Volume : 10, Issue : 11, November – 2023

Title:

PREVALENCE OF GLOBUS SYNDROME AND ASSOCIATED FACTORS: A PROTOCOL FOR SYSTEMATIC REVIEW

Authors :

Hanan I Almuzaini, Manal Abdulaziz Murad, Abdulaziz Ahmed Alshehri, Abdulrahman Abdulkarim Alzahrani, Ahmed Abdulhadi Alzaidi, Lamiaa Saleh Alzahrani, Lara Salah Menshawi, Abdulelah Abdullah Alotaibi, Asem Fadel Alofi, Mohammed Sulaiman Aljabri, Bandar Abdulkarim Alanzy, Abdulaziz Ali Alsaedi, Tamader Abdulaziz Alsaraa, Fatimah Kareem Alanazi and Awatf Manawar Alshmmri

 

Abstract :

Background: The feeling of globus refers to a consistent or sporadic non-painful perception of a mass or foreign object in the pharynx. The aforementioned clinical disease is often observed in medical practice, characterized by its chronic nature, resistance to treatment, and propensity for recurrence.
Methods: A comprehensive search was conducted using electronic databases, including PubMed, Embase, and Cochrane Library, to identify relevant studies published from 2000 to 2022. The search was limited to English-language studies that examined the prevalence of globus syndrome and other associated factors.
Results: The initial search identified a total of 3052 studies and 59 studies were eligible for inclusion in this systematic review. The elusive origin of globus makes the establishment of standardized inquiry and treatment approaches challenging for individuals experiencing this condition. In order to effectively manage globus, it is essential to engage in meticulous history collection and do nasolaryngoscopy as a first measure. Considering the non-malignant characteristics of the ailment and the contemporary understanding that gastroesophageal reflux disease (GERD) plays a significant role in the development of globus sensation, it is justifiable to pursue empirical treatment including the administration of proton pump inhibitors at a substantial dosage for individuals exhibiting typical globus symptoms. In cases when patients exhibit a lack of response to the treatment, it is advisable to consider doing definitive tests, including endoscopy, multichannel intraluminal impedance/pH monitoring, and manometry. In cases when patients continue to have symptoms after negative examinations, the implementation of speech and language therapy, administration of anti-depressants, and use of cognitive-behavioral therapy have shown potential efficacy.
Conclusion: Global syndrome is widespread. Research has identified this condition’s causes and triggers. Reflux acid may produce globus. Upper esophageal sphincter and motor dysfunction. A full diagnosis is needed since globus syndrome is connected to pharyngeal inflammatory illnesses, upper aerodigestive tract malignancy, tongue base hypertrophy, retroverted epiglottis, thyroid disorders, cervical heterotopic gastric mucosa, and uncommon malignancies. An unknown link exists between mental health and globus, however stress may increase symptoms. Globus evaluation and treatment must involve physical and psychological factors. Many psychological and physical causes induce globus syndrome. Understanding these factors may help clinicians treat this discomfort. This sickness requires further investigation and therapy.

Cite This Article:

Please cite this article in press Hanan I Almuzaini et al, . Prevalence of globus syndrome and associated factors: a protocol for systematic review., Indo Am. J. P. Sci, 2023; 10 (11).

Number of Downloads : 10

References:

