Surely everyone, at least once in their life, felt such an unpleasant sensation as a lump in their throat: during moments of intense psychoemotional stress, during periods of acute bacterial infections (ARVI), etc.
Lump in the throat It is a specific, uncomfortable sensation, localized in the region of the pharynx and larynx, which manifests itself as a feeling of compression, bursting, of a foreign body.
Few people pay much attention to the discomfort in the throat area, and it is in vain. Such a symptom as a lump in the throat can accompany a wide variety of processes, from relatively harmless, to terrible pathological, representing a threat to the health and even the life of the patient.
Lump in the throat: causes of discomfort in the throat
A sensation of a coma in the throat is a very common occurrence. Rarely, the discomfortable feeling is distinguished by independence, most often it is accompanied by one or another symptomatic complex, depending on the cause. Often, patients in search of an answer to the question of a lump in the throat that this can be sent to the doctor’s office. And this is absolutely true. It is almost impossible to independently determine what can be the cause of a coma in the throat: their number is so great that even a doctor can be stumped.
Lump in throat: psychosomatic factor
If you believe medical statistics (and the facts, as they say, a stubborn thing), the vast majority of cases of coma in the throat are due to psychosomatic causes. This is the so-called "neurotic lump" or "hysterical lump in the throat." Not always the development of coma in the throat associated with psychosomatic factors can be called "neurotic." Even in absolutely healthy and mentally stable people, this symptom can manifest itself. Usually the discomfort is preceded by:
• Excitement.
• Severely distressing situation.
• Fear.
• Stressful condition.
For example, before passing an important exam, before visiting the dentist’s office, many, if not all, experienced this. These causes account for up to 97-98% of all clinical cases of a coma in the throat. Especially often, a symptom is detected in people prone to neurosis. Thus, a certain proportion of all patients are often diagnosed with neurotic disorders, accompanied by regular panic attacks.
For years, psychotherapists and psychologists have been "developing" the topic of the psychosomatic mechanism of the development of coma in the throat. In the course of the research, an exemplary portrait of a person prone to the frequent formation of the discomfort under consideration was compiled. As a rule, we are talking about a woman, from 18 to 35 years old, of a hysteroid accentuation of character (according to Leonhard), who is in a state of prolonged psychoemotional stress (studying at a university, work related to increased mental stress, etc.). Of course, this is not an axiom or a dogma. Neurotic disorders also affect men. Often in the history of persons who complain of discomfort, the IRR (vegetative-vascular dystonia) is found.
Despite the fact that not all scientists and practitioners recognize VVD as an independent diagnosis (and meanwhile, it has long been proved that VVD is a special case of such a complex endocrine pathology as hypothalamic syndrome), this disease can become an independent cause of the development of frequent panic attacks, and, as a result, the formation of a sensation of coma in the throat.
A lump in the throat, having a psychic nature, develops according to a relatively simple mechanism. As a result of stress, severe nervous tension, the release of the hormones adrenaline and norepinephrine occurs. These hormones cause the nervous system to become overexcited. Active substances affect the muscles, causing them to come to a state of increased tone, and the nervous system sends a large number of chaotic electrical signals to the muscles. As a result, a spasm of the muscles of the pharynx is formed, which feels like a lump.
In patients with VVD, the development mechanism is approximately the same, with the only difference that the hypothalamus gives a “command” for hormone production not as a result of stress, but during the next attack of the disease (an attack can be triggered by a variety of factors, be it a change in weather and atmospheric pressure , the wrong diet, the same stresses as the secondary cause, etc.).
In a healthy person, the sensation passes by itself after the removal of the irritant (the exam is passed, the patient has already left the dentist’s office, life is beautiful again), within 3-5 minutes. If it did not pass, there is reason to think about the state of your health.
Lump in throat: ENT pathology
If a lump in the throat - the reasons for which lie in mental factors can be called a natural phenomenon, then in this case we can talk about serious diseases.
• Acute or chronic pharyngitis. Pharyngitis is an acute inflammation of the tissues of the pharynx. The disease in the acute phase and in the subacute period is characterized by the development of discomfort (including coma) in the throat.
