Rome IV Diagnostic Criteria for Globus
Rome IV criteria for globus -- the persistent or intermittent non-painful sensation of a lump, foreign body, or tightness in the throat not associated with dysphagia or odynophagia. After excluding structural and reflux causes.
Score interpretation
Criteria for globus pharyngeus not fully met -- further evaluation required
→ Exclude structural causes: ENT examination (laryngoscopy); upper endoscopy if alarm features or suspected EoE; barium swallow if dysphagia present; TFTs (goitre); exclude GERD (pH impedance testing or PPI trial); manometry for motility disorder; consider psychological causes (anxiety, depression -- common association).
Rome IV globus confirmed -- reassurance and addressing contributing factors
→ Reassure patient: benign condition, no structural abnormality; address GERD if any reflux contribution (PPI 4-8 weeks, may improve globus); speech and language therapy (laryngeal repositioning, swallowing therapy); treat anxiety/depression (CBT, SSRI -- strong association with globus); avoid frequent throat clearing (worsens symptoms); hydration; nasal saline irrigation if post-nasal drip contributing; sucralfate gargle may help; ENT referral if persistent or uncertain diagnosis.
Interpretation bands for the Rome IV Globus. Apply clinical judgement and local guidance.
References
- Aziz Q et al. Esophageal disorders. Gastroenterology. 2016;150(6):1368-1379.
- Ali M et al. An updated approach to the management of globus pharyngeus. Postgrad Med J. 2021;97(1143):60-65.
Related
Curated clinical cross-links plus same-class fallbacks.
- Manning Criteria for Irritable Bowel Syndrome · Functional GI Disorders
- Kruis Score for Diagnosis of Irritable Bowel Syndrome · Functional GI Disorders
- Rome IV Diagnostic Criteria for Functional Dyspepsia · Functional GI Disorders
- Rome IV Diagnostic Criteria for Functional Constipation · Functional GI Disorders
- Rome IV Diagnostic Criteria for Functional Chest Pain · Functional GI Disorders
- Rome IV Diagnostic Criteria for Cyclic Vomiting Syndrome (CVS) · Functional GI Disorders
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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.