1. Galmiche JP, Clouse RE, Bálint A, Cook IJ, Kahrilas PJ, Paterson WG, Smout AJ. Functional esophageal disorders. Gastroenterology. 2006;130:1459–1465.
2. Moloy PJ, Charter R. The globus symptom. Incidence, therapeutic response, and age and sex relationships. Arch Otolaryngol. 1982;108:740–744.
3. Drossman DA, Li Z, Andruzzi E, Temple RD, Talley NJ, Thompson WG, Whitehead WE, Janssens J, Funch-Jensen P, Corazziari E. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993;38:1569–1580.
4. Batch AJ. Globus pharyngeus (Part I) J Laryngol Otol. 1988;102:152–158.
5. Harar RP, Kumar S, Saeed MA, Gatland DJ. Management of globus pharyngeus: review of 699 cases. J Laryngol Otol. 2004;118:522–527.
6. Purcell J. A treatise of vapours or hysteric fits. 2nd ed. London: Edward Place; 1707. pp. 72–74.
7. Malcomson KG. Globus hystericus vel pharyngis (a recommaissance of proximal vagal modalities) J Laryngol Otol. 1968;82:219–230.
8. Josefsson A, Palsson O, Simrén M, et al. Oesophageal symptoms are common and associated with other functional gastrointestinal disorders (FGIDs) in an English-speaking Western population. United European Gastroenterol J. 2018; 6: 1461-1469.
9. Moloy PJ, Charter R. The globus symptom. Incidence, therapeutic response, and age and sex relationships. Arch Otolaryngol. 1982; 108: 740-744.
10. Rasmussen ER, Schnack DT, Ravn AT. A prospective cohort study of 122 adult patients presenting to an otolaryngologist’s office with globus pharyngeus. Clin Otolaryngol. 2018; 43: 854-860.
11. Norder Grusell E, Mjörnheim A-C, Finizia C, et al. The diagnostic value of GerdQ in subjects with atypical symptoms of gastro-esophageal reflux disease. Scand J Gastroenterol. 2018; 53: 1165-1170.
12. Van Daele DJ. Esophageal manometry, pH testing, endoscopy, and videofluoroscopy in patients with globus sensation. Laryngoscope. 2019.
13. Li J, Zhang J, Guo P, et al. Dynamic swallowing study for globus patients. World J Otorhinolaryngol Head Neck Surg. 2016; 2: 198-202.
14. Mohammed H, Coates M, Masterson L, et al. Role of transnasal flexible laryngo-oesophagoscopy (TNFLO) in investigating patients with globus symptoms. Clin Otolaryngol. 2017; 42: 1311-1318.
15. Järvenpää P, Ilmarinen T, Geneid A, et al. Work-up of globus: assessing the benefits of neck ultrasound and videofluorography. Eur Arch Otorhinolaryngol. 2017; 274: 931-937.
16. Dworkin JP, Dowdall JR, Kubik M, et al. The role of the modified barium swallow study and esophagram in patients with globus sensation. Dysphagia. 2015; 30: 506-510.
17. Bajbouj M, Becker V, Eckel F, et al. Argon plasma coagulation of cervical heterotopic gastric mucosa as an alternative treatment for globus sensations. Gastroenterology. 2009; 137: 440-444.
18. Kristo I, Rieder E, Paireder M, et al. Radiofrequency ablation in patients with large cervical heterotopic gastric mucosa and globus sensation: closing the treatment gap. Dig Endosc. 2018; 30: 212-218.
19. Tomoda C, Sugino K, Tanaka T, et al. Globus symptoms in patients undergoing thyroidectomy: relationships with psychogenic factors, thyroid disease, and surgical procedure. Thyroid. 2018; 28: 104-109.
20. Penovic S, Roje Z, Brdar D, et al. Globus pharyngeus: a symptom of increased thyroid or laryngopharyngeal reflux? Acta Clin Croat. 2018; 57: 110-115.
21. Kwiatek MA, Mirza F, Kahrilas PJ, et al. Hyperdynamic upper esophageal sphincter pressure: a manometric observation in patients reporting globus sensation. Am J Gastroenterol. 2009; 104: 289-298.
22. Ding H, Duan Z, Yang D, et al. High-resolution manometry in patients with and without globus pharyngeus and/or symptoms of laryngopharyngeal reflux. BMC Gastroenterol. 2017; 17: 109.
23. Tang Y, Huang J, Zhu Y, et al. Comparison of esophageal motility in gastroesophageal reflux disease with and without globus sensation. Rev Esp Enferm Dig. 2017; 109: 850-855.
