The diagnosis and management of globus: a perspective from the United Kingdom.
OBJECTIVE
Globus pharyngeus is a common disorder that accounts for approximately 4% of new ear, nose and throat referrals. The presenting symptoms are a cause of anxiety for patients and clinicians alike. There is a great deal of controversy surrounding the diagnosis and treatment of this disorder. This article discusses current trends in the management of this condition.


RESULTS
Globus symptoms are associated with proximal reflux. Globus symptoms in patients with laryngopharyngeal reflux treated with proton pump inhibitor resolve more slowly than classic reflux symptoms in patients with gastroesophageal reflux. Thyroid surgery may help improve globus symptoms in patients with goiter. Short-tem results suggest that speech therapy is effective in relieving symptoms of globus.


CONCLUSIONS
The cause of globus symptoms remains an enigma. The diagnosis of this symptom complex is essentially clinical. There is a limited role for investigations in patients with atypical symptoms. Treatment remains controversial and includes reassurance, speech therapy and proton pump inhibitors in patients with laryngopharyngeal reflux.
Khalil
Hisham Saleh
HS
Plymouth Hospitals NHS Trust, UK bPeninsula College of Medicine and Dentistry, Plymouth, UK. khalil@entplymouth.com
D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006113:United Kingdom