What is the cause of a globus sensation in the retrosternal area?

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Differential Diagnosis for Globes Sensation in Retrosternal Area

  • Single most likely diagnosis
    • Gastroesophageal reflux disease (GERD): This condition is characterized by the backflow of stomach acid into the esophagus, which can cause a sensation of a lump or globus in the retrosternal area. The symptoms are often exacerbated by lying down or eating certain foods.
  • Other Likely diagnoses
    • Esophageal spasm: This condition involves abnormal muscle contractions of the esophagus, which can cause chest pain and a sensation of a lump in the throat or retrosternal area.
    • Esophagitis: Inflammation of the esophagus, often caused by acid reflux, can lead to symptoms such as difficulty swallowing, chest pain, and a globus sensation.
    • Anxiety or stress: High levels of anxiety or stress can cause muscle tension in the throat and chest, leading to a sensation of a lump or globus in the retrosternal area.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Esophageal cancer: Although rare, esophageal cancer can cause a sensation of a lump or globus in the retrosternal area, especially if the tumor is located in the upper or middle part of the esophagus.
    • Cardiac conditions (e.g., myocardial infarction, angina): Chest pain or discomfort can sometimes be referred to the retrosternal area and may be accompanied by a sensation of a lump or globus.
  • Rare diagnoses
    • Esophageal ring or web: A narrowing of the esophagus caused by a ring or web of tissue can lead to difficulty swallowing and a sensation of a lump in the retrosternal area.
    • Zenker's diverticulum: A rare condition where a pouch forms in the upper part of the esophagus, which can cause symptoms such as difficulty swallowing, regurgitation of food, and a globus sensation.
    • Thyroid enlargement or goiter: An enlarged thyroid gland can put pressure on the esophagus and trachea, leading to a sensation of a lump in the throat or retrosternal area.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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