately, to get in to see an otolaryngologist. But very frequently your primary care doctor will send a referral to see an otolaryngologist. Especially here at the 人妻中出视频 of Utah, we have many wonderful ENTs who can hopefully get you in quickly and see and evaluate these symptoms.