Throat Foreign Body Sensation: Causes and Solutions

Foreign body sensation in the throat?

Since starting fitness training in September of last year, I have begun experiencing difficulty swallowing.
I have visited an otolaryngologist, neurologist, and endocrinologist, and all tests returned normal results.
Eventually, a gastroenterologist performed an endoscopy and identified gastroesophageal reflux disease (GERD).
I am currently undergoing treatment, but the swallowing difficulties persist.
My physical condition has been deteriorating, with symptoms including: shoulder and neck pain, intermittent chills and hot flashes, nausea, loss of appetite, shortness of breath, chest tightness, dizziness, and difficulty swallowing (particularly when trying to swallow food as it reaches the throat).
Traditional Chinese medicine has noted some abnormalities in the epiglottic cartilage, and my throat feels very tight, as if being constricted, with a significant sensation of a foreign body (this sensation becomes more pronounced after exercise, making swallowing even more difficult).
My exercise capacity has decreased significantly, and I sometimes experience generalized weakness and tinnitus.
Most of these symptoms do not occur regularly, but the swallowing difficulties and the sensation of a foreign body in the throat are constant.
I suspect there may be an autonomic nervous system issue, as I have noticed that carrying items exacerbates the sensation of a foreign body in my throat, leading to further swallowing difficulties, followed by the aforementioned symptoms.
I would like to ask the physician: First, could these issues be caused by fitness training? Second, are there any additional diagnostic tests that should be performed? Third, would you recommend seeing a psychiatrist or a psychosomatic specialist?

Zuo, 20~29 year old female. Ask Date: 2024/05/12

Dr. Jiang Junyi reply Neurology

Dear Mr.
Tso,
You mentioned that "difficulty swallowing and a sensation of a foreign body in the throat have persisted," which could be due to cervical nerve compression, brainstem dysfunction, or sympathetic nervous system abnormalities, among other reasons.
It is more likely that there is excessive activation of the sympathetic nervous system, which can manifest in various physical symptoms such as chest tightness, difficulty breathing, palpitations, gastrointestinal discomfort, and gastroesophageal reflux, as well as psychological symptoms like anxiety, mood disturbances, and insomnia.

Autonomic nervous system dysregulation is merely a warning sign, and the most common cause is the accumulation of long-term stress, compounded by insufficient sleep, lack of physical activity, and inadequate rest and relaxation.
Regarding the abnormal sensation while swallowing, if the symptoms progress, you may consider undergoing a fluoroscopic swallow study.
This examination is currently the most clinically valuable dynamic assessment, allowing for observation of the structural and physiological responses of the organs involved during the swallowing process.

I recommend that you consult a neurologist to discuss further evaluation and treatment options.
Thank you for your inquiry, and feel free to reach out for further discussion.
Wishing you good health, peace, and happiness.
Dr.
Jiang, Department of Neurology, Taoyuan Hospital / Hualien Hospital

Reply Date: 2024/05/12

More Info

The sensation of a foreign body in the throat, along with difficulty swallowing, can be quite distressing and may stem from various underlying causes. Given your history of symptoms following your engagement in fitness activities, it is essential to consider both physical and psychological factors that may contribute to your condition.

Firstly, it is possible that your symptoms could be related to the physical strain or changes in your body due to exercise. Intense physical activity can sometimes lead to muscle tension, particularly in the neck and throat area, which may contribute to sensations of tightness or discomfort. Additionally, if you have altered your diet or hydration habits while exercising, this could also impact your gastrointestinal function, potentially exacerbating issues like gastroesophageal reflux disease (GERD), which you have already been diagnosed with. GERD can lead to inflammation in the esophagus, causing sensations of tightness or a lump in the throat (often referred to as "globus sensation").

Your symptoms of neck and shoulder pain, along with feelings of nausea and lack of appetite, could also indicate a more systemic issue. Stress and anxiety, which can be heightened by changes in lifestyle such as starting a new fitness regimen, may contribute to physical symptoms, including those affecting the throat. The autonomic nervous system, which regulates involuntary bodily functions, can be influenced by stress, leading to symptoms such as throat tightness, difficulty swallowing, and even dizziness.

Regarding your questions:
1. Could this be caused by fitness activities? Yes, it is possible. If you have been engaging in exercises that strain your neck or throat, or if you have experienced significant changes in your diet or hydration, these factors could contribute to your symptoms. Additionally, if you have experienced any trauma or strain during workouts, this could also lead to muscle tension and discomfort.

2. What further examinations should be conducted? Since you have already undergone various examinations with normal results, it may be beneficial to consider a few additional assessments. A thorough evaluation by a gastroenterologist to assess the severity of your GERD and its management could be helpful. Furthermore, a consultation with a physical therapist specializing in neck and throat issues may provide insights into any muscular or postural problems contributing to your symptoms. If psychological factors are suspected, a referral to a mental health professional could also be beneficial.

3. Should you see a psychiatrist or psychologist? If you suspect that anxiety or stress may be exacerbating your symptoms, it would be wise to consult with a mental health professional. They can help you explore any underlying psychological issues and provide coping strategies or therapies that may alleviate your physical symptoms.

In summary, your symptoms of throat tightness and swallowing difficulties may be multifactorial, involving both physical and psychological components. It is crucial to address both aspects to find effective relief. Continue to work closely with your healthcare providers, and consider integrating stress management techniques, such as mindfulness or relaxation exercises, into your routine. This holistic approach may help alleviate your symptoms and improve your overall well-being.

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