The diagnostic value of GerdQ in subjects with atypical symptoms of gastro-esophageal reflux disease

ESNM/ANMS Review. Diagnosis and management of globus sensation: A clinical challenge

“…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.…”

“…The next step is to consider GERD as a potential mechanism of the globus sensation 2,5,11,12,31,38 . An empiric PPI trial is recommended in the absence of alarm symptoms to determine whether globus is responsive to acid suppression 1,2 .…”

“…Idiopathic globus is diagnosed when the clinical history is supportive and after alternate medical conditions have been excluded using prudent and specific investigation, including laryngoscopic evaluation, endoscopy with biopsy, high‐resolution manometry (HRM), and in some instances, ambulatory reflux monitoring 1 . Although as many as 90% of patients presenting to ENT clinics are reported to have abnormal bolus propulsion on videofluoroscopic examination, these do not necessarily correlate to the location or nature of the symptom 3,11 . Abnormal endoscopy (22%), abnormal pH testing (20%), motor abnormalities on HRM (63%), and abnormal barium swallow (24%) were reported in 172 patients presenting to ENT clinics for evaluation 12 .…”

“…The diagnosis of globus starts with taking a careful history, particularly to distinguish globus from oropharyngeal dysphagia, esophageal dysphagia, and upper airway symptoms (Figure 3). While the presence of concomitant typical reflux symptoms could raise the possibility of reflux disease, standard questionnaires such as the GERDQ have poor sensitivity (33%) to diagnose GERD in globus patients compared to ambulatory reflux monitoring, despite excellent specificity (89%), and good prediction of PPI response (sensitivity 69%, specificity 70%, positive predictive value 99%) 11 . The Glasgow Edinburgh Throat Scale (GETS) is a 10‐item questionnaire with three subscales relating to globus and other throat symptoms 44 .…”

Chinese expert consensus on gastroesophageal reflux disease in 2020

“…In one study in which endoscopic esophagitis and pathological esophageal reflux, as indicated by esophageal reflux monitoring, were used as positive diagnostic criteria. It was observed that in 308 patients with upper gastrointestinal symptoms the sensitivity and specificity of the reflux disease questionnaire (RDQ) in diagnosing GERD were 62% and 67%, respectively; while those of the gastroesophageal reflux disease questionnaire (GerdQ) were 65% and 71%, respectively 24,25 . The diagnostic value of both questionnaires is higher in patients with typical reflux symptoms than in those with atypical symptoms.…”