Non-erosive reflux disease rather than cervical inlet patch involves globus.

Area of Science:

• Gastroenterology
• Otolaryngology

Background:

• Globus sensation is often attributed to gastroesophageal reflux.
• Cervical inlet patches (heterotopic gastric mucosa) are increasingly implicated in globus etiology.
• This study investigates the association of inlet patches and reflux conditions with globus.

Purpose of the Study:

• To determine the relationship between cervical inlet patches, reflux symptoms, and globus sensation.
• To compare the association of non-erosive reflux disease and reflux esophagitis with globus.
• To identify independent risk factors for globus development.

Main Methods:

• A prospective cross-sectional survey of 2116 patients undergoing esophagogastroduodenoscopy.
• Pre-endoscopy interviews assessed globus sensations and reflux symptoms.
• Narrow-band imaging identified cervical inlet patches; non-erosive reflux disease defined by symptoms without esophagitis.

Main Results:

• Of 2053 patients, 5.8% had globus and 13.8% had inlet patches.
• Independent risk factors for globus included female gender, younger age, inlet patch, and reflux symptoms.
• Non-erosive reflux disease (OR 12.1) and inlet patch (OR 2.9) were significant risk factors for globus.

Conclusions:

• Non-erosive reflux disease shows a stronger association with globus than cervical inlet patches.
• The findings suggest esophageal visceral hypersensitivity may be involved in globus, challenging solely reflux-based etiologies.
• Reflux esophagitis was inversely associated with globus development.