Lump-in-the-throat feeling, constant gurling, and at my wit's end!

[mjk216]

About 3-4 months ago, I had a bad cold with a terrible sore throat.  The cold went away, but the sore throat and raspy voice hung around for a few weeks.  The hoarseness gradually progressed to a sensation of there being a lump in my throat. Also, I began having difficulty swallowing saliva, although I could (and still can) swallow all food and drink just fine. It was not that I couldn't swallow...it was more like the "timing" of my swallowing was off.  The 1st ENT I went to looked down my throat with a tube and diagnosed me with severe pharyngitis. He prescribed Prednisone and nasal spray, but these did not help. Symptoms got worse, and I ended up in the ER feeling like my throat was closing. I was given a mega-dose of Prednisone and some Benadryl and sent home.  Prednisone did not help, and did nothing but make me dizzy and light-headed.
I went to see a 2nd ENT, who looked down my throat with the tube, and said there was no obstruction or redness in my throat. He diagnosed me with a globus sensation caused by acid reflux, and prescribed Nexium. My first week on the Nexium, the symtoms went away completely. (Incidentally, during that week, I was on a cruise vacation). The following week, the tightness/lump in the throat, difficulty with the timing of my swallowing, and feeling of something moving around in my throat returned as severely as ever. I also began to experience dizziness and a feeling of being off-balance.
I then went to see a GI doctor referred by my ENT. GI doctor prescribed a double-dose of Nexium (and then switched me to twice-a-day Aciphex because of the dizziness).  The dizziness and loss of balance got worse, so, per my doctor, I stopped taking the Aciphex. I have been to every doctor from neurologists to ophtalmologists for the dizziness/disorientation, and taken every test in the book, including a brain MRI, all of which came back normal (no sign of a tumor, MS, or anything else). I finally went to see a neuro-otologist, who said that the dizziness and imbalance were probably due to labarynthitis (sp?), and scheduled me for further balance testing and vestibular rehabilitation.
But of course, this still leaves the throat problem, which is worse than ever. I am also experienced almost constant gurgling in my neck/thoat. It does not increase or decrease when I eat or drink. The globus sensation, tightness in the throat (which sometime extends to tbe upper chest near near the breastbone), and feeling like something is moving around in my throat are all continuing as severely as ever.
I

[Kevin Pho, MD]

You have been evaluated for the more common causes of globus sensation - namely, post-nasal drip and GERD.

You can consider more specialized testing - including 24-hr pH study looking definitively at GERD, as well as esophageal motility testing, looking at motility disorders or achalasia.  

An upper endoscopy can be considered for a more thorough look at the upper digestive tract.

These options can be discussed with your GI physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[mjk216]

[SORRY! I mistakenly submitted my post before it was done. Here's the rest...]
I am really at my wit's end with all of this.  I have heard that my symtoms can be caused by everything from achalasia to Zenker's diverticulum to cricopharyngeal or esophageal spasm. I don't know what to think! I am going for the endoscopy in a couple of weeks, but am I barking up the wrong tree with that? Any suggestions would be much appreciated.  Thanks.

[wassupwassabi]

I had gurgling in my throat for 6 months which would go on for hours and hours upon putting anything in my stomach... it was persistent because I was never able to belch before.  Since figuring out how to belch the "gurgling" is down from 1000 times/day to maybe 100... some improvement!

After a lot of testing the docs found I had weak esophageal motility and severe reflux.  I imagine severe reflux could cause all your throat problems; believe me I can sympathize, I go through a similar ordeal.

One thing, when you go back to the docs, ask them to listen to your stomach when you breathe.  They found that I was involuntarily "sucking air in" to my stomach when I would breathe in (aerophagia) which is why the gurgling would never stop.  Sadly there's no cure for this but if it's the reason for gurgling driving you crazy you might be able to control it by putting a pencil between your teeth or lying down (the gas would go the other way)

Good luck to you, and God bless.

[Lenno]

I've had a similar problem on and off for a while. It used to be really bad, but then it kinda eased off. I still need to swallow fairly constantly and I have that lump in the throat feeling. Sodium Chloride nasal spray seems to help a bit. The ENT told me there was nothing wrong with me and that I needed to relax, perhaps try meditation. I told him to go forth and multiply. Not sure if this is much comfort to you. It first came on when I had a sore throat I think. I had the feeling that my throat was closing off for quite a while, and getting to sleep was difficult. It is nowhere near as bad now.

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