Feeling of a lump in the throat: thoughts of a radiologist.

Radiological examination of over 300 patients complaining of feeling a lump in the throat and difficulty in swallowing, but in whom there was no visible lump, showed that in most cases there was no significant abnormality above the thoracic inlet. Oesophageal examination revealed no abnormality in one-third; definite gastric reflux with or without hiatus hernia in one-third; and impaired clearance of fluid in the horizontal position in the remainder. Reflux and impaired clearance were either seen spontaneously or were induced after the ingestion of hydrochloric acid of the same pH as gastric juice.