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Globus: Current Concepts and Dilemmas

Tawil, José, MD*; Fass, Ronnie, MD

doi: 10.1097/MCG.0000000000001129
CLINICAL REVIEWS

Globus is an area of interest for many medical specialists including otorhinolaryngologists, gastroenterologist, allergists, and psychiatrists. It may be caused by an organic disease, but it is not uncommon that an underlying etiology remains unidentified even after a full workup has been performed. Patients who suffer from globus usually visit several physicians from different specialties without finding a solution for their symptoms. Identifying the underlying cause of globus is not always a simple task; therefore, structural or functional abnormalities of the thyroid, larynx, pharynx, and esophagus should be investigated. Gastroesophageal reflux disease is commonly considered to be the underlying cause after being identified in an otorhinolarygeal (ear, nose, and throat) evaluation, which is usually the first diagnostic step. In the last few years, an inlet patch in the proximal esophagus has been shown to be associated with globus, and its elimination has resulted in symptom resolution in some patients. Finally, globus can be associated with psychiatric disorders as well as oropharyngeal hypersensitivity that could be either chemical or mechanical. Treatment is directed toward an identified organic cause; in those with a functional disorder, the mainstay of therapy includes neuromodulators and psychiatric/psychological interventions.

*Esophageal and Functional GI Disorders Division, Gedyt, Diagnostic & Therapeutic Gastroenterology and Endoscopy, Buenos Aires, Argentina

Digestive Health Center, Division of Gastroenterology and Hepatology, Esophageal and Swallowing Center at MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH

The authors declare that they have nothing to disclose.

Address correspondence to: José Tawil, MD, Esophageal and Functional GI Disorders Division, Gedyt, Diagnostic & Therapeutic Gastroenterology and Endoscopy, Buenos Aires, C1426EGR Argentina (e-mail: drjosetawil@gmail.com).

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