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To distinguish between globus pharyngeus and significant throat pathology.
Symptoms suggesting benign globus pharyngeus:
On physical examination does the patient have:
If the patient has any of the following refer as Head and Neck 2 week wait:
On the day emergency advice/admission should be sought if the patient presents with:
Of note, a recent multicentre, double blind, randomised, placebo controlled trial has demonstrated that PPIs offered no symptomatic benefit over matched placebo for patients with persistent throat symptoms.
If symptoms are no better in 6 weeks after watchful waiting +/-alginate or new symptoms are presented, consider a referral to ENT.
e-Referral Service Selection
Patient.co.uk leaflet - Globus hystericus
This guideline has been developed by Royal Devon and Exeter Healthcare Foundation Trust based on local guidelines.
The BMJ: Use of proton pump inhibitors to treat persistent throat symptoms: multicentre, double blind, randomised, placebo controlled trial
This guideline has been signed off by the Eastern Locality on behalf of NHS Devon CCG.
Publication date: April 2017
Updated: September 2021
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