There is a lump in my throat that never seems to go away

Dr Flo,

Hello Doc, I feel like something is blocking my throat constantly, especially when swallowing saliva. It feels like mucus stuck in my throat but it seems to never get out, no matter how much I try to expel it. However, there’s no pain and it doesn’t affect me in any way. I have felt it for some years.
Isaac.

Dear Isaac,

The feeling of having something stuck in the throat without anything there and no difficulty swallowing is called globus pharyngeus or having a globus sensation. It happens to most people for a brief period of time. Most of the time, the cause is unknown. Possible triggers include:

Increased muscle tension:

If the muscles at the back of the throat are not completely relaxed, there is muscle tension. This may be for no reason, or it may be due to muscle spasms. It may also happen due to emotional reactions like stress, anxiety, pride, grief or extreme fatigue. A physical therapist or a speech pathologist can help in managing the throat muscle tension. Practising self-care and visiting mental health professionals can help manage intense emotions.

Sinuses:

If you have chronic sinusitis (inflammation of the sinuses), and the sinuses have a lot of mucus within them, then some of it can flow out and backwards, down your throat, in what is called post-nasal drip, causing irritation at the throat, which may cause the globus sensation.

This can be diagnosed by symptoms of feeling that the nose is always blocked, sometimes on one side only. Occasionally, there may be a headache or pain at certain parts of the face, and on CT scan, the sinuses are noted to be full. Treatment includes antihistamines, decongestants, nasal sprays, and if necessary, surgery to drain the sinuses.

Nose:

If you have allergy to cold, dust, strong smells, pollen, dander, fur among others that cause constant running nose, or sneezing, or stuffiness of the nose, this can lead to irritation at the throat as well — and even excess formation of mucus. You may also have post-nasal drip. This is treated with antihistamines, decongestants and nasal sprays.

Laryngopharyngeal reflux (LPR):

This means that there is stomach content that comes back up the oesophagus and causes irritation at the throat, and sometimes some of it “spills over” into the airway, and irritates the vocal cords.

Sometimes this is associated with other symptoms of reflux like heartburn, nausea, and abdominal issues. But sometimes there is nothing other than throat irritation, which may generate the globus sensation or increase throat muscle tension.

This is usually diagnosed by an ENT specialist and you may be sent for further tests like barium swallow, and endoscopy. The treatment for LPR is usually the same as for reflux that leads to heartburn and other abdominal symptoms.

This includes medication that reduces the amount of acid produced in the stomach (proton pump inhibitors) and medicine that reduces reflux (regurgitation) like mosapride, domperidone, among others.

Some lifestyle changes that can help reduce the symptoms include avoiding alcohol, keeping off spicy and acidic foods and beverages, stopping smoking, eating at least two to three hours before bedtime, avoiding eating large meals in the evening, staying upright after eating, sleeping with the upper body raised with pillows, wearing loose fitting clothes while sleeping and having a healthy weight.

Medication:

There are some medications that can cause throat irritation and create a feeling of something stuck in the throat or even cough. Examples include some hypertension medicines and also some anti-depressants and inhalers.

To prevent or reduce the globus sensation, any potential triggers should be addressed. Also, take plenty of water, rest your throat when you are unwell, try not to clear your throat and sip water instead, maintain a healthy weight, and observe the mentioned lifestyle changes to prevent reflux.

Hey Doc,

I have been having recurring boils in my body even in private parts over the last four years. I have been to hospitals given antibiotics but after some time, it keeps recurring. What could be the cause of this?
R

Dear R,

A boil, or an abscess, is caused by infection getting into the layers of the skin through tiny cuts or around a hair follicle or sweat glands or sebaceous glands (skin glands that produce “oil”). Because of the infection, pus forms and accumulates in that place, leading to a painful swelling which may turn red. Sometimes, a part of it will turn yellow due to the pus underneath.

Getting recurrent boils is associated with poor hygiene, dirty environments, being near people with some kinds of skin infections and poor blood circulation. It could also be a sign of a weak immune system, for example due to diabetes, long-term use of steroids, cancer, blood disorders, alcoholism, Aids, and other diseases.

You can also get pimples that have pus in them as a result of other inflammatory skin conditions like acne, psoriasis and sometimes as part of a fungal infection.

In some people, though, there is no good reason for getting the recurrent boils.

Treatment involves opening the boil so that the pus can drain out. Sometimes, antibiotics are needed. If the swelling is small, less than 1cm diameter, you can press it with a cloth dipped in warm water several times a day for about 20 to 30 minutes.

Recurrent swellings or bumps in the private parts occur when the hair follicles (where the hair comes out of the skin) are blocked by bacteria and other substances. Some people overreact to the blocked follicle, either because their immunity system is overly sensitive or because of hormonal changes. It is also more common in overweight people.

It is not contagious and it does not occur due to poor hygiene.

Another cause of this may be shaving. After shaving, as the hair is growing back, the hair either re-enters the skin at the skin follicle or the sharp tip of the hair pierces the skin follicle before it grows out of the skin to become visible.

The simplest treatment is to let the hair grow, or only trim it, and not shaving completely.

In your case, where the swellings keep coming back, it would also be advisable to visit a skin specialist (dermatologist) when you have the pimples so that you can get an accurate diagnosis and the way forward.

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