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Abnormal esophageal manometry in globus hystericus
The Annals of Otology, Rhinology, and Laryngology
|July 1, 1981
Summary
Globus sensation, often called a "lump in the throat," may stem from esophageal motility issues, not psychic causes. Studies show hypertonic and uncoordinated esophageal activity can trigger this referred sensation.
Area of Science:
- Gastroenterology
- Otolaryngology
- Psychosomatic Medicine
Background:
- Globus hystericus, a sensation of a lump in the throat, is traditionally attributed to psychological factors.
- True difficulty swallowing (dysphagia) is typically absent in patients with globus syndrome.
- Organic causes are often presumed but require thorough investigation.
Purpose of the Study:
- To investigate the potential organic basis of globus syndrome.
- To explore the role of esophageal motor activity in globus sensation.
- To identify physiological mechanisms underlying the globus symptom.
Main Methods:
- Studied twelve patients diagnosed with globus syndrome.
- Conducted physical examinations, laryngoscopy, esophagoscopy, and cineesophagograms to rule out organic causes.
- Assessed esophageal resting pressures and motor activity in the esophageal body.
Main Results:
- Organic causes were successfully ruled out in all patients.
- Ten patients exhibited significantly elevated esophageal resting pressures.
- Nine patients demonstrated disordered motor activity within the esophagus.
Conclusions:
- The globus sensation may be a referred symptom originating from the esophagus.
- Esophageal hypertonicity and incoordination are proposed as the underlying physiological cause.
- This challenges the purely psychogenic origin of globus syndrome.