A prospective study of acid reflux and globus pharyngeus using a modified symptom index.

Previous authors have demonstrated an association between gastro-oesophageal reflux and globus pharyngeus. With the advent of 24-h pH monitoring the strength of this association has been questioned. A prospective study was performed using a 'Symptom Index' of acid reflux. A positive result was recorded when one out of two globus sensations occurred with acid reflux. The symptom index was assessed prospectively in 21 patients with a history of globus pharyngeus. In eight patients with significant acid reflux as defined by standard pH criteria the symptom index was positive in all cases. The remaining 13 patients had no objective evidence of significant reflux and the symptom index was negative. The symptom index is a useful additional marker to determine the significance of acid reflux in the pathogenesis of globus pharyngeus.