[42F] Experiencing globus and menthol-like sensations

Patient Description

A 42-year-old female reports a persistent globus sensation at the base of the throat, particularly pronounced when swallowing, especially during the consumption of hard foods. The patient rates this dull sensation as a 4 out of 10 in severity. Additionally, she experiences a menthol-like sensation in her chest, nose, and throat, which has been ongoing for two weeks. There is no associated chest pain, heartburn, regurgitation, voice changes, persistent cough, unintentional weight loss, or bleeding from the throat. The patient has no known allergies or history of acid reflux/GERD and is currently taking Stelara (ustekinumab) every 84 days at a dosage of .45 mg per syringe. No other medications, over-the-counter drugs, or supplements are being taken. There is no past medical history of chronic illnesses or conditions reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Gastroesophageal Reflux Disease (GERD): Although you don't report classic symptoms like heartburn or regurgitation, GERD can sometimes present with atypical symptoms like a lump in the throat (globus sensation) and unusual sensations in the chest and throat. GERD occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.

    • Treatment typically involves lifestyle modifications (like avoiding certain foods, not eating before bed) and over-the-counter or prescription medications to reduce stomach acid.
  • Postnasal Drip: This is when excess mucus from your nose goes down the back of your throat. It can cause a globus sensation and unusual sensations in the throat and chest. It can be caused by a variety of conditions, including allergies, sinus infections, or changes in weather.

    • Treatment depends on the cause but can include antihistamines, decongestants, or nasal sprays.
  • Side effects of Stelara (Ustekinumab): Uncommon side effects of this medication can include throat irritation or discomfort. However, the menthol sensation you're describing is not a typical side effect.

    • If you suspect your symptoms are due to your medication, it's important to discuss this with your doctor. Do not stop taking your medication without consulting your healthcare provider.

What you can do

While you should definitely seek care from a healthcare professional for a formal diagnosis and treatment, here are some things you can do in the meantime:

  1. Keep a symptom diary: Note when your symptoms occur, what you're doing at the time, and what foods you've eaten. This can help identify patterns or triggers.
  2. Try over-the-counter remedies: For possible GERD, you could try antacids. For postnasal drip, a decongestant or antihistamine might help. Always make sure to read the package instructions.
  3. Stay hydrated: Drinking plenty of fluids can help soothe an irritated throat.

What you should look out for

Please seek immediate medical attention if you experience:

  • Difficulty breathing or swallowing
  • Severe throat pain
  • Symptoms that are progressively worsening or not improving over time
  • Any other symptoms that are concerning to you

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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9 mo ago


People Also Ask


What is a globus sensation and what causes it?

A globus sensation is the feeling of having a lump or foreign body in the throat. It can be caused by various factors, including stress, GERD, or postnasal drip.


Can GERD occur without typical symptoms like heartburn?

Yes, GERD can present with atypical symptoms such as a globus sensation, throat irritation, or a menthol-like sensation in the chest and throat, even in the absence of heartburn or regurgitation.


What are the potential side effects of Stelara (ustekinumab)?

Common side effects of Stelara include upper respiratory infections, headache, and fatigue. Throat irritation is less common, and the menthol sensation described is not typical. It's important to discuss any unusual symptoms with a healthcare provider.


How can postnasal drip be managed or treated?

Postnasal drip can be managed by treating the underlying cause, such as allergies or sinus infections. Over-the-counter antihistamines, decongestants, or nasal sprays may help alleviate symptoms. Staying hydrated and using a humidifier can also be beneficial.


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