globus hystericas?

cindyrloJune 5, 2010

hi ive been experiencing the same symptoms mentioned above. im glad to hear im not alone. i was beginning to wonder if i had ee or achalasia. my speech patho suggested globus hystericas and several mds suggested it could be psychological. i refused the anti anxiety medication; however, would rather try therapist and learn relaxation tech. im beginning to believe it might be stress related. an egd was done gerd, hpylori and gastritis were found and treated, but still lump in my throat. a barrium swallow was fine also. i hope thats all it is and to be patient with myself. thanks for all of your postings. they were very helpful.

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I am in fine health after quite a topsy-turvy year last year. Not quite sure what the impetus was for the globus, but I was diagnosed with LPR, a funky acid reflux that shoots up to the throat and causes the sensation of a lump. It also is responsible for a very thick mucus that I need to clear each morning,but I have learned to live with that. I have seen two different Ear Nose and Throat doctors and they each prescribed the same treatment...proton pump imhibitors. I tried the diet route, but that just wasn't working although I did lose almost 30 lbs in 3 months because I was feeling so anxious. After a year I finally am down to one 40mg pill per day..i had been taking it twice a day (20 mg twice, that is).

I have gotten panic attacks for over 30 years...not constant, but at least one a month, sometimes more if there is a particular stressor. And I had experienced constant anxiety at one other time in my life that lasted 3 months and that was the worst. Last year after the globus incident, I was swept into a panic/anxiety wave that didn't let up for again 3 months. Along with this came health anxiety, which completely preoccupied my mind with fear of my health. After extensive consults with my GP, a therapist, and a psychiatrist, I agreed to go on a low dose of Lexapro which immediately relieved the circular thoughts on my health. I was opposed to meds, but could no longer see a way to fix this myself having gone to a Naturopathic doctor, done sleep and anxiety CDs to lull me to sleep as I was also waking at 2PM and 4PM each night and hardly getting any good sleep.

Now here's the kicker. I went to a new GYN in late June last year for a minor problem and she informed me that I had several very large fibroids which was surprising since I had my annual exam with my previous doctor that January. There was cause for concern because the assumption was that they grew very large, very fast. Over the course of June I started having a good deal of pain, and after consulting with a gyn oncology surgeon, I was schedule for surgery July 14. I ultimately had the surgery earlier on an emergency basis because one of the fibroids was necrotic (dying) which landed me in the ER twice. The second time they did they surgery which included removing my uterus (they kept my ovaries because they were fine and I didn't need to be thrust into menopause). Three days after being released I was back in the hospital for 5 days with an infection. After healing for 2 months, I was back to work and although I still have the LPR, I have no other anxiety. I am even down to 5mg of Lexapro, whichis considered a sub-clinical dose.

So, in retrospect, I feel that the fibroids had something to do with my anxiety and all that craziness. I think my body was fighting something and it brought out the big guns to fight it.

I am taking this time to answer your email, knowing nothing about who you are and how you might use this information, but knowing that I was in a bad place last year and would have been appreciative of someone taking the time to talk to me to help me understand how they survived the ordeal.

My best to you and I hope perhaps some of this information is helpful to you.


    Bookmark   June 6, 2010 at 12:41PM
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Thank you so much for taking the time to comment, i truly appreciated your posting. My doctor has prescribed lexapro 10 mg but i just feel so unsure about it, but am worried about the wt loss. I think i need to work on the mind. I am working on my spirituality in order to have mind and spirit all working together. I have had a very stressful event occur in my life recently, change is not easy for any of us. I guess what my mind can control is what goes in my body. Yes i have experienced the preocupation with my health also. i feel that im stuck and cant move. It was so severe that anything that would come near my face would freak me out. I had fear of everything. It was soooo bad. I had never experienced this in my whole entire life. I would just pray it away, read the bible and attended church as if to literally save my life, and so far it is.

