Many people suffer from lump throat for a long time and they often feel there is something locked in the throat, and cannot be removed by coughing or vomiting. They visit lots of the hospitals, seek for an effective regimen to cure it, but the effect is usually in vain. Such discomfort, also named globus hystericus, is what we called “chronic pharyngitis.”.

Clinical Manifestations

Patients often complain about lump throat with dry, itchy, and/or painful sensation. Hoarseness and habits of cleaning throat are also mentioned. Sometimes they have neck or shoulder muscle pain, chest tightness or dyspnea. Occasionally patients of chronic pharyngitis with unusual ulcerative lesions at pharynx are caused by syphilis, turberculosis or fungal infection.

Etiology

Generally, there are no definite causes that can provide a good explanation of why such symptoms and signs happened. Care must be taken to exclude mass lesions at hypopharynx and larynx. Hypotheses of etiology are divided into 3 categories:

1. Intrinsic factors:

Such patients often have personalities of nervous, highly sensitive, anxious and insomnia characters.

2. Extrinsic factors:

These patients have symptoms of post-nasal dripping or gastroesophageal reflux, which produce stimulations at throat for a long time. Irritant food intake, smoking, or drinking is also possible causes.

3. Infective causes:

Syphilis, tuberculosis, and fungal infection are well-known causes of chronic pharyngitis.

Diagnosis

Delicate physical examinations by an otorhinolaryngologist to exclude malignancy are necessary.

The diagnosis of chronic pharyngitis could be made by clinical symptoms and signs. If infective causes are suspected, tissue biopsy and culture should be done for further investigation. Esophageal PH monitor may be indicated if chronic pharyngitis caused by gastroesophageal reflux is speculated.

Treatment

Causes of rhinitis, tonsillitis or enterogastritis should be treated first.

Furthermore, avoid irritant, quit smoking, and drinking. Habits of cleaning throat or dry cough have to be prohibited to decrease lump sensation. Do not use mouth rinse or drugs over-the-counter in a long period. If possible, psychiatric consultation and anti-anxious drugs may be of help.

If diseases are caused by infection, appropriate antibiotics should be prescribed and long term follow-up is suggested.