• Acute and chronic laryngitis. It is an inflammation of the mucous membrane of the larynx. Since the larynx is anatomically located deeper, the feeling of discomfort (fullness) is manifested much more pronounced.
• Sore throat (primarily purulent). Catarrhal sore throats cause atrophy of the tissues of the pharynx. The inflammatory process in itself entails a lot of uncomfortable sensations, and the transformation of normal tissues into an almost amorphous granular mass (in the most severe cases) can contribute to the fact that the feeling of a coma in the throat will become a constant companion of a person.
• Tonsillitis. Tonsil inflammation can feel like a lump in the throat.
In addition, the feeling of a foreign object in the structures of the respiratory tract can be a "harbinger" of more serious pathologies (abscesses, etc.). Do not give a damn about your own health. If you suspect - it is better to consult a doctor.
Allergic pathologies and lump in the throat
Everyone probably knows about the existence of such conditions as angioedema or anaphylactic shock. In both cases, inflammation of the walls of the larynx and trachea occurs, followed by edema. The process does not always develop rapidly, we can talk about dozens of minutes and even hours. If there is a tendency to allergies, before the development of a coma sensation there was contact with the suspected allergen, in no case should one pull. It is necessary to take urgent measures (calling an ambulance, taking antihistamines and absorbents, etc.).
Oncological diseases
The feeling of a coma in the throat can be a specific symptom of a malignant tumor of the larynx, trachea, pharynx. In this case, the discomfort is associated with squeezing the tumor of the larynx or its lumen. In the later stages of the disease, choking is possible, this should not be done. In the early stages, oncology of the respiratory tract is cured relatively easily and has a favorable prognosis.
Endocrine pathologies
Often, diseases of the thyroid gland are felt by a sensation of a coma in the throat. In this case, there is reason to suspect thyroiditis (inflammation of the tissues of the gland) or, more likely, diffuse toxic goiter of the thyroid gland.
Neurological and vertebral pathologies
In persons suffering from hernia of the cervical spine or osteochondrosis, as a result of the inflammatory process, compression of the nerve endings occurs. Squeezing can lead to the development of a discomfort in the throat.
Diseases of the gastrointestinal tract (gastroenterological pathology)
As a rule, people who suffer from diseases of the stomach feel com. In this case, dyspeptic symptoms are observed (for example, the patient may complain about a throat and belching, etc.). Therefore, if there is besides a coma in the throat, belching, heartburn, pain or discomfort in the abdomen, there is reason to suspect GI disease.
Lump in throat: other reasons
The sensation of a coma may be present as a result of mechanical (for example, after swallowing the probe on FGDS), chemical (eating products, for example, raw onions), thermal (for example, drinking hot water) injuries.
Thus, the answer to the question of someone in the throat is that this can be multifaceted, and only a doctor can find it.
Lump in throat - diagnostic methods
The first thing that a patient needs to do if he feels a lump in his throat for a long time is to contact a specialist. There may be a lot of specialized specialists here, as, probably, it is already clear from the variety of causes causing this symptom.
First of all, the most reasonable thing to visit otolaryngologist (ENT doctor).
During a full-time examination and interview, the doctor will collect an anamnesis. Usually, when collecting an anamnesis, a specialist evaluates the general condition of the patient, previous illnesses, the duration of discomfort and intensity, as well as other factors at his discretion.
If the ENT doctor suspects the presence of a particular pathology, most likely he will give directions to laboratory and instrumental studies.
The most informative, from the point of view of otolaryngology, are: a general blood test, a smear from the throat, from instrumental methods: laryngoscopy and pharyngoscopy.
Blood test and throat swab will determine the presence of inflammation and its nature. It is not always possible to identify the inflammatory process during the initial internal examination, it can occur in a latent form. The clinical picture is appropriate: leukocytosis, increased ESR, red blood cells, etc.
