Abstract
Background
Globus sensation is common, but its pathogenesis is not yet clear.
Aims
Our purpose was to investigate subjective perception of swallowing and esophageal motility by combined multichannel intraluminal impedance and manometry (MII-EM) for patients with globus sensation.
Methods
Combined MII-EM was performed for 25 globus patients and 15 healthy controls. Swallows were abnormal if hypocontractivity or simultaneous contractions occurred. Esophageal bolus transit was incomplete if bolus exit was not found at one or more of all measurement sites. Perception of each swallow was assessed by use of a standardized scoring system, and was enhanced if the score was >1.
Results
Few globus patients reported enhanced perception during viscous or solid swallows. Incomplete bolus transit and enhanced perception occurred similarly between viscous and solid boluses. Agreement between enhanced perception and proximal bolus clearance was greater during solid swallows (κ = 0.45, 95 % CI: 0.32–0.58) than during viscous swallows (κ = 0.13, 95 % CI: 0–0.25) (P < 0.05). Similarly, agreement between enhanced perception and total bolus clearance was greater during solid swallows (κ = 0.46, 95 % CI: 0.34–0.58) than during viscous swallows (κ = 0.11, 95 % CI: 0–0.22) (P < 0.05).
Conclusions
Enhanced swallow perception is uncommon in patients with globus sensation, although there is a significant association between enhanced esophageal perception and solid bolus clearance. Application of a solid bolus may help better delineation of the interrelationship between the subjective perception of bolus passage and the objective measurement of bolus clearance.
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Acknowledgments
This study was supported by a grant, NSC 99-2314-B-303-005, from the National Science Council, Taiwan. Part of this study was presented as a poster presentation at DDW 2012 in San Diego and was published in abstract form in Gastroenterology (2012) 142 (5 Suppl. 1):S282.
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Chen, CL., Yi, CH. & Liu, TT. Association Between Swallow Perception and Esophageal Bolus Clearance in Patients with Globus Sensation. Dig Dis Sci 58, 1042–1048 (2013). https://doi.org/10.1007/s10620-012-2463-2
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DOI: https://doi.org/10.1007/s10620-012-2463-2