Why do I feel a lump in my throat and nausea in the mornings?Ear, Nose & Throat Gastroenterology
I'm a 19 year old female, and I almost constantly have feelings of nausea and even vomiting in the morning. I also realised it intensifies if I feel stressed or nervous. However, a few hours into the day or after having lunch, the feeling subsides.
The feeling of a lump in the throat is a symptom medically known as a globus sensation. This is often a symptom encountered in patients with:
1. Postnasal drip
Postnasal drip refers to mucous flowing down the throat from your nose and sinuses. As the voice box is a very sensitive organ. Irritation of the voice box from mucous from the nose and sinuses can cause it to be inflamed (swollen), resulting in a feeling of something stuck in the throat. The two most common reason for this are Rhinitis (Sensitive nose) and Sinusitis (Infection of the sinuses). Patients with Rhinitis typically experience runny nose, sneezing, blocked nose, postnasal drip, itchy nose and itchy eyes.
Treatment includes allergen avoidance, nasal steroid sprays and antihistamines. Patients with sinusitis typically experience coloured nasal discharge (yellow, green, brown etc), blocked nose, facial pain, postnasal drip and reduced or loss of sense of smell. Treatment includes a course of oral antibiotics, nasal wash and nasal steroid spray. By reducing postnasal drip, the voice box will be less inflamed and the globus sensation may recover with time.
2. Laryngopharyngeal reflux
This refers to backflow of acid content from the stomach up to the level of the voice box. Common symptoms include feeling of a lump in the throat, sore throat, cough, frequent throat clearing and hoarse voice. The voice box can be swollen from the acid content of the stomach, resulting in the symptoms in the throat. Treatment includes lifestyle modifications (E.g. reducing acid-reflux triggering food, not eating and drinking at least 3 hours before lying down or sleeping, taking small meals etc) and medications to reduce acid in the stomach.
3. Stress and anxiety
Stress and anxiety can cause many different symptoms in our body and a feeling of a lump in the throat is one of them. This usually occurs due to tightening of the muscles in the voice box and throat region. From the clinical history that you provided, this may be the most likely reason for your symptom.
The first two conditions mentioned above does not usually cause nausea or vomiting. Hence, I would suggest that you visit a general practitioner first to help determine the likely cause of your symptoms and if necessary, refer you to the appropriate specialist.
Hope this helps and all the best!
Dr Gan Eng Cern
MBBS, MRCS, MMed, FAMS
38 Irrawaddy Road #08-45
Mount Elizabeth Novena Specialist Centre
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