Im so tired of hearing people say how much wt ive lost or stare. omg no one is as stressed out about it as i am. well i was told that i had gerd that gave me the sensation of something in my throat also. idk sometimes i get the impression md's are just as baffled as we are about things. lol

Again thank you so much for sharing your experience with me. cynthia

    Bookmark   June 6, 2010 at 10:16PM
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i have a question. what did your diet consist of? since eating is quite difficult.


    Bookmark   June 8, 2010 at 10:00PM
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I was actually too anxiety ridden to eat much but basically followed a low acid diet. I recall that I ate lots of fresh baby spinach - uncooked, in salads with just olive oil and lemon juice (yes you head that right...lemons are one of the most alkaline things on the planet) and wild salmon patties that I get at Costco. I had a hard time eating and drinking initially because I was so afraid. everything went down crooked and felt dry. Even water caused odd feelings in my esophagus. That did go away once my anxiety lessed, though.

I must have gone to the ENT 3 times in two months (after the FEES test that diagnosed the LPR)just so he could scope my throat and assure me nothing was wrong. He understood. the sensation makes one crazy.

Cindy, this was a very, very troubling time for me. I got help from a number of professionals, including a therapist specializing in anxiety and panic attacks. I also had good friends and family who understood my pain and helped me with their support. They were very concerned because this wasnt me.

I was absolutely against any medications, having been on an AD once before for 4 years following a death in the family and it was very difficult coming off it. I actually should never have been on it. we learn so much in retrospect, but hopefully it makes us wiser. that's part of the reason for my opposition.

It wasnt until I realized that diet and relaxation techniques, even several trips to the naturopathic doctor for supplements to help my body help itself, wasnt going to rid me of the anxiety...oh and the depression that started setting in.

I remember the visit to the psychiatrist, I think it was the third visit, where I realized that I couldn't do it myself...and needed to try the meds. I had been so opposed to it, feeling that I just couldnt take that step.
He didn't push it, but rather brought me to the decision myself. I was so sick with the thought of it, but knew I had no other options. It was that or lose myself in this.

I cannot tell you the relief I felt when the health anxiety disappeared...overnight. Some say it was mind over matter because the drugs dont work that fast, but I know what I know...and only 5mg, my starting dose, brought me instant relief. And the constant state of anxiety dissipated too. that was the toughest part as I said in my earlier email.

Mind you, I had every test imaginable, blood work up the ying yang that my doctor ordered at the request of the naturopath (they arent licensed as primary care physicians in NY State). They took 8 vials of blood for those tests!

One thing I forgot to mention was that I developed severe hives during this time. One day they just started on my chest...that was just the beginning. My sister happened to be over, and she gave me a benedryl. I went for allergy allergies. I had every blood test imaginable (see above)...nothing unusual. One day I got hives over my entire body...the hives had hives. I called the allergist and went right away and he watched as they popped up on my back, chest, arms, you name it.

Dont struggle needlessly. There is nothing wrong with trying the meds. It doesn't mean youve failed. Its a tool to help you get back your life. I tried everything I could, but I knew when it was time to give my body a break.

Start slow...5mg and give it a couple of weeks (as longas the Dr. advises that too). I felt I needed something that would take off the edge just enough so that I could function. Going to work was difficult but I did it every day. Once I started the meds, I continued with my therapy, learning how to respond to the panic attacks and arming myself for the future. I didn't just let the meds do the work, i worked at it too.

I did go up to 10mg, but now, a year later, I no longer have fear of reverting back plus the 10mg just started making me very tired, so I dialed it back and that went away. I guess my body accepted the meds when I really needed them, and started telling me when it no longer was necessary.

I hope some of this helps.

