INTRODUCTION

Globus sensation (which has also been referred to as globus pharyngeus and globus hystericus) is common in the general population. This topic will review the definition, epidemiology, etiology, clinical manifestations and the evaluation and treatment of patients with globus sensation.

DEFINITION

Globus sensation has been defined using the following criteria [1]:

• The persistent or intermittent nonpainful sensation of a lump or foreign body in the throat
• Occurrence of the sensation between meals
• Absence of dysphagia and odynophagia
• Absence of evidence that gastroesophageal reflux is the cause of symptoms
• Absence of histopathology-based esophageal motility disorders
• Criteria fulfilled for the last three months with symptom onset at least six months before diagnosis.

EPIDEMIOLOGY

Globus sensation (which has also been referred to as globus pharyngeus and globus hystericus) is common in the general population as illustrated in a study in which 45 percent of 147 healthy volunteers had experienced it at least once [2]. The sensation usually occurred during an emotional event and was more common in women (53 versus 35 percent).

Some patients have recurrent or persistent globus that is the primary reason they seek medical care. In one report, for example, globus sensation was the primary reason for consultation in 4 percent of 4330 consecutive new patients seen at a general otolaryngology clinic [3]. Globus was three times more common in women than in men who were under the age of 50, while there was no difference in prevalence between men and women over the age of 50. In another series involving 88 patients referred to a psychosomatic center because of globus, the median age was 43 (range 22 to 71), and the median duration of symptoms was two years (range 1 month to 36 years) [4].