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What is Globus and How I manage it.

Updated: Nov 14, 2023

As an ENT surgeon, I have encountered numerous patients who complain of a lump-like sensation in their throat, known as Globus. This condition can be challenging to diagnose and treat, as it can be caused by a variety of factors. In this article, I will describe some of my experiences in managing patients with Globus and how I made a proper diagnosis and provided appropriate treatment.

Clinical Scenario 1: A 45-year-old man came to my clinic with a history of Globus for the past two months. He reported no difficulty in swallowing, but the sensation of a lump in his throat was persistent and worrisome. Upon examination, I found no significant abnormalities in his throat. However, I suspected that his condition might be related to stress or anxiety. I referred him to a psychologist for further evaluation and management. After a few therapy sessions, his symptoms improved significantly.

Clinical Scenario 2: A 50-year-old woman came to my clinic with complaints of difficulty in swallowing, along with a lump-like sensation in her throat. She had a history of GERD (gastroesophageal reflux disease), and I suspected that acid reflux might be causing her symptoms. I recommended a trial of proton pump inhibitors (PPIs) to reduce the acid production in her stomach. After two weeks of PPIs, her symptoms resolved completely.

Clinical Scenario 3: A 30-year-old man presented to my clinic with complaints of difficulty in breathing, along with a sensation of a lump in his throat. On examination, I found that his thyroid gland was enlarged, which was causing compression on his trachea. Further evaluation with a thyroid ultrasound and a biopsy confirmed that he had a benign thyroid nodule. We decided to monitor his condition regularly and recommended a follow-up after six months. Fortunately, his condition remained stable, and we avoided surgery.

Clinical Scenario 4: A 55-year-old woman came to my clinic with complaints of a persistent lump-like sensation in her throat, along with difficulty in swallowing. Upon examination, I found a small mass in her throat. A biopsy confirmed that it was a malignant tumor, and we immediately referred her to an oncologist for further evaluation and treatment. She underwent surgery and chemotherapy and made a full recovery.

In conclusion, Globus is a common condition that can be caused by several factors. As an ENT surgeon, I always prioritize a comprehensive evaluation of my patients with Globus, including a detailed history, physical examination, and appropriate investigations. Treatment may vary depending on the underlying cause of the condition, which can range from stress and anxiety to more severe conditions such as tumors or thyroid nodules. By providing appropriate diagnosis and treatment, I ensure that my patients receive the best possible care and achieve the best possible outcomes.

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