The Diagnosis and Treatment of Globus Pharyngeus
Authors:
K. Zeleník 1; P. Komínek 1; I. Stárek 2; E. Machytka 3; P. Schwarz 1
Authors‘ workplace:
Otorinolaryngologická klinika FN Ostrava2Otorinolaryngologická klinika LF UP a FN Olomouc3Interní klinika FN Ostrava
1
Published in:
Gastroent Hepatol 2010; 64(1): 27-33
Category:
Review Article
Overview
Globus pharyngeus is the subjective sensation of a lump, tightness or something stuck in the throat. In the past, this symptom was more frequently observed in patients with a tendency to hysterical behavior and therefore, it was called globus hystericus. Trying to explain its cause, many theories were gradually developed, which more or less successfully reveal the etiology of globus hystericus. Currently, the most widely considered causes of globus pharyngeus include extra-esophageal reflux, hypertensive upper esophageal sphincter, neurosis, goiter, allergy and tetany. The first goal of the clinical examination of patients with globus pharyngeus is to differentiate patients with the risk of potential malignant disease. The second goal is to identify the most likely cause of pure globus pharyngeus. This article aims to report an overview of up-to-date information about the diagnosis and treatment of this controversial symptom.
Key words:
diagnosis – extra-esophageal reflux – globus pharyngeus – globus hystericus – treatment
Sources
1. Karkos PD, Wilson JA. The diagnosis and management of globus pharyngeus: our perspective from United Kingdom. Curr Opin Otolaryngol Head Neck Surg 2008; 16(6): 521–524.
2. Oridate N, Nishizawa N, Fukuda S. The diagnosis and management of globus: a perspective from Japan. Curr Opin Otolaryngol Head Neck Surg 2008; 16(6): 498–502.
3. Galmiche JP, Clouse RE, Balint A. Functional esophageal disorders. Gastroenterology 2006; 130(5): 1459–1465.
4. Khalil HS. The diagnosis and management of globus: a perspective from the united Kingdom. Curr Opin Otolaryngol Head Neck Surg 2008; 16(6): 516–520.
5. Zeleník K, Komínek P, Stárek I, Machytka E: Extraezofageální reflux (1. část) Epidemiologie, patofyziologie a diagnostika. Otorinolaryngologie a Foniatrie 2008; 57: 143–150.
6. Park KH, Choi SM, Kwon SU et al. Diagnosis of laryngopharyngeal reflux among globus patients. Otolaryngol Head Neck Surg 2006; 134(1): 81–85.
7. Borhan-Manesch F, Farnum JB. Incidence of heterotopic gastric mucosain the upper oesophagus. Gut 1991; 32(9): 968–972.
8. Allani A, Jassar P, Warfiel AT et al. Heterotopis gastric mucosa in the cervical oesophagus (onlet patch) and globus pharyngeus – an under-recognised association. J Laryngol Otol 2007; 121(9): 885–888.
9. Meining A, Bajbouj M, Preeg M et al. Argon plasma ablation of gastric inletpatches in the cervical esophagus may alleviate globus sensation: a pilot trial. Endoscopy 2006; 38(6): 566–570.
10. Burns P, Timon C. Thyroid pathology and globus the pharyngeus: are they related? A two year prospective trial. J Laryngol Otol 2007; 121(3): 242–245.
11. Maung KH, Hayworth D, Nix A et al. Thyreoidectomy does not cause globus pattern symptoms. The Journal of Laryngology and Otology 2005; 119: 973–975.
12. Corso KJ, Pursnani KG, Mohiuddin MA et al. Globus sensation is associated with hypertensive upper esophageal sphincter but not with gastroesophageal spincter. Dig DisSci1998; 43(7): 1513–1517.
13. Waering M, Elias A, Mitchell D. Managemet of globus sensation by the speech therapist. Logoped Phoniatr Vocol 1997; 22: 39–42.
14. Jaruchinda P, Saengsapawiriya A, Chakkaphak S et al. The study of allergic skin test in patients with globus pharyngeus: a preliminary report. J Med Assoc Thai 2009; 92(4): 531–536.
15. Steidl, L. Tetanický syndrom v interní praxi, jeho obsah, diagnóza a léčba z hlediska metabolizmu magnezia. Interní medicína 2002; 3: 113–118.
16. Cook IJ, Dent J, Collins SM. Upper esophageal sphincter tone and reactivity to stress in patiens with a history of globus sensation. Dig Dis Sci 1989; 34(5): 672–676.
17. Oyama O, Paltoo C, Greengold J. Somatoform Disorders. Am Fam Physician 2007; 76(9): 1333–1338.
18. Harris MB, Deary IJ, Wilson JA. Life events and difficulties in relation to the onset of globus pharyngis. J Psychosom Res 1996; 40(6): 603–615.
19. Deary IJ, Wilson JA, Harris MB et al. Globus pharyngis: a developmentof a symptom assessment scale. J Psychosom Res 1995; 39(2): 203–213.
20. Ali KHM, Wilson JA. What is the severity of globus sensation in individuals who have never sought health care for it? J Laryngol Otol2007; 121(9): 865–868.
21. Alaani A, Vengala S, Johnston, MN. The role of barium swallow in the management of the globus pharyngeus. Eur Arch Otorhinolaryngol 2007; 264(9): 1095–1097.
22. Harar RP, Kumar S, Saeed MA et al. Management of globus pharyngeus: a review of 699 cases. J Laryngol Otol 2004; 118(7): 522–527.
23. Burns P, O’Neill JP. The diagnosis and management of globus: a perspective from Ireland. Curr Opin Otolaryngol Head Neck Surg 2008; 16(6): 503–506.
24. Takwoingi YM, Kale US, Morgan DV. Rigid endoscopy in globus pharyngeus: how valuable it is? J Laryngol Otol 2006; 120(1): 42–46.
25. Zeleník K, Komínek P, Stárek I et al. Extraezofageální reflux (2. část) ORL manifestace a léčba. Otorinolaryngologie a Foniatrie 2008; 57: 151–158.
26. Khalil H, Bridger S, Hilton Pierce MV et al. The use of speech therapy in the treatment of globus pharyngeus patients. A randomised controlled trial. Rev Laryngol Otol Rhinol 2003; 124(3): 187–190.
27. Kroenke K. Efficacy of treatment for somatoform disorders: a review of randomized controlled trials. Psychosom Med 2007; 69(9): 881–888.
28. Rowley H, O’Dwyer TP, Jones AS. The natural history of globus pharyngeus. Laryngoscope 1995; 105(10): 1118–1121.
29. Timon C, O’Dwyer T, Cagney D et al. Globus pharyngeus:long-term follow-up and prognostic factors. Ann Otol Rhinol Laryngol 1991; 100: 351–354.
Labels
Paediatric gastroenterology Gastroenterology and hepatology SurgeryArticle was published in
Gastroenterology and Hepatology
2010 Issue 1
Most read in this issue
- The Diagnosis and Treatment of Globus Pharyngeus
- Recommendation for Vaccinations in Patients with Crohn’s Disease and Ulcerative Colitis on Immunosuppressive and/or Biological Therapy
- Neuroendocrine Tumors of the Large Bowel
- Enteropathy-Associated Non-Hodgkin T-Lymphoma as a Complication of Late Diagnosis of Celiac Disease in a Geriatric Patient