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Lumps in throats

Hey Matt:

Right when we had the jolt from the last earthquake, I actually got a lump in my throat. I know that can happen when one is stressed or scared, but what causes that "lump" and why did it take hours to go away?

-- Twisting and Shouting in La Jolla

According to our old pal and Alice Institute staff quack, Dr. Doctor, some people are lumpy for days, weeks, months. A few hours isn't so strange. After that, he was a little short on facts, as usual. Medicine's still trying to figure out what to call it. "Globus syndrome" is one popular choice, but there's also "globus sensation" and the more traditional, pie-in-the-face diagnosis, "globus hystericus." The significant point is that there is no actual lump; it's just the feeling that you've swallowed a rock. Most people experience it when they suppress the urge to cry, but people with chronic anxiety disorders can have the sensation continually.

The best physiological explanation we could wheedle out of Doc Doc has to do with the autonomic nervous system's stress response, which involves opening the glottis muscle (a throat muscle, above the larynx) to help increase air volume into the lungs. (Stress generally raises our heart rates and makes greater demands for oxygen, a holdover from the days when we had to be ready to flee from the club-wielding guy in the cave next door rather than spammers and telemarketers.) At the same time, the glottis has to close when we swallow so we don't get smoothies and cupcakes in our airway. So in a stressful situation, our throats are very confused. The result is the tension-filled "lump." It usually goes away once we calm down, so I guess you were more freaked by the shaker than you thought. And of course, I'm not a doctor, and Dr. Doctor is barely a doctor, but our lawyers are definitely lawyers. Real, prolonged throat lumps could be serious, so go see a real physician.

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Hey Matt:

Right when we had the jolt from the last earthquake, I actually got a lump in my throat. I know that can happen when one is stressed or scared, but what causes that "lump" and why did it take hours to go away?

-- Twisting and Shouting in La Jolla

According to our old pal and Alice Institute staff quack, Dr. Doctor, some people are lumpy for days, weeks, months. A few hours isn't so strange. After that, he was a little short on facts, as usual. Medicine's still trying to figure out what to call it. "Globus syndrome" is one popular choice, but there's also "globus sensation" and the more traditional, pie-in-the-face diagnosis, "globus hystericus." The significant point is that there is no actual lump; it's just the feeling that you've swallowed a rock. Most people experience it when they suppress the urge to cry, but people with chronic anxiety disorders can have the sensation continually.

The best physiological explanation we could wheedle out of Doc Doc has to do with the autonomic nervous system's stress response, which involves opening the glottis muscle (a throat muscle, above the larynx) to help increase air volume into the lungs. (Stress generally raises our heart rates and makes greater demands for oxygen, a holdover from the days when we had to be ready to flee from the club-wielding guy in the cave next door rather than spammers and telemarketers.) At the same time, the glottis has to close when we swallow so we don't get smoothies and cupcakes in our airway. So in a stressful situation, our throats are very confused. The result is the tension-filled "lump." It usually goes away once we calm down, so I guess you were more freaked by the shaker than you thought. And of course, I'm not a doctor, and Dr. Doctor is barely a doctor, but our lawyers are definitely lawyers. Real, prolonged throat lumps could be serious, so go see a real physician.

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