Positive findings on barium swallow in patients presenting with a “sensation of a lump in the throat”

Abstract

Our objective is to evaluate the pickup rate of a significant pathology, on barium swallow, in patients who present to our clinic with a feeling of a lump in the throat (globus symptoms). Hospital--secondary referral centre. This is a retrospective study of 192 patients who had barium swallow in our department between August 2009 and August 2010. We revised 500 case notes to rule in 192 who presented with only a feeling of a lump in their throat. All patients with positive clinical findings, such as dysphagia, odynophagia, referred otalgia, hoarseness of voice, weight loss, neck swelling or vocal cord palsy, were ruled out. Eight patients were diagnosed on barium swallow as having significant pathology: five with diverticulae and three patients with oesophageal web. The percentage of significant pathology in our study is 4.17% (eight patients). Out of those eight cases, there was no malignant pathology identified on further panendoscopy. Our conclusion is that barium swallow adds very little to the diagnosis of Globus Pharyngeus, but it plays a role in the reassurance particularly from the patients' perspective.