Anatomical Location as a Predictor of Treatment Response in Globus Pharyngeus.

Abstract

Objective: This study aimed to investigate whether the anatomical location of the globus sensation influences treatment outcome in patients with globus pharyngeus.

Methods: A prospective cohort study was conducted between March 2023 and May 2024 with 55 patients who presented with globus sensation. The participants were categorized into the upper and lower globus groups based on the anatomical location of globus sensation relative to the upper esophageal sphincter. All patients received proton pump inhibitor (PPI) therapy for up to 12 weeks, and treatment response was assessed using the Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). Log-rank tests and logistic regression analysis were performed to identify the factors associated with treatment response.

Results: Patients with upper globus showed a significantly-higher rate of symptom improvement (78.6%) than those with lower globus (40.7%). Symptom severity (measured by the RSI) was higher in the lower globus group, while posterior commissure hypertrophy (measured by the RFS) was more prevalent in the upper globus group. Factors positively associated with symptom improvement included the location of the upper globus and coffee cessation. The lower globus group showed resistance to PPI therapy.

Conclusion: Patients with upper globus respond better to PPI therapy, whereas those with lower globus do not. The anatomical location of the globus sensation may affect treatment outcomes.