Globus: Current Concepts and Dilemmas

Area of Science:

• Gastroenterology and Otolaryngology
• Investigating the complex etiology of globus sensation.

Background:

• Globus sensation is a common condition of interest to various medical specialists.
• Despite thorough investigation, the underlying cause of globus often remains unidentified.
• Patients frequently seek care across multiple specialties without symptom resolution.

Purpose of the Study:

• To explore the diverse potential causes of globus sensation.
• To highlight the diagnostic challenges in identifying the etiology of globus.
• To review current understanding of globus pathophysiology and treatment approaches.

Main Methods:

• Review of literature concerning globus sensation.
• Discussion of diagnostic investigations for structural and functional abnormalities of the upper aerodigestive tract.
• Analysis of potential contributing factors including gastroesophageal reflux disease, esophageal inlet patches, and oropharyngeal hypersensitivity.

Main Results:

• Gastroesophageal reflux disease is a frequently suspected cause identified during ear, nose, and throat evaluations.
• Esophageal inlet patches have emerged as a potential contributor, with their removal sometimes resolving symptoms.
• Globus can be linked to psychiatric disorders and oropharyngeal hypersensitivity (chemical or mechanical).

Conclusions:

• Diagnosis of globus requires a comprehensive evaluation of the thyroid, larynx, pharynx, and esophagus.
• Treatment strategies are tailored to the identified cause, whether organic or functional.
• For functional globus, neuromodulators and psychological interventions are primary therapeutic options.