    Bookmark   June 9, 2010 at 11:38PM
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hi sue, thanks for your insightful information. i truly appreciate your time and patience. i will consider the lexapro thank you.

i saw the gi md today and he recommended a medication called motilium only found in canada and mexico, in other words anywhere but usa, since it has not been approved by fda. he said my esophagus might need a jump start, since ive been on fluids for about 2 mo. i hope thats all it is and not that i have something more serious going on.
please let me know if youve heard of motilium. i was rather dissapointed by gi md because i asked when will i get back to myself, such as eating without the cardbard stuck in my throat? he just said it was normal physiology. well that is bull crap! i dont believe that! im 40 yrs old this is not normal physiology for someone my age. it would be for an 80 yr old lady but not for someone my age! i was sooooo dissapointed i want a second opinion. i dont believe he answered my question. i want an explanation that makes sense.

sue i also experienced the hives, but i had just started antibiotic, md and i assumed it was due to the medication, so discontinued it and now i have an known allergy to a certain antibiotic omg. im beginning to wonder if it was stress related. nah, they went away as soon as i stopped the meds.

i will start a anxiety therapy session on saturday. i really hope it helps me and i will make her aware about the lexapro issue.

so did you have any physical therapy to assist with swallowing exercises etc? i wonder if it is a muscular issue. i just dont know what to think anymore. i just want to be normal.

sue seriously the rubber ball sensation in your throat went away after the lexapro? well im getting to that point already. yes, i want my life back.

Again, sue thanks a million for all of your helpful information.


    Bookmark   June 10, 2010 at 10:08PM
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I haven't heard of motilium. I can't say that the sensation went away with Lexapro, I think it might have lessened before that.

I checked out this site which helped me understand what was happening.

I did not have physical therapy for swallowing. I was somewhat relieved to see the video from the FEEST test which showed no abnormalities and from the endoscopy which lessened my anxiety (to a small extent) so I continued eating sparingly until all my different therapies started working.

What I hear when you are typing is a great deal of anxiety, and I feel for you because I was there last year and it is the WORST.

See how the therapy goes but consider Lexapro if thats what they recommend. Maybe its not for you, but there are many different meds out there and a good psychiatrist will find the right one for you. I was sorry I waited so long to try the meds. Then I swore I;d never come off them...Now I have my life back with a sub-clinical dose that I might discontinue althogether in the coming months...that's how good I feel. I have my life back. it took a while but I did. You can too. There is help out there in many forms...take advantage of all of them.

Oh and if you feel the need for a second opinion, find an esophageal specialist. If you are near NYC, I have one I can recommend.

    Bookmark   June 12, 2010 at 1:37PM
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sue, thank you for answering my blog questions. i hope i find you and your family in good health. yes i guess i do have alot of anxiety. im scheduled to see a psychologist soon and i guess we can discuss anxiety medication if she still thinks i need it when i consult her. i have come along way but my main concern right now is the inability to eat like i used to. i wonder if that day will ever come. i dont think there is an esophageal specialist where im from. however thank you for the suggestion. The GI specialist that i recently saw really didnt have much to say about why my food is going slowly down my esophagus and just recommmended motilium. im afraid it might be achalasia or some other neurological disorder. i hope and pray that it isnt. i have consulted another gi md for a 2nd opinion. well the fact that you and alot of the other bloggers posted that it did take from 3,6 to 1 yr for symptoms to resolve was comforting for me. However, i still need to cover all my bases. i guess i need reasurance that im ok and that its only globus hystericas. i have consulted dietician, she gave me info on kcalories to intake, hospital cafeteria is pureeing food for me, and i gained 1 lb in a week. yay
thank you very much for all of your help. sincerely your friend cynthia

    Bookmark   June 15, 2010 at 10:10PM
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I forgot to mention that my dad has esophageal motility issues due to an abnormality and Barrett's syndrome. He has had his lower esophagus dilated and botoxed. He also has acid reflux. He just had open-heart surgery and the meds, trauma, and sedation techniques worsened his esophageal symptoms initially, but he is much better now.

He sometimes has problems getting the food down but chews his food well and eats slowly. Sometimes (gag alert) he gets liquid back up but that doesn't happen all the time.

I am telling you this not to scare you, but to let you know what can occur with motility issues - which may or may not be happening to you.

He has been seeing a GI doctor specializing in esophageal issues You are wise to get a definitive diagnosis of the issue, and sounds like you are covering all bases including anxiety therapy. It's an unpleasant road, but you WILL be ok. It just takes time.