Unlike the primary inspection tools, laryngoscopy and pharyngoscopy allow a thorough and detailed assessment of the state of deeper-lying airway structures. These are unpleasant endoscopic examination methods, but still much more informative. In addition, the results of laryngo-and pharyngoscopy can be judged on the presence or absence of cancer tumors. If suspicious areas or formations are detected in the structures, biological materials for biopsy will be taken at the same time as endoscopy in order to exclude oncology.
If from the point of view of otolaryngology, and from the point of view of oncology no changes are detected, it is worth referring to gastroenterologist.
Since, in gastroenterological practice, most often a lump in the throat is associated with diseases of the stomach, the most informative examination is FGDS (endoscopic examination of the stomach).
The next expert who will help "open the veil of secrecy" and determine the cause of the sensation of coma - neurologist.
The cause of the discomfort is determined during functional tests, x-ray examination cervical spine and MRI.
If, from the point of view of neurology, "everything is clean," you should turn to endocrinologist. To determine the pathology of the thyroid gland, you can use Ultrasound diagnostics and conducting laboratory studies (hormone analyzes are required with information on the following indicators: T3 free, T4 free, TSH).
If by the method of elimination nothing remains but to recognize the psychosomatic nature of the coma in the throat. In this case, the only specialized specialist is a psychotherapist. However, it is important to keep in mind that Russian medicine has a pronounced orientation not to treat, but to stigmatize. Therefore, you should not contact neuropsychiatric dispensaries. It is better to entrust your problem to a private psychotherapist.
Lump in the throat - methods of treatment
As is already clear, the sensation itself should not be treated. It is necessary to eliminate the source of the disease. However, self-medication should not be practiced; treatment should be prescribed by specialists. From open sources, the patient can get only information for review. None of the sources, no matter how authoritative, they can not be taken as a guide to action.
If the sensation has a purely mental nature (neurosis, panic attacks, not caused by attacks of VSD) the most effective treatment is to change the patient’s internal settings (which is achieved mainly by working with a competent psychotherapist). In addition to this, the patient is prescribed a course of mild sedatives (safe sedatives, such as Novo-Passit, valerian root, etc.).
Therapy for ENT pathologieswhen there is a lump in the throat and pain, it is prescribed only by an otolaryngologist. Its purpose is to eliminate the source of damage (antibacterial agents), pain (analgesics) and the removal of inflammation (anti-inflammatory drugs).
Eliminate neurological diseases (such as osteochondrosis of the cervical spine) is not so simple. Chondroprotective drugs, local anti-inflammatory drugs, physiotherapeutic measures (electrophoresis, etc.), massage, exercise therapy are used. This eliminates the compression of the nerve roots.
If the discomfort has an endocrine nature, there is a lump in the throat and pain, as well as discomfort in the area of the thyroid cartilage, it becomes difficult to swallow and the specialist has every reason to suspect goiter - drugs are used to reduce the functional activity of the thyroid gland, and a specialized diet with a low iodine content is also prescribed.
Specific names of drugs, as well as treatment in general, can be prescribed only by a specialist. Pursuing self-treatment, the patient runs the risk of saying goodbye to his health, and possibly life.
Lump in the throat - prevention
There are no special preventive measures against a coma in the throat: there are too many reasons for this symptom. However, if we proceed from the frequency of development and the most common reasons, some recommendations can still be given.
• It is necessary to strengthen the nervous system. The weaker the nervous system and the higher the intensity and frequency of psycho-emotional stress, the more important this recommendation becomes. You should resort to breathing practices, training, etc. The less stress, the less discomfort will manifest itself.
• Monitor the condition of the throat and upper respiratory tract. If a common cold develops, you can’t let things go by themselves. It should be treated carefully and responsibly.
• Pass preventive examinations. Regular examinations allow you to identify quite serious diseases that can cause a feeling of coma in the throat.
Thus, a lump in the throat is not an independent disease, but a symptom. Do not assume that this symptom is so harmless.
In some cases, it may indicate the presence of formidable pathologies. Therefore, if only he manifested and did not disappear at the end of a stressful situation - you need to consult a doctor.
