Globus sensation

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KitKat880
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Date Joined Apr 2012
Total Posts : 111
   Posted 4/13/2012 4:37 PM (GMT -6)   
This afternoon I had my first appointment with an ENT. When I told the doctor my symptoms (lump in throat, burping, bloating), he asked if any of the doctors I had seen thus far had actually looked at my throat. I told him no. He was not happy with that response. Given that the lump in throat is my primary symptom, I guess it did not make logical sense that no one has looked down my throat. I've been thinking this for the past two months!

Upon looking down my throat, the doctor found..... NOTHING. No ulcers. No polyps. Not even a trace of inflammation. He asked if I was dry swallowing a lot (yes) and if the sensation of the lump went away when I ate or drank (yes). Apparently this condition has been brought on by my dry swallowing. I feel like there is something in my throat, so I dry swallow. It's self-perpetuating. Break the habit of dry swallowing and the feeling of the lump will eventually go away. I was told to drink water, chew gum, or use sugar-free hard candy so that I am always swallowing something. My throat should eventually relax and then I will eventually no longer feel the need to dry swallow. So, if you have this problem, the best thing you can do is stop swallowing when there is nothing to actually swallow.

The best part? I do not have LPR!!! smilewinkgrin

The ENT isn't even sure that I have reflux, since none of my symptoms are responding at all to the PPIs. In two weeks I go back for a pH monitoring test. It doesn't sound like much fun. A bit nervous....

Cylon101
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Date Joined Mar 2012
Total Posts : 68
   Posted 4/13/2012 5:04 PM (GMT -6)   
That is pretty interesting. Perhaps the dry swallowing is causing the burping as you are just swallowing air.

I wonder why the dry swallowing is causing the globus sensation?

My ENT didn't see anything in my throat either, other than some irritation - it seems odd that the globus feeling still persists.

My PPI's after a month haven't seemed to really change my symptoms either. I have to ask about that during my next appoint.

Keep us posted!

KitKat880
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Date Joined Apr 2012
Total Posts : 111
   Posted 4/13/2012 5:47 PM (GMT -6)   
I think the dry swallowing causes the muscles in the throat to tense up. My doctor also asked me if I was an anxious person. I do tend to get anxious over little things, so in my case, anxiety is probably adding to my issue. In January I lost a very dear pet that I had since childhood. The lump in throat symptom appeared shortly after that. Then I was told I potentially have GERD, which made me even more anxious.

Since this feeling is from muscle tension, I would think maybe a hot or cold compress on the throat might help the muscles relax. I am going to try this later tonight. Will post if it is effective. I also read that stretching and massaging the throat can help. Sit with your back straight and tilt your head back as far as possible, then move it from side to side. Then massage your throat, moving your fingers lengthwise. It helped me a little bit.

I've got my fingers crossed on the air swallowing theory. Tonight I had one of my favorite foods for dinner, spaghetti with a little tomato sauce. I only burped twice. Maybe this is a good sign.

ericapeace2000
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Date Joined Mar 2012
Total Posts : 1110
   Posted 4/13/2012 9:06 PM (GMT -6)   
Sounds like you could have esophageal spasm. It could be caused by reflux or anxiety. Go through with the testing, you will get more answers

KitKat880
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Date Joined Apr 2012
Total Posts : 111
   Posted 4/14/2012 5:52 AM (GMT -6)   
ericapeace2000-

What did your doctor suggest for the spasms? Do they eventually go away with regular treatment for reflux?

ericapeace2000
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Date Joined Mar 2012
Total Posts : 1110
   Posted 4/14/2012 6:14 AM (GMT -6)   
He has me on a high ppi dose for 8 weeks, then I am getting weened off. Dr. said reflux can cause the cells in your esophagus to separate ( you cant see the separation on the endoscopy scope wgich could be why people are getting "normal scopes" while in pain) and that's where the acid is getting in to cause spasm. I'm on my diet and this high dose of Zegrid so that my esophagus can heal the cells and the separation and the spasms stop. I am not happy about being on a high ppi dose but it's only fo 8 weeks. I hope I don't get side effects. Dr. Thinks by allowing the cells to heal and being on my diet, that the spasms will stop. We will see, at least he is not trying to keep me on ppi for life like other doctors.

Cylon101
Regular Member


Date Joined Mar 2012
Total Posts : 68
   Posted 4/14/2012 12:12 PM (GMT -6)   
Can you have the E. spasms w/o pain? Most of the reports of people having spams report pain when it happens.