All the best,

    Bookmark   June 16, 2010 at 11:23AM
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sue, i hope all is well with you. thank you for responding and for your reasuring words of encouragement.

omg and how is your dad doing such as eating and etc? how is he spirit wise? is he coping ok? i hope so.
sue what originally happened to me, which lead to all of this is that i accidentally swallowed a piece of broccolli and didnt pass it until the next day, but meanwhile my esophagus was going through major spasms, then acid refulx and then major gastritis. my previous md did nothing for me so i got another primary md, she ordered prevacid for me, which was a lifesaver. Then i had a barrium and an egd (hpylori, gerd, and gastritis) which biopsy showed negative for cancer, etc. the acid was refluxing so severe that i was sob due to acid irritating my lungs and my throat was so inflammed. i was barely able to swallow watered down ensure ok?

Unfortunately all of this occured while i was beginning to experience teenage problems. so it could be an anxiety thing but i need to make sure that is the case.

well im scheduled for a full barrium, then an esophageal manometry (to measure pressure of esophagus). i think that once all that is covered might be reasurance for me that im ok, because it doesnt feel like it for now.

sometimes i think ok just give yourself time, but then i think what if so and so. well, all i can do is pray for strength to deal with whatever is coming my way. i didnt think that i could ever live without my children and i am so far.

    Bookmark   June 16, 2010 at 8:38PM
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My dad is doing well mentally and physically.

He got past the tough part of spasms and regurg, which were terrible after his heart surgery. He does have bad reflux so its all interconnected with his motility and malformations.

The acid coming up into the throat and spilling into the lungs is typically diagnosed as LPR (Laryngopharyngeal reflux), which is what I have. Nexium 40mg once per day is keeping it under changes had no affect. I had a FEEST test to diagnose that.

I was on Omeprazole 40mg twice a day initially, but had a negative side effect that made the thought of food repulsive (I guess that's the anorexic side effect). I'm an eater so that scared the heck out of me and I stopped it immediately...was losing too much weight as it was with my curtailed eating and anxiety.

BTW, I had reassurance up the kazoo but it didn't stop my health anxiety - a whole new thing for me. That train had already left the station and I needed to attack it separately and very aggressively.

You might also want to consider a naturopathic Dr. in conjuction with your primary MD. They look at things holistically and recommend supplements that help your body help itself.

If you're entering peri-menopause, then perhaps consider the impact that is having on you as well. That's a whole 'nother train wreck.

That and my fibroids might have been behind my circus last year.


    Bookmark   June 17, 2010 at 1:55PM
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hi sue,
well im glad to hear your dad is doing better.

ok i was wondering about the omeprazole. i tried prevacid, but recently tried the nexium and that works wonderfully. how long have you been on it? Are you worried about the bone fracture risk with long term use?

thanks for the tip about seeing a naturopathic md. im scheduled to see a pshycologist on saturday. we'll see how that goes. i hope well.

how are you doing? i hope all is well. take care, and thank you for all of your helpful advise. sue, you have helped me so much. im so grateful for all of your helpful information. i hope i can do the same for somebody else someday.

godspeed, cynthia

    Bookmark   June 17, 2010 at 9:09PM
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I have been on Nexium for over a year. I started at 2x20mg daily, but am not on 40mg, once daily. I am not concerned abot long-term affects because I don't plan on being on it forever. I am losing weight and hope that when I am down to my goal I will no longer need it. In the interim, I am going to see if 20mg 1x daily will be good.

If reaching my goal weight doesn't eliminate the problem, then I will have to figure out my next step. I skipped a few days last week and my throat started getting sore so I knew it wasn't yet time to come off it.

All the best to you. email me any time.


    Bookmark   June 19, 2010 at 5:44PM
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hi sue how are you doing? i just wanted to share something with you i have recently tried the kengan water (alkaline water). it worked immediately. i hope i can stop with the nexium asap. please try it. i just wanted to share this with you. ps the rubber ball is gone.
take care, cynthia

    Bookmark   July 4, 2010 at 1:26PM
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