2013
DOI: 10.1038/nrgastro.2013.221
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The complexity of globus: a multidisciplinary perspective

Abstract: Globus is a topic of interest for many specialties including otorhinolaryngology, gastroenterology and psychiatry/psychosomatic medicine, but, although many hypotheses have been suggested, key questions about its aetiology remain. This Review provides an overview of the extensive literature concerning this topic and discusses the quality of the evidence to date. Globus has been associated with oropharyngeal structural lesions, upper oesophageal sphincter disorders, oesophageal disorders, GERD, psychosocial fac… Show more

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Cited by 22 publications
(19 citation statements)
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“…22 The findings may suggest that altered oesophageal motor function is rather subtle and may not be a predominant etiopathological factor that directly causes the symptomatology of globus sensation. 23 However, oesophageal manometry is still useful in excluding primary oesophageal motility disorders when upper endoscopy is negative and there is no response to acid suppression therapy.…”
Section: Discussionmentioning
confidence: 99%
“…22 The findings may suggest that altered oesophageal motor function is rather subtle and may not be a predominant etiopathological factor that directly causes the symptomatology of globus sensation. 23 However, oesophageal manometry is still useful in excluding primary oesophageal motility disorders when upper endoscopy is negative and there is no response to acid suppression therapy.…”
Section: Discussionmentioning
confidence: 99%
“…The role of GERD as a potential cause of globus has been suggested by several studies 2,5,11,12,31,38 . The hypotheses underlying symptom generation consist of the following: (a) regurgitation leading to pharyngeal irritation; (b) reflex contraction of the UES, and (c) altered localization of esophageal sensation to the neck.…”
Section: Etiology Of Globusmentioning
confidence: 99%
“…Whether ambulatory reflux monitoring should be performed can be debated but if no other cause can be identified, it may be useful to perform ambulatory pH (or pH‐impedance) monitoring off therapy to document abnormal baseline reflux metrics which could justify optimization of GERD treatment 1,2 . On the other hand, negative prolonged wireless pH monitoring performed at index endoscopy could provide robust exclusion of abnormal acid exposure and avoid unnecessary PPI therapy, 51,52 while a positive pH study would establish GERD and predict PPI response 53 .…”
Section: Diagnosis Of Globusmentioning
confidence: 99%
“…Interestingly, there is a small subset of patients in whom the foreign body can migrate over time, leading to delayed and much more subtle presentation [ 2 4 ]. In those patients, sensation of a foreign body or lump in the throat may be the primary symptom [ 5 , 6 ]. Other potential etiologies for this symptom include gastroesophageal reflux disease, postnasal drip, cricopharyngeal spasm, lingual tonsil hypertrophy, cervical osteophytes, and malignancy [ 5 , 6 ].…”
Section: Introductionmentioning
confidence: 99%
“…In those patients, sensation of a foreign body or lump in the throat may be the primary symptom [ 5 , 6 ]. Other potential etiologies for this symptom include gastroesophageal reflux disease, postnasal drip, cricopharyngeal spasm, lingual tonsil hypertrophy, cervical osteophytes, and malignancy [ 5 , 6 ]. Thorough history and flexible laryngoscopy are key components of the initial assessment.…”
Section: Introductionmentioning
confidence: 99%