24. Peng L, Patel A, Kushnir V, et al. Assessment of upper esophageal sphincter function on high-resolution manometry: identification of predictors of globus symptoms. J Clin Gastroenterol. 2015; 49(2): 95-100.
25. Zhou W-C, Jia L, Chen D-Y, et al. The effects of paroxetine and amitriptyline on the upper esophageal sphincter (UES) pressure and its natural history in globus pharyngeus. Dig Liver Dis. 2017; 49: 757-763.
26. Cook IJ, Dent J, Shannon S, et al. Measurement of upper esophageal sphincter pressure. Gastroenterology. 1987; 93: 526-532.
27. Tokashiki R, Funato N, Suzuki M. Globus sensation and increased upper esophageal sphincter pressure with distal esophageal acid perfusion. Eur Arch Otorhinolaryngol. 2010; 267: 737-741.
28. Blais P, Patel A, Sayuk GS, et al. Upper esophageal sphincter (UES) metrics on high-resolution manometry (HRM) differentiate achalasia subtypes. Neurogastroenterol Motil. 2017; 29:e13136.
29. Blais P, Bennett MC, Gyawali CP. Upper esophageal sphincter metrics on high-resolution manometry differentiate etiologies of esophagogastric junction outflow obstruction. Neurogastroenterol Motil. 2019; 31:e13558.
30. Moser G, Wenzel-Abatzi T-A, Stelzeneder M, et al. Globus sensation: pharyngoesophageal function, psychometric and psychiatric findings, and follow-up in 88 patients. Arch Intern Med. 1998; 158: 1365-1373.
31. Hill J, Stuart RC, Fung HK, et al. Gastroesophageal reflux, motility disorders, and psychological profiles in the etiology of globus pharyngis. Laryngoscope. 1997; 107: 1373-1377.
32. Fukui A, Nakayama M, Sakamoto N, et al. Relation between globus pharyngeus and OSA in patients examined simultaneously by PSG and pH monitor: a cross sectional study. Auris Nasus Larynx. 2018; 45: 1033-1040.
33. Kato MG, Isaac MJ, Gillespie MB, et al. The incidence and characterization of globus sensation, dysphagia, and odynophagia following surgery for obstructive sleep apnea. J Clin Sleep Med. 2018; 14: 127-132.
34. Manolakis AC, Broers C, Geysen H, et al. Effect of citalopram on esophageal motility in healthy subjects-Implications for reflux episodes, dysphagia, and globus. Neurogastroenterol Motil. 2019; 31: 1-8.
35. Haft S, Carey RM, Farquhar D, et al. Anticholinergic medication use is associated with globus pharyngeus. J Laryngol Otol. 2016; 130: 1125-1129.
36. Hamdan A-L, Khalifee E, Ghanem A, et al. Predictive value of globus pharyngeus in patients with functional dysphonia versus organic dysphonia. Laryngoscope. 2019; 129: 930-934.
37. Chukwuneke F, Akpe J, Okoye L, et al. Concurrent presentation of burning mouth syndrome and globus pharyngis in enugu, nigeria: a ten-year clinical evaluation. Oral Health Prev Dent. 2014; 12: 259-263.
38. Tokashiki R, Yamaguchi H, Nakamura K, et al. Globus sensation caused by gastroesophageal reflux disease. Auris Nasus Larynx. 2002; 29: 347-351.
39. Chen CL, Szczesniak MM, Cook IJ. Evidence for oesophageal visceral hypersensitivity and aberrant symptom referral in patients with globus. Neurogastroenterol Motil. 2009; 21: 1142-e96.
40. Khan MR, Saha M, Mamun MA, et al. Upper GIT endoscopic evaluation and psychological state assessment of patients with globus sensation. Mymensingh Med J. 2019; 28: 405-409.
41. Bouchoucha M, Girault-Lidvan N, Hejnar M, et al. Clinical and psychological characteristics of patients with globus. Clin Res Hepatol Gastroenterol. 2019; 43: 614-622.
42. Tang B, Wang X, Chen C, et al. The differences in epidemiological and psychological features of globus symptoms between urban and rural Guangzhou, China: a cross-sectional study. Medicine (Baltimore). 2018; 97:e12986.
43. Nevalainen P, Walamies M, Kruuna O, et al. Supragastric belch may be related to globus symptom – a prospective clinical study. Neurogastroenterol Motil. 2016; 28: 680-686.
44. Deary IJ, Wilson JA, Harris MB, et al. Globus pharyngis: development of a symptom assessment scale. J Psychosom Res. 1995; 39: 203-213.
