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DrRussMD, Board Certified Physician
Category: Medical
Satisfied Customers: 65276
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.
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For a few months i have had on and off pain when swallowing

Customer Question

hello doctor, for a few months i have had on and off pain when swallowing especially right after i sneeze and then swallow. after the first swallow when i sneeze it goes away. i also have a lump sensation in my throat and i am feeling like i need to burp always and swallow saliva. i went to doctor nd he said i have globus and posibly acid reflux. i do have bad allergies and am constantly thiking about swallowing or nervous about it.
any recommendations
Submitted: 1 year ago.
Category: Medical
Expert:  Dr Uzair replied 1 year ago.

Hi and thanks for the query.

I agree with your doctor. Globus hystericus is caused by anxiety and anxiety also aggravates acid reflux.

However, before any conclusions are drawn, there are a few tests that should be done. A barium swallow to see if this is actually globus or is there an actual lump in the throat and an upper GI endoscopy and 24 hour pH monitoring for the reflux.

For globus hystericus, the treatment is with annxiolytics. They improve the globus as well as reduce anxiety related reflux. And along with that a proton pump inhibitor like Omeprazole 20 mg twice a day should be started.

Seeing a Gastroenterologist and an ENT specialist will be the best course of action, and you can ask your PCP for these referrals.

Mean while, I would suggest that you keep your mind off the swallowing and avoid very cold and very hot beverages as they induce pharyngeal muscle spasms leading to globus. Hot beverages also aggravate reflux.

Avoid alcohol, smoked, salted, barbecued and salted foods specially at dinner time.

Do not over fill your stomach at one point in time, eat smaller portions, chew them well. You can eat more frequently instead.

Sleep with a head up tilt of about 30-45 degrees using a wedge pillow for the purpose.

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Customer: replied 1 year ago.
ok doctor i asked mty docor about the possibilty of a tumor he said no because your stmptoms are not that of a tumor that if it were a tumor they would be more severe and constant. is he correct?
Expert:  Dr Uzair replied 1 year ago.

Yes, he is correct, this does not sound like a tumor.

Let me know if you have further questions.

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Customer: replied 1 year ago.
can you recommend a good anti acidon another note could it be a hiatal hernia?
Expert:  Dr Uzair replied 1 year ago.

Well, a hiatal hernia can mimic symptoms of acid reflux but can only be ruled out either on upper GI contrast studies or endoscopy, so I will not speculate.

You can use anything OTC like "equate antacid", TUMS, Alka-seltzer etc.

They are all good.

Expert:  Dr Uzair replied 1 year ago.

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Expert:  DrRussMD replied 1 year ago.


A hiatal hernia is a situation where the stomach slips in the diaphragm.

This does not mimic acid reflux, it contributes as a cause to acid reflux.

The standard of care in the united states is that if your symptoms are not controlled with your doctors therapy, you need a scope, down to the stomach.

You do not need an ENT doctor and a GI doctor both if this is acid reflux. GI will scope all the way.

If this is post nasal drip causing all of this, then ENT not GI.

We do not treat here, your doctor needs to recommend the ant acid, and in this situation, you need a prescription for a prescription amount of prilosec, zantac or other standard drug.

I am a double board certified US doctor.

Over 20 years taking care of people such as your self.

Please click a positive rating.

Find me as needed.

Customer: replied 1 year ago.
Integrative medicine cures what would that entail
Expert:  DrRussMD replied 1 year ago.

Alternative and complementary medicine.

If you want me to go into this area, please accept the premium services offer.

Otherwise, just finish the current post with a positive rating.