[Globus pharyngis and gastroesophageal equivalents]

Globus sensation is a phenomenon of largely unknown etiology. Dyskinesia of the upper esophageal sphincter is quite often evident without pathological ENT findings elsewhere.

One hundred ten patients were examined in a interdisciplinary approach. The investigation included videofluoroscopy, esophagogastroduodenoscopy with biopsy, pharyngoesophageal computer manometry, and esophageal pH monitoring. One hundred five cases were evaluated.

In 13 cases (12.4%) there was no evidence for any organic or functional disorder. In 92 cases (87.6%) abnormal findings were seen with two constellations being predominant. These are primarily inflammatory lesions in the stomach or the duodenum in 69.5% of all patients (73/105) associated with helicobacter pylori colonization in 58% (42/73) as well as ulcera and/or erosions in 8.2% (6/73). Concurrent disorders of the lower esophageal sphincter play the second role. Sixty-one point nine percent of all patients (65/105) had an hiatal hernia, with gastroesophageal reflux in 36.9% (24/65). In 21.5% (14/65) a reflux esophagitis was evident. A cardiac sphincter insufficiency was found in 6.7% (7/105).

Based on these findings a gastroenterologic diagnosis is recommended in all patients with globus sensation as the symptom may be associated with corresponding disorders.