The Globus Symptom

Abstract

The complaint of a lump in the throat without obvious local causes was investigated in a series of 77 patients. Conventional and acid barium studies of the upper alimentary tract revealed pathology in 46.8% of the cases. In one-third of these cases, the diagnosis was provided by the acid barium technique alone. Oesophagoscopy and biopsy were of lesser diagnostic value. Treatment of the reflux oesophagitis results in disappearance of the globus sensation.

Aetiological aspects of the globus symptom

“…Oesophagoscopy and biopsy from the supra-cardial region were performed in the majority of patients with X-ray evidence of abnormalities at the gastro-oesophageal junction. The results have been reported previously (Mair et al, 1973).…”

“…We accept unreservedly the theoretical basis for the referral of symptoms from the lower oesophagus to the neck in cases of reflux oesophagitis, but endoscopic examination in our series has revealed mild oesophagitis in only 45 per cent of the radiologically-positive cases (Mair et al, 1973). We would therefore recommend caution in accrediting hiatus hernia with a causal relationship for pharyngeal symptomatology, particularly in the absence of definite endoscopic evidence of reflux, and when the symptoms are restricted to the globus complaint alone.…”

Globus Sensation

“…16 Paraesophageal masses, 18 carcinoma, 21 gastroduodenal lesions, 17 and hiatal hernias 17,22,23 also have been thought to underlie the sensation. In the past decades, a disordered contractile activity of the upper esophageal sphincter (UES), 11,12,17,[24][25][26] esophageal body, [27][28][29][30] or the lower esophageal sphincter (LES) 17,20,28,29 and gastroesophageal reflux (GER) 11,12,18,23,28,[31][32][33][34][35][36][37][38][39] were suggested to elicit the globus sensation.…”