Differential Diagnosis for Sensation of Something Stuck in the Throat and Pain on Swallowing
- Single Most Likely Diagnosis
- Globus pharyngeus: This condition is characterized by a persistent sensation of having something stuck in the throat, often without an actual physical obstruction. It's a common complaint and can be related to stress, anxiety, or gastroesophageal reflux disease (GERD), although the patient in question has been ruled out for GERD.
- Other Likely Diagnoses
- Esophagitis: Inflammation of the esophagus, which can cause pain on swallowing (odynophagia) and a sensation of something being stuck. This could be due to various causes, including infections, allergies, or chemical injuries.
- Esophageal spasm: Abnormal contractions of the esophagus can cause chest pain and difficulty swallowing, sometimes feeling like something is stuck.
- Pharyngitis: Inflammation of the pharynx, often due to viral or bacterial infections, can cause sore throat, pain on swallowing, and potentially a sensation of obstruction.
- Do Not Miss Diagnoses
- Esophageal cancer: Although less common, it's crucial to consider, especially in older adults or those with a history of smoking or alcohol use. Symptoms can include progressive difficulty swallowing (dysphagia) and pain.
- Foreign body obstruction: Especially in children or adults with altered mental status, a physical object could be lodged in the throat or esophagus, causing the sensation of something being stuck and pain.
- Epiglottitis: A potentially life-threatening condition involving inflammation of the epiglottis, which can cause severe pain on swallowing and a sensation of obstruction. It requires immediate medical attention.
- Rare Diagnoses
- Eosinophilic esophagitis: A chronic immune system disease in which a type of white blood cell, the eosinophil, builds up in the esophagus in response to an allergen or irritant, leading to difficulty swallowing and food getting stuck.
- Zenker's diverticulum: A condition where a pouch forms in the pharynx, which can trap food and cause symptoms of obstruction and dysphagia.
- Oropharyngeal or hypopharyngeal tumors: Although rare, these can cause a sensation of something being stuck in the throat and pain on swallowing, among other symptoms.