Lump sensation in throat is common symptom in middle aged woman and in that case, true dysphagia is usually absent. Globus hystericus is generally assumed to be of psychic origin but its pathophysiology is still remained this study to evaluate
esophageal functional abnormality in patients with globus hystericus by esophageal manometry. An organic cause for their symptoms were ruled out by physical examination of laryngopharynx and esophagoscopy. Patients with posterior nasal drip were
excluded. Thirty six patients(mean age 45 years, 28-63) and control group of 23 (mean age 49 years, 35-67) were examined with water perfused 6-lumen catheter and low compliance system. The data was analyzed with software of Synetics(r)Low
esophageal
sphincter(LES) pressure of control group was 18.2(r)5.3mmHg (station pull through : SPT, mean±S.D.), 25.7±6.5mmHg(rapid pull throught, RDT) and % relaxation was 94.3±5.9%. Five(14%) of patient group showed abnoramlly high or low LES pressure
and
the
other 2 patients showed incomplete relaxation. Upper esophageal sphicter (UES) pressure of control group was 82.1±29.1mmHg(SPT, mean±S.D.), 91.5±30.3mmHg (RPT) and % relaxation was 88.8±5.5%. Three(8%) of patient group showed abnormally high
UES
pressure and the other 3 patients showed incomplete relaxatio. Basal pressure of upper esophageal body(7.5mmHg) was significantly higher than that of control group (4.3mmHg, p<0.01, t-test). In the body of esophagus various kinds of abnormal
finding
with wet swallow were noted ; nutcracker esophagus in 3 patients(8%), high amplitude of upper esophagus in 3 patients(8%), and non-specific esophageal motility disorder in 7 patients. Twenty three out of 36 patients(64%) with globus hystericus
showed at
least one abnormal esophageal motility findings. It could be concluded that dysmotility of esophageal body as well as UDS may be pathophysiology of globus hystericus. (Korean J Gastroenterol 1994 ; 26 : 625-63).
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