45. Timon C, Cagney D, O’Dwyer T, et al. Globus pharyngeus: long-term follow-up and prognostic factors. Ann Otol Rhinol Laryngol. 1991; 100: 351-354.
46. Burns P, Timon C. Thyroid pathology and the globus symptom: are they related? A two year prospective trial. J Laryngol Otol. 2007; 121: 242-245.
47. Sanyaolu LN, Jemah A, Stew B, et al. The role of transnasal oesophagoscopy in the management of globus pharyngeus and non-progressive dysphagia. Ann R Coll Surg Engl. 2016; 98: 49-52.
48. Orosey M, Amin M, Cappell MS. A 14-year study of 398 esophageal adenocarcinomas diagnosed among 156,256 EGDs performed at two large hospitals: an inlet patch is proposed as a significant risk factor for proximal esophageal adenocarcinoma. Dig Dis Sci. 2018; 63: 452-465.
49. Peitz U, Vieth M, Evert M, et al. The prevalence of gastric heterotopia of the proximal esophagus is underestimated, but preneoplasia is rare – correlation with Barrett’s esophagus. BMC Gastroenterol. 2017; 17: 87.
50. Lin T, Linn S, Ona MA, et al. Helicobacter pylori-positive inlet patch without concurrent Helicobacter pylori gastritis: case report of a patient with sleeve gastrectomy. Ann Gastroenterol. 2017; 30: 251.
51. Gawron AJ, Rothe J, Fought AJ, et al. Many patients continue using proton pump inhibitors after negative results from tests for reflux disease. Clin Gastroenterol Hepatol. 2012; 10: 620-625; quiz e57.
52. Yadlapati R, Ciolino JD, Craft J, et al. Trajectory assessment is useful when day-to-day esophageal acid exposure varies in prolonged wireless pH monitoring. Dis Esophagus. 2019; 32(3). pii: doy077.
53. Sung HJ, Chung WC, Roh JW, et al. Prediction of the response to proton pump inhibitor treatment using wireless ambulatory pH monitoring in patients with globus sense. Korean J Gastroenterol. 2015; 65: 85-89.
54. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon consensus. Gut. 2018; 67: 1351-1362.
55. Kahrilas PJ, Bredenoord AJ, Fox M, et al. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015; 27: 160-174.
56. Deary IJ, Wilson JA, Kelly SW. Globus pharyngis, personality, and psychological distress in the general population. Psychosomatics. 1995; 36: 570-577.
57. Harris MB, Deary IJ, Wilson JA. Life events and difficulties in relation to the onset of globus pharyngis. J Psychosom Res. 1996; 40: 603-615.
58. Deary IJ, Smart A, Wilson JA. Depression and ‘hassles’ in globus pharyngis. Br J Psychiatry. 1992; 161: 115-117.
59. Meining A, Bajbouj M, Preeg M, et al. Argon plasma ablation of gastric inlet patches in the cervical esophagus may alleviate globus sensation: a pilot trial. Endoscopy. 2006; 38: 566-570.
60. Klare P, Meining A, von Delius S, et al. Argon plasma coagulation of gastric inlet patches for the treatment of globus sensation: it is an effective therapy in the long term. Digestion. 2013; 88: 165-171.
61. Cybulska EM. Globus hystericus – a somatic symptom of depression? The role of electroconvulsive therapy and antidepressants. Psychosom Med. 1997; 59: 67-69.
62. Brown SR, Schwartz JM, Summergrad P, et al. Globus hystericus syndrome responsive to antidepressants. Am J Psychiatry. 1986; 143: 917-918.
63. Kiebles JL, Kwiatek MA, Pandolfino JE, et al. Do patients with globus sensation respond to hypnotically assisted relaxation therapy? A case series report. Dis Esophagus. 2010; 23: 545-553.
64. Khalil HS, Bridger MW, Hilton-Pierce M, et al. The use of speech therapy in the treatment of globus pharyngeus patients. A randomised controlled trial. Rev Laryngol Otol Rhinol (Bord). 2003; 124: 187-190.
65. Nakano S-I, Iwasaki H, Kondo E, et al. Efficacy of proton pump inhibitor in combination with rikkunshito in patients complaining of globus pharyngeus. J Med Invest. 2016; 63: 227-229.
66. Tokashiki R, Okamoto I, Funato N, et al. Rikkunshito improves globus sensation in patients with proton-pump inhibitor-refractory laryngopharyngeal reflux. World J Gastroenterol. 2013; 19: 5118-5124.