Symptoms
Globus syndrome1 manifests as the sensation of having a lump, foreign body, uncomfortable feeling, or tightness/pressure in the throat. On medical examination, no foreign body or tissue overgrowth can be detected. The discomfort occurs primarily with empty swallowing and improves with eating or drinking. Difficulty swallowing and pain, on the other hand, do not occur. Patients swallow and clear their throat frequently. 1
Causes
The causes are not fully understood. The development appears to be multifactorial. Gastroesophageal reflux can often contribute to its development. Stress, psychogenic problems, fatigue, and emotions may exacerbate and trigger the symptoms (somatization disorder). Other possible factors (selection):
- Increased pressure of the upper esophageal sphincter.
- Dysfunction of the esophagus
- Inflammatory diseases in the upper respiratory tract (eg, rhinitis, sinusitis, pharyngitis).
- Hypertrophy of the base of the tongue
- Rarely, medications such as local anesthetics and anticholinergics can also cause globe syndrome.
Diagnosis
Diagnosis is usually made in medical treatment by an ear, nose and throat specialist based on symptoms and physical examination (nasopharyngoscopy). Other possible causes, such as dysphagia, cancer, infectious diseases, and muscle disorders, must be ruled out.
Nonpharmacologic treatment
- Reduce stress
- Sucking candy, drinking water or eating something is symptomatically effective
- Physiotherapy, speech therapy
- Relaxation techniques
- Cognitive behavioral therapy
- Psychotherapy
Drug treatment
Gastroesophageal reflux is usually treated tentatively with proton pump inhibitors. They inhibit gastric acid secretion by binding to the proton pump in the gastric vestibular cells. Antacids neutralize gastric acid and may also form a protective film on the mucosa. H2 receptor antagonists such as ranitidine inhibit the secretion of acid and pepsin in the stomach. The effects are based on binding to histamine H2 receptors. Medications available for stress include antidepressants, adaptogens such as rose root and ginseng, and sedatives.
