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Effect of low-dose amitriptyline on globus pharyngeus and its side effects

World Journal of Gastroenterology 2013年第42期19卷 7455-7460页

作者： Le-Qing You Jing Liu Lin Jia Shu-Man Jiang Gui-Qin Wang Department of Gastroenterology Guangzhou First People’s HospitalGuangzhou Medical University Department of Gastroenterology Guangzhou Nansha Central Hospital

AIM:To compare the efficacy and side effects of lowdose amitriptyline(AMT)with proton pump inhibitor treatment in patients with globus ***:Thirty-four patients who fulfilled the RomeⅢcriteria for functional esophageal disorders were included in this *** were randomly assigned to receive either 25 mg AMT before bedtime(AMT group)or 40 mg Pantoprazole once daily for 4 wk(conventional group).The main efficacy endpoint was assessed using the Glasgow Edinburgh Throat Scale(GETS).The secondary efficacy endpoints included the Medical Outcomes Study 36-item short form health survey[social functioning(SF)-36]and the Pittsburgh Sleep Quality *** response was defined as a>50%reduction in GETS *** patients entering this study recorded side effects at days 1,8,15,22 and 29 using a visual analogue ***:Thirty patients completed the *** 4 wk of treatment,the AMT group had a greater response than the conventional group(75%vs 35.7%,P=0.004).At day 3,the AMT group showed significantly more improvement than the Conventional group in GETS score(3.69±1.14 vs 5.64±1.28,P=0.000).After 4 wk of treatment,the AMT group showed significantly greater improvement in GETS score and sleep quality than the Conventional group(1.25±1.84 vs 3.79±2.33,4.19±2.07 vs 8.5±4.97;Ppharyngeus.

关键词： Amitriptyline Globus pharyngeus Side effect Pantoprazole Treatment response

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Review: Current Trends in the Diagnosis and Management of Globus pharyngeus

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International Journal of Otolaryngology and Head & Neck Surgery 2012年第3期1卷 57-62页

作者： Scott Mitchell Oladejo Olaleye Matthew Weller Department of Otolaryngology Dudley Group of Hospitals West Midlands UK

Aim: To review recent literature on the diagnosis and management options for globus pharyngeus. Recent Findings: Strong evidence for the cause of globus pharyngeus is lacking however there is some research to suggest a possible link between laryngopharyngeal reflux (LPR) and globus pharyngeus. Radiological investigations used to find the cause of globus pharyngeus are often normal with little evidence to support their routine use. There are no long term controlled studies investigating the effectiveness of proton pump inhibitors (PPI’s) for the treatment of globus pharyngeus however, these are commonly used. A recent nonplacebo-controlled study has shown promising results using liquid alginate suspension to treat laryngopharyngeal reflux symptoms. Other treatment modalities used, such as speech and language therapy, have shown some improvement in symptoms but these are often small trials. Summary: Globus pharyngeus is a clinical diagnosis. Investigations should be reserved for those with atypical symptoms. Thorough clinical evaluation and examination, including fibreoptic laryngoscopy, are key points in management.

关键词： Globus pharyngeus Hystericus Laryngopharyngeal Reflux

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Clinical significance of heterotopic gastric mucosal patch of the proximal esophagus

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World Journal of Gastroenterology 2013年第3期19卷 331-338页

作者： Vui Heng Chong Endoscopy Unit Department of MedicineRIPAS HospitalBandar Seri Begawan BA 1710Brunei Darussalam

Heterotopic gastric mucosa of the proximal esophagus (HGMPE),also referred to as"inlet patch"or"cervical inlet patch",is a salmon colored patch that is usually located just distal to the upper esophageal sphincter. HGMPE is uncommon with endoscopic studies reporting a prevalence ranging from less than one percent to 18%.Most HGMPE are asymptomatic and are detected incidentally during endoscopy for evaluations of other gastrointestinal *** consider HGMPE as clinically irrelevant *** clinical significance of HGMPE is mainly acid related or neoplastic *** reported prevalence of laryngopharyngeal reflux symptoms varies from less than 20%to as high as 73.1%.However,most of these symptoms are mild. Clinically significant acid related complications such as bleeding,ulcerations,structure and fistulization have been *** rare,dysplastic changes and malignancies in association with HGMPE have also been *** with Barrett's esophagus have also been reported but the findings so far have been *** are still many areas that are unknown or not well understood and these include the natural history of HGMPE,risk factors for complications,role of Helicobacter pylori infection and factors associated with malignant ***-up may need to be considered for patients with complications of HGMPE and surveillance if biopsies show intestinal metaplasia or dysplastic *** the overall low incidence of clinically relevant manifestations reported in the literature,HGMPE is a clinically significant entity but further researches are required to better understand its clinical significance.

关键词： Cervical inlet patch Laryngopharyngeal reflux Globus pharyngeus Neoplasms Barrett’s esophagus

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