Supragastric belch may be related to globus symptom – a prospective clinical study

Background The etiology of globus is poorly understood. It is controversial, whether gastroesophageal reflux disease (GERD) has a role in globus. To investigate the possible esophageal background of this symptom, we performed transnasal esophagoscopy (TNE), high‐resolution manometry (HRM), and 24‐h multichannel intraluminal impedance (MII) and pH monitoring on globus patients. Methods Thirty consecutive patients were referred to Helsinki University Hospital, Department of Otorhinolaryngology – Head and Neck Surgery for treatment of globus; 24 consecutive patients with difficult reflux symptoms from the Department of Surgery served as controls. We compared the results of the patient groups in endoscopies, HRM, and 24‐h MII‐pH monitoring. Key Results In MII monitoring, globus patients had supragastric belch (6/20, 30% vs 1/24, 4%; p = 0.038) more often than controls. Total reflux time was higher in controls (p = 0.004), and they had more acid reflux events (p = 0.002) in MII, but between groups, the number of non‐acid reflux events was similar. In pH monitoring, DeMeester score and total pH