Skip to main content Accessibility help
×
×
Home

Anticholinergic medication use is associated with globus pharyngeus

  • S Haft (a1) (a2), R M Carey (a1), D Farquhar (a1) (a3) and N Mirza (a1)
Abstract
Background:

Globus pharyngeus has been linked to salivary hypofunction. We hypothesise that a considerable portion of the globus experienced by patients is due to a drying effect secondary to anticholinergic medication use; this study aimed to determine their association.

Methods:

A cross-sectional study was conducted of 270 patients who presented to a laryngology practice over 6 months. Participants rated globus sensation on a 5-point severity scale, with those scoring 0 considered as controls (non-globus). Participants were excluded if they had a likely cause of globus. Scores were compared with participants’ medication lists, co-morbidities, age and gender, and evaluated using multivariate analysis, with significance set at p < 0.05.

Results:

Any participant taking at least 2 anticholinergic medications had a 3.52 increased odds (p = 0.02) of experiencing globus. A previous diagnosis of gastroesophageal reflux disease was also significantly associated with globus (p = 0.004), with an odds ratio of 3.75.

Conclusion:

A substantial portion of idiopathic globus may be due to anticholinergic use or reflux. The findings implicate medication use as a risk factor for globus. An awareness of these associations is invaluable for identifying cause and treating globus.

Copyright
Corresponding author
Address for correspondence: Dr Ryan M Carey, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, 5 Ravdin, Philadelphia, PA 19104, USA E-mail: rcarey@mail.med.upenn.edu
Footnotes
Hide All

Presented as a poster at the 94th Annual Meeting of the American Broncho-Esophagological Association, 14–15 May 2014, Las Vegas, Nevada, USA.

Footnotes
References
Hide All
1 Lee, BE, Kim, GH. Globus pharyngeus: a review of its etiology, diagnosis and treatment. World J Gastroenterol 2012;18:2462–71
2 Park, KH, Choi, SM, Kwon, SU, Yoon, SW, Kim, SU. Diagnosis of laryngopharyngeal reflux among globus patients. Otolaryngol Head Neck Surg 2006;134:81–5
3 Webb, CJ, Makura, ZG, Fenton, JE, Jackson, SR, McCormick, MS, Jones, AS. Globus pharyngeus: a postal questionnaire survey of UK ENT consultants. Clin Otolaryngol Allied Sci 2000;25:566–9
4 Baek, CH, Chung, MK, Choi, JY, So, YK, Son, YI, Jeong, HS. Role of salivary function in patients with globus pharyngeus. Head Neck 2010;32:244–52
5 Mese, H, Matsuo, R. Salivary secretion, taste and hyposalivation. J Oral Rehabil 2007;34:711–23
6 Cassolato, SF, Turnbull, RS. Xerostomia: clinical aspects and treatment. Gerodontology 2003;20:6477
7 Proctor, GB, Carpenter, GH. Regulation of salivary gland function by autonomic nerves. Auton Neurosci 2007;133:318
8 Haft, S, Farquhar, D, Carey, R, Mirza, N. Anticholinergic use is a major risk factor for dysphonia. Ann Otol Rhinol Laryngol 2015;124:797802
9 Carnahan, RM, Lund, BC, Perry, PJ, Pollock, BG, Culp, KR. The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol 2006;46:1481–6
10 Rudolph, JL, Salow, MJ, Angelini, MC, McGlinchey, RE. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med 2008;168:508–13
11 Bergdahl, M, Bergdahl, J. Low unstimulated salivary flow and subjective oral dryness: association with medication, anxiety, depression, and stress. J Dent Res 2000;79:1652–8
12 Belafsky, PC, Postma, GN, Koufman, JA. Validity and reliability of the reflux symptom index (RSI). J Voice 2002;16:274–7
13 You, LQ, Liu, J, Jia, L, Jiang, SM, Wang, GQ. Effect of low-dose amitriptyline on globus pharyngeus and its side effects. World J Gastroenterol 2013;19:7455–60
14 Mittal, RK. Upper esophageal sphincter. In: Motor Function of the Pharynx, Esophagus, and its Sphincters. San Rafael, CA: Morgan & Claypool Life Sciences, 2011;1013
15 Deary, IJ, Wilson, JA, Harris, MB, MacDougall, G. Globus pharyngis: development of a symptom assessment scale. J Psychosom Res 1995;39:203–13
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed