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Ding H, Duan Z, Yang D, Zhang Z, Wang L, Sun X, Yao Y, Lin X, Yang H, Wang S, Chen JDZ. High-resolution manometry in patients with and without globus pharyngeus and/or symptoms of laryngopharyngeal reflux. BMC Gastroenterol 2017; 17:109. [PMID: 29061118 PMCID: PMC5654000 DOI: 10.1186/s12876-017-0666-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 10/12/2017] [Indexed: 12/11/2022] Open
Abstract
Background Globus pharyngeus is common and has a low cure rate. Its etiology is complex and reported to be associated with laryngopharyngeal reflux (LPR). However, some patients with globus do not exhibit any reflux symptoms or respond to proton pump inhibitors (PPIs) treatments. The purpose of this study was to clarify the related risk factors of these patients with a final objective of improving the curative effect. Methods Forty two patients afflicted with globus pharyngeus (G group) and 38 patients without globus pharyngeus (NG group) were included in this study. According to the laryngopharyngeal Reflux Symptom Index and the response to PPIs treatments, the patients were further divided into reflux groups (G-R, NG-R) and non-reflux groups (G-NR, NG-NR). High Resolution Manometry (HRM) was performed to assess esophageal motility. Questionnaires, including categories such as life exposure factors, were conducted. Results a) The average resting and residual pressures of the upper esophageal sphincter (UES) in the G-NR group was higher than in the NG-NR and NG-R groups (P < 0.05). b) The average resting and residual pressures of the lower esophageal sphincter showed no differences between the G-NR group and the NG-NR group (P > 0.05). c) The esophageal distal contractile integral score of the G-NR group was not different from the NG-NR group (P > 0.05). d) Compared to the NG-NR group, the G-NR group showed higher incidence of stress, smoking, drinking, high salt and anxiety (P < 0.05). Conclusions Globus pharyngeus without LPR may occur due to high UES pressure. Stress, smoking, alcoholic drinking, high salt and anxiety may be its risk factors. Electronic supplementary material The online version of this article (10.1186/s12876-017-0666-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heyan Ding
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Zhijun Duan
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
| | - Dong Yang
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Zhifeng Zhang
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Lixia Wang
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Xiaoyu Sun
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yiwen Yao
- Otolaryngology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Xue Lin
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Hang Yang
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Shan Wang
- Neurogastroenterology and Motility Center of China-US Cooperation, Second Gastroenterology Department, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Jiande D Z Chen
- Division of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, MD, 21224, USA.
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