Gastroesophageal Reflux, Motility Disorders, and Psychological Profiles in the Etiology of Globus Pharyngis

• Published in: The Laryngoscope 1997-10, Vol.107 (10), p.1373-1377
• Main Authors: Hill, John, Stuart, Robert C., Fung, Hin K., Ng, Enders K.W., Cheung, Fanny M., Chung, Sidney C.S., Andrew van Hasselt, C.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Case-Control Studies; Conversion Disorder - etiology; Conversion Disorder - psychology; Endoscopy, Digestive System; Esophageal Motility Disorders - complications; Esophageal Motility Disorders - epidemiology; Female; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - epidemiology; Gastrointestinal Diseases - complications; Gastrointestinal Diseases - epidemiology; Hong Kong - epidemiology; Humans; Hydrogen-Ion Concentration; Incidence; Male; Manometry; Medical sciences; Monitoring, Ambulatory; Non tumoral diseases; Otorhinolaryngology. Stomatology; Personality Inventory; Prevalence; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/00005537-199710000-00015

The aim of this study was to investigate the origin of globus pharyngis with particular reference to esophageal disorders such as gastroesophageal reflux disease (GERD), motility disorders, structural abnormalities, other gastrointestinal tract diseases, and psychological profile. Previous studies on this subject using 24‐hour pH monitoring give conflicting results and are hampered by the high background prevalence of asymptomatic GERD in the normal Western population. The local Chinese population is known to have a very low background level of GERD and therefore is an ideal study population. Twenty‐six patients with globus pharyngis underwent 24‐hour ambulatory pH monitoring, esophageal manometry, and esophagogas‐troduodenoscopy with lower esophageal biopsy. A control group of 20 patients presenting with non‐ulcer dyspepsia was similarly investigated. Personality profiles of the globus pharyngis subjects and an appropriate control group were assessed. Eight of the globus pharyngis group (30.7%) had evidence of GERD, whereas only one of the controls (5%) demonstrated GERD on 24‐hour esophageal pH monitoring (P < 0.05). The manometric and personality profile studies did not show significant differences between study and control groups. We concluded that the finding of GERD in patients with globus pharyngis is not a coincidental finding but that there is a true association between GERD and globus pharyngis.