- Kristen M Robson, MD, MBA, FACG
Kristen M Robson, MD, MBA, FACG
- Assistant Professor
- Tufts University School of Medicine
- Anthony J Lembo, MD
Anthony J Lembo, MD
- Associate Professor of Medicine
- Harvard Medical School
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.
Globus sensation has been defined using the following criteria :
●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
- Galmiche JP, Clouse RE, Bálint A, et al. Functional esophageal disorders. Gastroenterology 2006; 130:1459.
- Thompson WG, Heaton KW. Heartburn and globus in apparently healthy people. Can Med Assoc J 1982; 126:46.
- Moloy PJ, Charter R. The globus symptom. Incidence, therapeutic response, and age and sex relationships. Arch Otolaryngol 1982; 108:740.
- Moser G, Wenzel-Abatzi TA, Stelzeneder M, et al. Globus sensation: pharyngoesophageal function, psychometric and psychiatric findings, and follow-up in 88 patients. Arch Intern Med 1998; 158:1365.
- Woo P, Noordzij P, Ross JA. Association of esophageal reflux and globus symptom: comparison of laryngoscopy and 24-hour pH manometry. Otolaryngol Head Neck Surg 1996; 115:502.
- Hill J, Stuart RC, Fung HK, et al. Gastroesophageal reflux, motility disorders, and psychological profiles in the etiology of globus pharyngis. Laryngoscope 1997; 107:1373.
- Locke GR 3rd, Talley NJ, Fett SL, et al. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology 1997; 112:1448.
- Anandasabapathy S, Jaffin BW. Multichannel intraluminal impedance in the evaluation of patients with persistent globus on proton pump inhibitor therapy. Ann Otol Rhinol Laryngol 2006; 115:563.
- Hori K, Kim Y, Sakurai J, et al. Non-erosive reflux disease rather than cervical inlet patch involves globus. J Gastroenterol 2010; 45:1138.
- Wilson JA, Heading RC, Maran AG, et al. Globus sensation is not due to gastro-oesophageal reflux. Clin Otolaryngol Allied Sci 1987; 12:271.
- Corso MJ, Pursnani KG, Mohiuddin MA, et al. Globus sensation is associated with hypertensive upper esophageal sphincter but not with gastroesophageal reflux. Dig Dis Sci 1998; 43:1513.
- Färkkilä MA, Ertama L, Katila H, et al. Globus pharyngis, commonly associated with esophageal motility disorders. Am J Gastroenterol 1994; 89:503.
- Vakil NB, Kahrilas PJ, Dodds WJ, Vanagunas A. Absence of an upper esophageal sphincter response to acid reflux. Am J Gastroenterol 1989; 84:606.
- Chen CL, Szczesniak MM, Cook IJ. Evidence for oesophageal visceral hypersensitivity and aberrant symptom referral in patients with globus. Neurogastroenterol Motil 2009; 21:1142.
- Kwiatek MA, Mirza F, Kahrilas PJ, Pandolfino JE. Hyperdynamic upper esophageal sphincter pressure: a manometric observation in patients reporting globus sensation. Am J Gastroenterol 2009; 104:289.
- Caldarelli DD, Andrews AH Jr, Derbyshire AJ. Esophageal motility studies in globus sensation. Ann Otol Rhinol Laryngol 1970; 79:1098.
- Cook IJ, Dent J, Collins SM. Upper esophageal sphincter tone and reactivity to stress in patients with a history of globus sensation. Dig Dis Sci 1989; 34:672.
- Wilson JA, Pryde A, Piris J, et al. Pharyngoesophageal dysmotility in globus sensation. Arch Otolaryngol Head Neck Surg 1989; 115:1086.
- Deary IJ, Smart A, Wilson JA. Depression and 'hassles' in globus pharyngis. Br J Psychiatry 1992; 161:115.
- Wilson JA, Deary IJ, Maran AG. Is globus hystericus? Br J Psychiatry 1988; 153:335.
- Deary IJ, Wilson JA, Mitchell L, Marshall T. Covert psychiatric disturbance in patients with globus pharyngis. Br J Med Psychol 1989; 62 ( Pt 4):381.
- Wilson JA, Deary IJ, Mardon SL. Globus (letter). Lancet 1989; 1:780.
- Bradley PJ, Narula A. Clinical aspects of pseudodysphagia. J Laryngol Otol 1987; 101:689.
- Takwoingi YM, Kale US, Morgan DW. Rigid endoscopy in globus pharyngeus: how valuable is it? J Laryngol Otol 2006; 120:42.
- Hajioff D, Lowe D. The diagnostic value of barium swallow in globus syndrome. Int J Clin Pract 2004; 58:86.
- Harar RP, Kumar S, Saeed MA, Gatland DJ. Management of globus pharyngeus: review of 699 cases. J Laryngol Otol 2004; 118:522.
- Caylakli F, Yavuz H, Erkan AN, et al. Evaluation of patients with globus pharyngeus with barium swallow pharyngoesophagography. Laryngoscope 2006; 116:37.
- Marshall JN, McGann G, Cook JA, Taub N. A prospective controlled study of high-resolution thyroid ultrasound in patients with globus pharyngeus. Clin Otolaryngol Allied Sci 1996; 21:228.
- Maung KH, Hayworth D, Nix PA, et al. Thyroidectomy does not cause globus pattern symptoms. J Laryngol Otol 2005; 119:973.
- Cybulska EM. Globus hystericus--a somatic symptom of depression? The role of electroconvulsive therapy and antidepressants. Psychosom Med 1997; 59:67.
- Brown SR, Schwartz JM, Summergrad P, Jenike MA. Globus hystericus syndrome responsive to antidepressants. Am J Psychiatry 1986; 143:917.
- You LQ, Liu J, Jia L, et al. Effect of low-dose amitriptyline on globus pharyngeus and its side effects. World J Gastroenterol 2013; 19:7455.
- Cybulska EM. Globus hystericus or depressivus? Hosp Med 1998; 59:640.
- Sinn DH, Kim JH, Kim S, et al. Response rate and predictors of response in a short-term empirical trial of high-dose rabeprazole in patients with globus. Aliment Pharmacol Ther 2008; 27:1275.
- Kirch S, Gegg R, Johns MM, Rubin AD. Globus pharyngeus: effectiveness of treatment with proton pump inhibitors and gabapentin. Ann Otol Rhinol Laryngol 2013; 122:492.
- Kiebles JL, Kwiatek MA, Pandolfino JE, et al. Do patients with globus sensation respond to hypnotically assisted relaxation therapy? A case series report. Dis Esophagus 2010; 23:545.
- Meining A, Bajbouj M, Preeg M, et al. Argon plasma ablation of gastric inlet patches in the cervical esophagus may alleviate globus sensation: a pilot trial. Endoscopy 2006; 38:566.
- Bajbouj M, Becker V, Eckel F, et al. Argon plasma coagulation of cervical heterotopic gastric mucosa as an alternative treatment for globus sensations. Gastroenterology 2009; 137:440.
- Klare P, Meining A, von Delius S, et al. Argon plasma coagulation of gastric inlet patches for the treatment of globus sensation: it is an effective therapy in the long term. Digestion 2013; 88:165.