possible lump in throat?

Question

For the past two weeks, I have had what feels like a lump of sorts when I swallow. It comes and goes but is most prominent at night. It scares me a little that maybe my throat is closing up. But, since it comes and goes, I'm not sure what it could be or what to do about it.

Answer 1

Cricopharyngeal spasm
Information for patients with a lump in the throat sensation

Causes
This syndrome results from a spasm in the cricopharyngeus muscle. It is a self limiting disorder that will resolve on its own. The symptoms are so characteristic that as soon as a patient tells me they have a lump in the throat, I can usually describe all of their symptoms to them.

Symptoms
Lump in the throat sensation
feels like a golf ball, tennis ball ... is stuck in my throat
feels like my tie is too tight
feel like I am being strangled
my throat feels swollen
The symptoms can be mimicked by pushing on the cartilage in the neck just below the Adams apple.
The lump comes and goes depending on the day.
Symptoms are usually best in the AM and worse later in the day
Stress aggravates the symptoms.
Saliva is difficult to swallow yet food is easy to swallow.
Eating, in fact, often makes the tightness go away for a time.
The symptoms are similar to getting choked up at a wedding or a funeral.

Physiology 101
There are two valves in the esophagus or swallowing tube. The are normally contracted and they relax when you swallow so that food can pass through them going to the stomach. They then squeeze closed again to prevent regurgitation of the stomach contents. If the normal contraction becomes a spasm, like a charlie horse of the calf muscle, these symptoms start. Stress often makes these spasms much worse. Many people have experienced neck tightness when stressed and this is similar. Even if not caused by stress, stress will make the spasm much worse.

A management program
An exam of the neck and throat is extemely important to eliminate serious problems. In fact, it enters most peoples minds that a lump in the throat might be a cancer. In practice, real lumps in the throat, such as a cancer are not felt. It is one of the reasons that a cancer can get so big before it is discovered. It probably is fortunate that we don't have great sensation in the throat as we would then feel every particle of food, with every meal as it travels down the throat. So lacking great sensation in the throat, problems are a little mysterious there.

Unfortunately, many physicians are not familiar with how symptomatic a cricopharyngeal spasm can be and I often see patients who have been extensively tested with Barium swallows, esophageal endoscopies, pH testing, CT scans, xrays, MRI scans and they all come back normal or possibly with some finding that is completely unrelated to the lump in the throat sensation. Really, just a good exam of the throat, voice box and neck is all that is necessary and it is sufficient as well. You should know the following:

Just knowing the tightness is not a sign of cancer frequently helps relieve the discomfort.
You will get better. Often improvement is over several weeks or even a few months, but occurs once one knows what the problem is.
Warm fluids should comfort the throat. Consider a cup of warm tea when the lump is bothersome.
If stress lets up, the symptoms improve. Think about what stress might be making this lump worse.
Muscle relaxants, such as valium, would be a good treatment, except for their addictive properties.

Medication
I sometimes dispense several valium (perhaps 4) as a test to prove the symptoms are from muscle spasms. I recommend taking one of the Valium on a weekend, when being alert is not important. When the lump occurs, one takes the Valium. Within an hour, there should be significant improvement in the lump sensation. If the symptoms improve after taking the muscle relaxant, then the symptoms are reasonably from a muscle spasm. Again, the knowledge that a muscle relaxant makes a lump disappear can help confirm that the cause of the lump is from a muscle and not an actual lump.
I have also tried injections with a local anesthetic, often with good, but temporary results. It does help to confirm in the patients mind, there is the possibility of relief.
If a local anesthetic injections helps, I have with inconsistent results injected botulinum toxin into the cricopharyngeus muscle, sometimes with prolonged relief.

Answer 2

I think you should go to an endocrinologist rather than an ENT doc. Before any surgery or Iodine-131 treatments they will need to do tests to determine what the lump is. A lot of people have their thyroid removed and do just fine. Even if it is malignant, the survival rate for thyroid cancers is 95+%. Just let them do the tests to determine what it is before you get too worried. The surgery will be expensive. Not a good time to be without insurance.

Answer 3

You probably need to drink water. Have a doctor check it out. I am sure you are ok, as I have this same problem. What helped me was drinking water throughout the day. Read the book: you're not sick, you're thirsty.

Answer 4

best thing to do is go to the doctor, they can always reassure you and give you the piece of mind you search for.
it may be a swollen gland or benign tumor or could just be internal cold sores or cysts, in any case it needs to be seen by a doctor. best of luck

Answer 5

Since it seems to come and go, it may be related to anxiety.
It could be related to your thyroid, or other causes. The last line is always that you should see your physician.

Answer 6

I have depression and anxiety and I used to get that feeling a lot when I was anxious. See a doctor.