title: Association between swallow perception and esophageal bolus clearance in patients with globus sensation.
abstract: BACKGROUND
  Globus sensation is common, but its pathogenesis is not yet clear.
  
  
  OBJECTIVE
  Our purpose was to investigate subjective perception of swallowing and esophageal motility by combined multichannel intraluminal impedance and manometry (MII-EM) for patients with globus sensation.
  
  
  METHODS
  Combined MII-EM was performed for 25 globus patients and 15 healthy controls. Swallows were abnormal if hypocontractivity or simultaneous contractions occurred. Esophageal bolus transit was incomplete if bolus exit was not found at one or more of all measurement sites. Perception of each swallow was assessed by use of a standardized scoring system, and was enhanced if the score was >1.
  
  
  RESULTS
  Few globus patients reported enhanced perception during viscous or solid swallows. Incomplete bolus transit and enhanced perception occurred similarly between viscous and solid boluses. Agreement between enhanced perception and proximal bolus clearance was greater during solid swallows (κ = 0.45, 95 % CI: 0.32-0.58) than during viscous swallows (κ = 0.13, 95 % CI: 0-0.25) (P < 0.05). Similarly, agreement between enhanced perception and total bolus clearance was greater during solid swallows (κ = 0.46, 95 % CI: 0.34-0.58) than during viscous swallows (κ = 0.11, 95 % CI: 0-0.22) (P < 0.05).
  
  
  CONCLUSIONS
  Enhanced swallow perception is uncommon in patients with globus sensation, although there is a significant association between enhanced esophageal perception and solid bolus clearance. Application of a solid bolus may help better delineation of the interrelationship between the subjective perception of bolus passage and the objective measurement of bolus clearance.
authors.affiliation: Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, 707, Sec. 3, Chung-Yang Rd., Hualien, Taiwan. harry.clchen@msa.hinet.net
authors.forename: Chien-Lin
authors.initials: CL
authors.lastname: Chen
authors.forename: Chih-Hsun
authors.initials: CH
authors.lastname: Yi
authors.forename: Tso-Tsai
authors.initials: TT
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis*; D004947:Esophagus / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis