DEAR DR. ROACH: I was recently diagnosed with diabetes and immediately changed my diet and exercise regimen. I was able to lose 17 pounds in about two months but have started to experience a feeling of something being stuck in my throat. Could the sudden weight loss have brought this on? I was sent to get an ultrasound on my thyroid, and it came back negative.

— V.J.

ANSWER: A sensation of something stuck in the throat is common in clinical practice and can have many causes. It is referred to as a “globus” sensation. An ultrasound is a very reasonable test as a large thyroid mass (goiter) can cause a mechanical effect on the esophagus, leading to this sensation. Similarly, abnormalities in the esophagus, oropharynx and larynx may also lead to this sensation. Most experts recommend an evaluation with an endoscopy and a laryngoscopy for people with a persistent globus sensation.

Unintentional weight loss is a red flag in people with a globus sensation because if the cause behind the globus sensation is also leading people to lose weight, this means that it is more likely to be something serious. But this is not the case with you, so I can’t think of how losing weight could have been the cause behind your globus sensation.

If the sensation of something in your throat continues, I recommend further evaluation by an ENT physician.

DEAR DR. ROACH: My in-laws are being evaluated for infertility, and my brother-in-law has a varicocele. They say that he needs an operation. Is this necessary in order for them to have children?

— C.F.

ANSWER: A varicocele is a common enlargement of the veins in the male scrotum. There is some evidence that a large varicocele could reduce fertility in men. However, the repair of a varicocele is usually indicated for fertility only when both the varicocele is large and the man has an abnormal semen analysis.

The benefit in fertility is thought to be small; it is estimated that 17 men need to be operated on to produce one pregnancy, so there’s roughly a 6% chance that the operation will help the couple conceive.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.