title: The complexity of globus: a multidisciplinary perspective.
abstract: Globus is a topic of interest for many specialties including otorhinolaryngology, gastroenterology and psychiatry/psychosomatic medicine, but, although many hypotheses have been suggested, key questions about its aetiology remain. This Review provides an overview of the extensive literature concerning this topic and discusses the quality of the evidence to date. Globus has been associated with oropharyngeal structural lesions, upper oesophageal sphincter disorders, oesophageal disorders, GERD, psychosocial factors and psychiatric comorbidity. However, findings are often contradictory and the literature remains highly inconclusive. Indeed, with the exception of patients with structural-based globus, the Rome III criteria for functional globus only apply to a subgroup of patients with idiopathic globus. In clinical reality, there exists a group of patients who present with idiopathic (nonstructural) globus, but nevertheless have dysphagia, odynophagia or GERD-exclusion criteria for globus diagnosis according to Rome III. The symptomatology of patients with globus might be broader than previously thought. It is therefore crucial to approach globus not from one single perspective, but from a multifactorial point of view, with focus on the coexistence and/or interactions of different mechanisms in globus pathogenesis. This approach could be translated to clinical practice by adopting a multidisciplinary method to patients presenting with globus.
authors.affiliation: Department of Neurosciences, ExpORL and Translational Research Center for Gastrointestinal Disorders (TARGID), Herestraat 49 (PO 701), 3000 Leuven, Belgium.
authors.forename: Margot
authors.initials: M
authors.lastname: Selleslagh
authors.affiliation: TARGID, Herestraat 49 (PO 701), 3000 Leuven, Belgium.
authors.forename: Lukas
authors.initials: L
authors.lastname: van Oudenhove
authors.affiliation: TARGID, Herestraat 49 (PO 701), 3000 Leuven, Belgium.
authors.forename: Ans
authors.initials: A
authors.lastname: Pauwels
authors.affiliation: TARGID and Department of Gastroenterology, Neurogastroenterology & Motility, Herestraat 49 (PO 701), 3000 Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
authors.affiliation: Department of Neurosciences, ExpORL and Department of Gastroenterology, Neurogastroenterology & Motility KU Leuven, Herestraat 49 (PO 701), 3000 Leuven, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rommel
mesh_terms: D001007:Anxiety / Q000150:complications / Q000503:physiopathology; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology* / Q000523:psychology; D003863:Depression / Q000150:complications / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000150:complications / Q000503:physiopathology; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000503:physiopathology; D006801:Humans