Association of a globus sensation with esophageal diseases

Nagano, Hikaru; Yoshifuku, Kousuke; Kurono, Yuichi

doi:10.1016/j.anl.2009.06.004

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…For example, a large postal survey of UK ENT consultants, conducted in 2000 5 to investigate the management of globus, showed that 61 per cent would investigate with rigid endoscopy, while 17.5 per cent would investigate with both barium swallow and rigid endoscopy. Published studies and reviews on this topic focus predominantly on the investigation and management of globus, yet they continue to be divided in their conclusions, on the one hand adopting a ‘reassurance' approach for normal out-patient examinations, 6 while on the other hand dispensing warnings about potential occult oesophageal malignancy in such patients 7 . A 2006 review 8 of the benefits of rigid endoscopy in patients with globus, assessing a similar population number to our own study, concluded that rigid endoscopy may well be an inappropriate investigation for such patients.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of flexible nasoendoscopic and rigid endoscopic examination for patients with upper aerodigestive tract symptoms

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Comparative study of flexible nasoendoscopic and rigid endoscopic examination for patients with upper aerodigestive tract symptoms

et al. 2013

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“…62.7% of the patients were found to have pathology that could possibly have caused their globus though no sinister pathology was noted. Similarly, Nagano et al [29] in their study found a 36.5% incidence of benign oesophageal pathology in patients with globus on flexible endoscopy, but again no malignancies were identified.…”

Section: Investigationmentioning

confidence: 68%

Management of Globus Pharyngeus

Kortequee

Karkos

Atkinson

et al. 2013

International Journal of Otolaryngology

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Globus pharyngeus is a common ENT condition. This paper reviews the current evidence on globus and gives a rational guide to the management of patients with globus. The aetiology of globus is still unclear though most ENT surgeons believe that reflux whether acidic or not plays a significant role. Though proton pump inhibitors are used extensively in practice, there is little evidence to support their efficacy. Most patients with globus can be discharged after simple office investigations. The role of pepsin-induced laryngeal injury is an exciting concept that needs further study. Given the benign nature of globus pharyngeus, in most cases, reassurance rather than treatment or extensive investigation with rigid oesophagoscopy or contrast swallows is all that is needed. We need more research into the aetiology of globus.

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“…A recent study by Nagano et al (14) showed that 36.5% of patients with globus sensation had esophageal diseases in the absence of an aberrant otorhinolaryngological region, which suggests that consideration of esophageal disorders is important in patients with globus sensation without laryngeal and hypopharyngeal findings. In our study (15), among the 350 patients complaining of globus sensation, 13 patients (3.7%) had endoscopic evidence of organic disease, including 10 patients with esophageal cancer, 2 patients with pharyngeal cancer, and 1 patient with Zenker's diverticulum (Fig.…”

Section: Potential Causes Of Globus Sensationmentioning

confidence: 99%

Pathophysiology and treatment of patients with globus sensation —from the viewpoint of esophageal motility dysfunction—

Manabe

Tsutsui

Kusunoki

et al. 2014

J. Smooth Muscle Res.

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"Globus sensation" is often described as the sensation of a lump in the throat associated with dry swallowing or the need for dry swallowing, which disappears completely during eating or drinking and for which no organic cause can be established. Due to the uncertain etiology of "globus sensation", it remains difficult to establish standard treatment strategies for affected patients. Lately most attention has been focused on gastroesophageal reflux disease and several reports have indicated that there is a close relationship between esophageal acid reflux and globus sensation. Nowadays, empirical therapy with a high dose of a proton pump inhibitor (PPI) is considered to be indicated for patients with globus sensation, after excluding organic diseases such as pharyngeal cancer, Zenker's diverticulum, or thyroid enlargement. If patients are nonresponsive to PPI therapy, evaluation of esophageal motility should be done. In our recent study, 47.9% had abnormal esophageal motility, with the most common esophageal motility abnormality being an ineffective esophageal motility in PPI-resistant patients with globus sensation. This suggests that prokinetics alone or adding prokinetics to PPI should be the treatment to be considered, although few studies have investigated the efficacy of prokinetics in the treatment of patients with globus sensation. If patients without any esophageal motility dysfunctions are nonresponsive to PPI therapy, either cognitive-behavioral therapy, anti-depressants, or gabapentin could be helpful, although further well-designed, randomized controlled large-scale studies will be necessary to determine the effectiveness of each treatment strategy on patients with globus sensation.

show abstract

Association of a globus sensation with esophageal diseases

Cited by 10 publications

References 8 publications

Comparative study of flexible nasoendoscopic and rigid endoscopic examination for patients with upper aerodigestive tract symptoms

Comparative study of flexible nasoendoscopic and rigid endoscopic examination for patients with upper aerodigestive tract symptoms

Management of Globus Pharyngeus

Pathophysiology and treatment of patients with globus sensation —from the viewpoint of esophageal motility dysfunction—

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