Globus pharyngeus: an update for general practice.

Abstract

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling. It is often associated with persistent clearing of the throat, chronic cough, hoarseness, and catarrh.1 Globus pharyngeus makes up 4% of ear, nose, and throat (ENT) referrals and is reported to have been experienced by up to 45% of the population.1 The aetiology of globus pharyngeus remains uncertain. Causes suggested include cricopharyngeal spasm, lingual tonsil, cervical osteophytosis, hiatus hernia, gastro-oesophageal reflux, sinusitis, post-nasal drip, goitre, foreign body, anxiety, and, very rarely, hypopharyngeal cancer.2 It has been suggested that regurgitation of stomach acid and digestive enzymes induces chronic inflammation of the laryngopharynx resulting in symptoms. Studies have reported reflux in 23–68% of patients with globus sensation. However, some report a similar rate in asymptomatic control patients.1 It is thought that gastro-oesophageal reflux is likely to be the cause in a subgroup of patients but cannot explain all cases.2 Oesophageal motility disorders are another potential aetiological factor. Studies suggest an association between upper oesophageal sphincter function and globus sensation, with one showing elevated sphincter pressure in 28% of patients with globus pharyngeus compared with 3% of controls.1 Psychological …