Globus pharyngeus a diagnostic challenge for otolaryngologist

<p class="abstract"><strong>Background:</strong> Globus pharyngeus, also known as globus sensation, can be defined as the sensation of a lump or foreign body in the absence of a mass on examination. The disorder is frequently linked to catarrh, hoarseness, chronic cough and persistent throat clearing. Globus pharyngeus accounts for 4 percent of ENT (ear, nose and throat) referrals. The exact cause of globus pharyngeus is unknown. The presence of lingual tonsil, cricopharyngeal spasm, hiatus hernia, cervical osteophytosis, sinusitis, gastro-oesophageal reflux, goiter post-nasal drip and anxiety have all been shown as associations in the literature. Digestive enzymes and regurgitation of stomach acid are thought to cause persistent inflammation, for example, of the laryngopharynx, which causes symptoms. Reflux has been depicted in 23-68 percent of patients with globus sensation. Notably, some studies claim that asymptomatic control patients have a similar rate.</p><p class="abstract"><strong>Methods:</strong> We presented our audit study of 50 subsets of patients. It was considered that gastro-oesophageal reflux was the reason; however, it cannot explain all the potential causes.</p><p class="abstract"><strong>Results:</strong> Barium swallow was found to be a very key diagnostic tool in this group of patients.</p><p class="abstract"><strong>Conclusions:</strong> Panendoscopy in globus sensation in the throat, looking through the possible causes of globus sensation, current trends and diagnosis as well as methods of treatment.</p>

Assessment of Short-term Outcomes of 10 mg Daily Amitriptyline Therapy in Globus Pharyngeus Patients

Background: Globus pharyngeus or feeling of a lump in the throat is a very common complaint in patients visiting the otolaryngology outpatient department. Pharmacotherapy with low dose amitriptyline has a significant effect in relieving the symptoms, although success rate varies among patients. Objectives: Aim for this study was to find out the benefits of low dose amitriptyline therapy in the management of Globus pharyngeus on a short term basis. Materials & Methods: This is an observational study conducted from Jan 2019 to Jan 2020. Total 50 patients were included in this study. Inclusion criteria were – subjective feeling of a lump in the throat persisting for more than 2 months, Clinical oral examination and Upper GI endoscopy revealed normal findings, age between 18–60 years of both sexes. All the patients were prescribed with 10mg Amitriptyline per oral at night for 2 months, and patients were followed during the course of treatment to assess relief of symptoms and to evaluate any side effects. Results: In this study male to female ratio was 1:4. Mean age of study group was 42.66 (_ 4.78) years. Symptomatic relief occurred in 37 (74%) patients. Increased somnolence was found in 21 patients (42%) during first 2 weeks of treatment, No improvement occurred in 8 patients (16%), and worsening of symptom occurred in 5 patients (10%). Conclusion: Low dose Amitriptyline is effective in alleviating symptoms of globus pharyngeus in most patients on a short-term basis. Although some minor side effects can occur, these are manageable. KYAMC Journal.2021;12(02): 75-77

Globus Pharyngeus - The Total Burden at a Tertiary Hospital in Gangtok, East Sikkim, North East India

BACKGROUND Globus Pharyngeus, previously known as Globus hystericus, is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat of indeterminate origin. It is a commonly encountered clinical condition seen in ear, nose and throat Outpatient Department (ENT OPD). It is usually long-lasting, difficult to treat and has a tendency to recur. It is a common disorder and constitutes about 4 - 5 % of all new ENT referrals with a slight female preponderance. Sikkim is second smallest state in India with a total population of 6.1 lakhs. It is a mountainous region with subtropical climate. Central Referral Hospital is the only Medical College in the state and takes care of the patients from all over the state. This study was conducted to determine the prevalence of globus pharyngeus among patients attending ENT OPD. METHODS This was a descriptive cross-sectional study done in the ENT Outpatient Department (OPD) of Central Referral Hospital, Gangtok, Sikkim among patients attending directly or referred from the government health sectors with complaints of globus symptoms in the throat. Data was entered in Microsoft Excel 16.4 version and used for statistical purposes. RESULTS The total burden of the disease was found to be 0.6 % with 73.77 % of the patients with globus positive for H. pylori infection and 36 % of them positive for laryngopharyngeal reflex (LPR). CONCLUSIONS The number of globus cases found in this study (0.6 %) was comparatively less as compared to various studies done globally (4 - 5 %). The low number of cases determined in this study may be due to the bias of selection of the study population from the only available private tertiary care centre in the state. KEYWORDS Globus Pharyngeus, Foreign Body Throat

