Feeling Something Stuck in Throat

To distinguish between globus pharyngeus and significant throat pathology.

Assessment

Signs and Symptoms

Symptoms suggesting benign globus pharyngeus:

  • Noticed at midline or suprasternal notch?
  • Intermittent
  • No true dysphagia

History and Examination

On physical examination does the patient have:

  • Normal oral cavity, head and neck examination?
  • No pain?
  • Normal voice quality?

Red Flags

If the patient has any of the following refer as Head and Neck - 2WW referral

  • Significant smoking / alcohol history
  • Significant referred otalgia
  • Dysphagia
  • Hoarseness
  • Stridor
  • Persistently unilateral symptoms
  • Abnormal neck examination e.g. enlarged nodes

Management

Reassure patient, no further intervention

If no better in 6 weeks or new symptoms are presented, consider a referral to ENT. See referral criteria (section below)

Chapter 12 ENT section 12.1 Ear

Referral

Referral Criteria

  • Reassure patient, no further intervention
  • Advise the patient to return if they develop any new symptoms
  • Induction dose trial of PPI/ Alginate if oesophageal symptoms, 1 month high dose and 1 month maintenance dose

Referral Instructions

e-Referrals Service Selection

  • Specialty: ENT
  • Clinic: Throat (incl Voice/Swallowing)
  • Service: DRSS-South Devon & Torbay-Ear Nose and Throat- Devon CCG -15N

Referral Forms

DRSS referral form

Torbay and South Devon seeking advice form

Supporting Information

Patient Information

Patient.co.uk leaflet - Globus hystericus

Pathway Group

This guideline has been signed off by South Devon and Torbay CCG.

Publication date: April 2017

 

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