I have no pain, only the globus feeling when I swallow, which must be due to some swelling of some point of the esphogael mechanism from I would think. It's not painful just annoying, and the throat clearing/hoarseness.

I jus wish I knew what would help to clear it up. It's been 4 weeks on PPIs and for the most part I've followed a diet that kept out tomatoes, citrus, spicy food, etc. I still have one coffee per day, as I just can't give up everything I enjoy.

I just can't imagine a lifetime of this swallowing lump feeling. There must be a way to heal it.

ericapeace2000
Forum Moderator


Date Joined Mar 2012
Total Posts : 1110
   Posted 4/14/2012 12:47 PM (GMT -6)   
Look into low fat and low carb diet. That and chewing gum has been the most helpful

KitKat880
Regular Member


Date Joined Apr 2012
Total Posts : 111
   Posted 4/14/2012 1:09 PM (GMT -6)   
If what I am having is spasms, I don't have any pain with them either. Just the lump in my throat. My ENT explained if avoiding dry swallowing is not effective, it could be a reflex; the throat will tighten up to keep the acid out. So you might be on the right track with swelling idea. Even if acid is not coming up, the throat may respond in the same way to pepsin and bile reflux, which could be why the PPIs aren't working. I guess I'll find out when I have the pH test done in a few weeks. Can't wait to have a catheter sticking out of my nose!

Last night's test with the cold compress on my throat was unsuccessful. Tonight I will try the warm compress and see how that goes. I must agree that the gum is really very helpful!

If this is reflux, I just want to have surgery and get it over with. Like you, Cylon, I can't imagine the rest of my life with this darn lump!

Cylon101
Regular Member


Date Joined Mar 2012
Total Posts : 68
   Posted 4/14/2012 2:11 PM (GMT -6)   
@kitkat

Yes, I wonder if I'll be scheduled for more tests after my next ENT visit.
I'm not sure where you located, but it seems like there is always a long wait between appointments for specialists - i still have a month to wait for a followup.

It seems like there is just much ambiguity in what the symptoms mean and how to treat it. I was so happy and relieved when the ENT did a throat scope and told me there were no growths/polyps etc, and figured the PPI's would clear it up in weeks - it's just so disappointing to find out that they didn't fix things and it basically means back to square one and possibly more and more tests.

ericapeace2000
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Date Joined Mar 2012
Total Posts : 1110
   Posted 4/16/2012 11:42 AM (GMT -6)   
The problem with refllux and related conditions is that it requires more than just medication (which is not good long term ) it requires a huge change in diet and lifestyle. The change can be challanging as you learn to live a different way. I was on a PPI and stayed away from most of the "trigger" foods but that was not enough. It was not until I completely changed my diet that I saw any changes. I have learned a lot from this board and I will continue to try and lean everything I can about this condition as I make my quest to heal. My only regret is that I did not do this sooner.

Cylon101
Regular Member


Date Joined Mar 2012
Total Posts : 68
   Posted 4/16/2012 12:56 PM (GMT -6)   
Erica - you are on the Koufman diet correct?  low acid, low fat etc?
 
What sorts of recipes are you using? I'm following a lot of her suggestions, but still enjoying non 'trigger' foods that aren't on her list for low acid foods.
 
I've been on PPI for 4 weeks and haven't noticed a dramatic change.   I can't even correlate my diet with any of my symptoms, as when I've not noticed any changes after having a few beers the other night (friends bday party) etc.    The only food that has caused me any grief is anything with real spice in it that has felt like a burning senstation in my throat.
 
 
 
 

ericapeace2000
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Date Joined Mar 2012
Total Posts : 1110
   Posted 4/16/2012 2:01 PM (GMT -6)   
Cylon, what are you symptoms now?

ericapeace2000
Forum Moderator


Date Joined Mar 2012
Total Posts : 1110
   Posted 4/16/2012 2:02 PM (GMT -6)   
Is it just the globus sensation?

Cylon101
Regular Member


Date Joined Mar 2012
Total Posts : 68
   Posted 4/16/2012 3:00 PM (GMT -6)   
Erica

Lump sensation when I swallow. Occassional hoarseness of voice which gets tired if I have to speak at a loud volume for long.

Throat Clearing.

If I drink really cold water I can sometimes feel a dull pain as well.

ericapeace2000
Forum Moderator


Date Joined Mar 2012
Total Posts : 1110
   Posted 4/16/2012 4:23 PM (GMT -6)   
sounds like LPR symptoms. LPR does not respond as well to PPI use. Have you tried diet chages?
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