The assessment and management of globus pharyngeus

Globus is the sensation of a foreign body in the throat. Investigation and management of patients with globus is widely variable. Most investigations yield negative results yet incur varying patient morbidity and healthcare costs, while malignancy is vanishingly rare in the absence of red flag symptoms and ear, nose and throat examination findings. History taking is key and can help to identify possible causative pathology, directing further investigations and management if necessary. Treatment of globus mainly centres on patient reassurance and counselling, and may include reflux management, neuromodulation, or speech therapy in selected cases, and treatment of any identified cause.

Gambaran Pasien Laryngopharyngeal Reflux di Bagian Poliklinik THT-KL RSUP Dr. M. Djamil Padang Periode 2017.

Abstrak Latar Belakang. Laryngopharyngeal reflux (LPR) adalah aliran balik cairan lambung ke laring, faring, trakea dan bronkus. Objektif. Penelitian ini bertujuan untuk melihat gambaran pasien dengan LPR di bagian Poliklinik THT-KL RSUP Dr. M. Djamil, Padang periode 2017. Metode. Jenis penelitian ini adalah merupakan deskriptif retrospektif yang menggunakan data sekunder diambil dari rekam medis pasien LPR di Poliklinik THT-KL RSUP Dr. M. Djamil, Padang periode 2017. Sampel pada penelitian ini diambil dengan teknik total sampling, dimana didapatkan populasi pasien dengan LPR sebanyak 89 orang yaitu 20% daripada jumlah pasien di Sub Bagian Laringofaring. Hasil. Hasil penelitian ini didapatkan bahwa terdapat 83 orang pasien yang memenuhi kriteria inklusi dan dimasukkan ke dalam penelitian. Frekuensi kasus LPR lebih tinggi pada jenis kelamin perempuan sebanyak 55 orang (66,27%) berbanding laki-laki sebanyak 28 orang (33,73%) dengan rasio 2:1. Kelompok usia terbanyak pasien LPR pada penelitian ini adalah 46-55 tahun sebanyak 32 orang (38,55%), dengan rata-rata usia pasien adalah 49,30±12,12 tahun. Gejala terbanyak yang dikeluhkan pasien adalah sensasi mengganjal di tenggorok / globus pharyngeus (78,31%). Sementara pilihan pengobatan yang paling banyak diresepkan adalah Lansoprazol (93,98%). Kesimpulan. Dapat disimpulkan bahwa jumlah pasien LPR adalah sebanyak 20% dari seluruh pasien Sub Bagian Laringofaring. Kata Kunci: LPR, Gejala, Pengobatan Abstract Background. Laryngopharyngeal reflux (LPR) is the backflow of gastric fluid into the larynx, pharynx, trachea and bronchi. Objectives. This study aims to see the pattern of patients with LPR in the Polyclinic of ENT-HN Department at Dr. M. Djamil Hospital, Padang in 2017 period. Method. This type of research was a retrospective descriptive which using secondary data taken from the medical record of LPR patients at the Polyclinic of ENT-HN Department at Dr. M. Djamil Hospital, Padang period 2017. The sample in this study was taken by total sampling technique, which obtained 89 patients of LPR as the population that represented 20% of patients in the sub-section of laryngopharynx. Results.The results showed 83 patients who met the inclusion criteria and were included in the study. The cases of LPR was higher in female as many as 55 people (66,27%) compared to men as many as 28 people (33,73%) with a ratio of 2:1. The largest age group of LPR patients in this study was 46-55 years as many as 32 people (38,55%), with the average age of patients was 49,30 ± 12,12 years. The most symptoms complained were the sensation of lump in the throat / globus pharyngeus (78,31%). While the most prescribed medicine options are Lansoprazole (93,98%). Conclusion. It can be concluded that the number of LPR patients is as much as 20% of all Laryngopharyngeal Sub Division patients. Keywords: LPR, Symptoms, Medicines.