Globus/ FOSSIT

Borders Ref Help Toolkit
NHS Borders

Globus is the painless sensation of a lump in the throat in the midline and may be described as a foreign body sensation, a tightening or choking feeling.

On its own It is nearly always benign.

Who to refer, who not to refer, how to refer

Refer urgently if associated with:

  • Dysphagia
  • Hoarseness > 3 weeks
  • Neck mass
  • Progressive or unilateral symptoms > 3 weeks
  • Voice change
  • High risk patient, ie heavy smoker and 40+yrs
  • Unexplained weight loss

 

Refer routinely if patient reassurance is required.

These patients will put on a nationally developed opt in pathway where they will be sent information on globus and then given a phone number to call should they want to arrange a face to face appointment.

 

How to Refer:

Via SCI Gateway, please note different proformas for urgent and routine referrals:

BGH -> Ear, Nose & Throat (ENT) -> B ENT – General Referral

Or

BGH -> Ear, Nose & Throat (ENT) -> B ENT – Urgent

Primary care management

  1. Reassurance that there is no underlying disease
  2. Psychological support – management of stress
  3. Vocal hygiene advice
    1. Encourage hydration
    2. Reduce caffeine, alcohol and late night eating
    3. Advise to stop smoking and fizzy drinks
    4. Avoid throat clearing/dry swallowing

Resources and links

Globus patient information sheet.pdf

Local service details

ENT@borders.scot.nhs.uk

Editorial Information

Last reviewed: 18/09/2025

Next review date: 18/09/2027

Author(s): Esmond Carr.

Author email(s): Esmond.carr@borders.scot.nhs.uk.