I feel a lump in my throat — what is it?

I KEEP getting a lump in my throat, like it’s about to close up. I don’t have any problems eating or swallowing, but I just feel like my throat seizes when I swallow saliva. I’m worried about cancer.

THIS sounds like globus, a condition with a sensation there is a lump in the throat, when no lump exists. This doesn’t mean you are imagining it, but rather that the sensation doesn’t come from a lump but a problem within the throat itself. Although there is great debate as to what causes globus, it is generally held that it is due to muscle tension in the throat and voice box and also possibly reflux of stomach acid into the throat.

The symptoms are that of a lump or a feeling or tightness or constriction. This gets worse if you are stressed or tired. It is also thought that smoking, overuse of the voice and nasal problems such as post-nasal drip, may all make matters worse. The problem becomes apparent when swallowing saliva but does not impact your ability to eat or drink on a daily basis.

It’s incredibly common and accounts for almost 1 in every 20 referrals to ENT clinics. Young women tend to suffer more than most.

Stress can both cause and contribute to it. The concern about cancer, which is understandable, is also very common and tends to result in a worsening of symptoms. Globus has nothing to do with throat cancer; it is a benign condition.

With throat cancer the symptoms may include pain, difficulty swallowing liquids and solids, and food getting physically stuck in the throat. You can swallow fine, are pain-free and your story to me is suggestive of globus.

Go to your GP, who may refer you to an ear, nose and throat specialist. This never requires any surgery to treat. Medications are sometimes prescribed to reduce acid or relax the muscles in the gullet. Any ENT problems like a post-nasal drip, which may be contributing, are also dealt with. Relaxation techespecially niques are useful to tackle any muscle tension, and you must reduce stress too. THE university doctor told my son he had scabies. He prescribed him a treatment and told him to do it twice. He is no better.

SCABIES is common. Generally, GPs and dermatologists don’t do any tests as the diagnosis is usually obvious. Scabies is due to an infestation with a mite called sarcoptes scabiei, caught by close skin-to-skin contact.

It often thrives on university campuses. The mites can survive on clothes or bed linen for about 72 hours, so sharing towels and duvets can help it spread. Typically, it produces a rash, which may be red, raised, and sometimes blister. Usually it crops up on the wrists and in between the finger webs, as well as the limb and trunk area. It can also affect the genitals, in males. It’s incredibly itchy at night and quiet by day. The skin reaction is caused by the saliva and faeces of the scabies mite, which causes an allergic response in its host.

Often treatment is not applied adequately. The main treatments used are permethrin and malathion. Permethrin is left on for 8 to 12 hours and malathion for 24 hours, and this protocol must be followed for it to work. It must go all over the body, not just the itchy parts. This involves putting it on the genitals and cutting the nails back and putting it right in there.

We advise putting it on from tips of the ears and the chin down. Clothes must also be washed, that’s every potentially contaminated garment, at 50 degrees. They must then be tumble-dried. If this isn’t an option, the clothes can be bagged for 5 to 7 days in airless plastic bags. This will also kill any mites. A whole household needs to be treated.

There are two further issues with scabies that are often not reinforced on a doctor’s visit. Firstly, the itch may persist for several weeks after the infestation is gone. The second issue is that because of this many people believe themselves to still have scabies, and so they inadvertently do a further treatment. This can result in allergic skin rashes as the treatment can cause skin reactions.