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Anticholinergic medication use is associated with globus pharyngeus

Published online by Cambridge University Press:  27 October 2016

S Haft ,
R M Carey ,
D Farquhar  and
N Mirza
S Haft
Affiliation:
Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA Division of Otolaryngology, University of California, San Diego, USA
R M Carey*
Affiliation:
Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA
D Farquhar
Affiliation:
Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA Department of Otolaryngology: Head and Neck Surgery, University of North Carolina, Chapel Hill, USA
N Mirza
Affiliation:
Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA
*
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: [email protected]
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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.

Keywords

AnticholinergicsGlobusDrug Side EffectsReflux Symptom IndexSiccaLaryngopharyngeal Reflux
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 12 , December 2016 , pp. 1125 - 1129
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

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

References

1 Lee, BE, Kim, GH. Globus pharyngeus: a review of its etiology, diagnosis and treatment. World J Gastroenterol 2012;18:2462–71Google Scholar
2 Park, KH, Choi, SM, Kwon, SU, Yoon, SW, Kim, SU. Diagnosis of laryngopharyngeal reflux among globus patients. Otolaryngol Head Neck Surg 2006;134:81–5Google Scholar
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;25:566–9Google Scholar
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;32:244–52Google Scholar
5 Mese, H, Matsuo, R. Salivary secretion, taste and hyposalivation. J Oral Rehabil 2007;34:711–23Google Scholar
6 Cassolato, SF, Turnbull, RS. Xerostomia: clinical aspects and treatment. Gerodontology 2003;20:64–77 Google Scholar
7 Proctor, GB, Carpenter, GH. Regulation of salivary gland function by autonomic nerves. Auton Neurosci 2007;133:3–18 Google Scholar
8 Haft, S, Farquhar, D, Carey, R, Mirza, N. Anticholinergic use is a major risk factor for dysphonia. Ann Otol Rhinol Laryngol 2015;124:797–802 Google Scholar
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;46:1481–6Google Scholar
10 Rudolph, JL, Salow, MJ, Angelini, MC, McGlinchey, RE. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med 2008;168:508–13Google Scholar
11 Bergdahl, M, Bergdahl, J. Low unstimulated salivary flow and subjective oral dryness: association with medication, anxiety, depression, and stress. J Dent Res 2000;79:1652–8Google Scholar
12 Belafsky, PC, Postma, GN, Koufman, JA. Validity and reliability of the reflux symptom index (RSI). J Voice 2002;16:274–7Google Scholar
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;19:7455–60Google Scholar
14 Mittal, RK. Upper esophageal sphincter. In: Motor Function of the Pharynx, Esophagus, and its Sphincters. San Rafael, CA: Morgan & Claypool Life Sciences, 2011;10–13 Google Scholar
15 Deary, IJ, Wilson, JA, Harris, MB, MacDougall, G. Globus pharyngis: development of a symptom assessment scale. J Psychosom Res 1995;39:203–13Google Scholar