Globus pharyngeus: radiographic evaluation and 24-hour pH monitoring of the pharynx and esophagus in 22 patients.

Abstract

Most patients with globus pharyngeus had normal results at pH monitoring and radiographic examination of the pharynx.

Role of salivary function in patients with globus pharyngeus

“…The subjective symptoms were determined using the following 8 items: (1) a parched feeling in the mouth, (2) stickiness in the mouth, (3) strong desire to drink (thirst), (4) pain in the oral cavity, (5) taste abnormality, (6) speech impairment, (7) difficulty in mastication, and (8) difficulty in swallowing. The physical findings were determined using the following 9 items: (1) dryness of the mucosa in the oral cavity, (2) redness of the mucosa in the oral cavity, (3) ulcer of the oral cavity, (4) coating of the tongue surface, (5) smoothing of the tongue surface, (6) wrinkles and creases on the tongue surface, (7) cracks on the tongue surface, (8) redness of the mucosa in the oropharynx, and (9) dryness of the mucosa in the oropharynx. Each item was scored semiquantitatively from 0 (no complaints) to 3 (severe discomfort or findings).…”

“…7 The mechanisms proposed to explain laryngopharyngeal reflux and the resultant globus sensation include direct inflammation of the pharynx, referred discomfort from the esophagus due to reflux esophagitis, and reflex hypertonicity of the upper esophageal sphincter. 8 In addition, many other conditions that cause irritation and inflammation of the pharynx, such as tonsillitis or chronic sinusitis with postnasal drip, are considered to be related to globus sensation. 2 A hypertensive upper esophageal sphincter, esophageal dysmotility, hiatal hernia, local anatomical abnormalities, and psychological problems such as stress, anxiety, or depression are also thought to be factors that can trigger the onset of globus.…”

Clinical and Radiologic Evaluation Reveals High Prevalence of Abnormalities in Young Adults with Dysphagia

“…An association between globus sensation and cricopharyngeal dysfunction has been claimed [16,17]; this relation was not found in this series. Another suggested etiology has been esophageal reflux disease, which we also found in some of our patients [18,19]. We only included gastroesophageal reflux disease as a cause of the patient's symptom if pH monitoring was positive or if the patient became asymptomatic on H 2 -blockers.…”

“…The relationship among globus pharyngeus, reflux disease, or psychological factors has been debated [18]. Only in 2 patients was globus the only symptom.…”

Empirical Trials in Treatment of Gastroesophageal Reflux Disease

“…Although association between GERD and various oropharyngeal, laryngeal and pulmonary disorders has been documented, proving causality in many cases has been a more difficult task [25,[38][39][40][41]. However, in these patients the PPI empirical trial may be helpful.…”