Yes, globus sensation can occur in patients with IBS and is more common than in the general population.
Patients with IBS have a significantly higher prevalence of globus sensation compared to age-matched controls, though the overlap is relatively modest at approximately 17-49% depending on how it's measured 1, 2, 3.
Understanding the Association
The relationship between globus and IBS reflects the broader concept of disorders of gut-brain interaction (DGBI). Here's what the evidence shows:
Prevalence and Overlap Patterns
- Globus occurs in approximately 0.75% of the general population globally 3
- When globus is present, 49% of patients have concurrent non-esophageal DGBI (including IBS), which is substantially higher than the 17.4% who have coexisting heartburn 3
- This suggests that the connection between globus and IBS is stronger than the traditional assumption that globus is primarily reflux-related
Clinical Characteristics
The typical patient with both conditions:
- Is between 40-64 years of age (46.6% of cases) 3
- Has a slight female predominance (55.4%) 3
- Frequently has anxiety and/or depression (60.5% of globus patients) 3
- May experience other extraintestinal symptoms like back pain, bladder symptoms, or fibromyalgia 4
Pathophysiological Mechanism
The dispersed pattern of symptoms affecting both ends of the gastrointestinal tract suggests a systemic mechanism, possibly hormonal or related to central sensitization, rather than localized pathology 1. This aligns with the modern understanding of IBS as a disorder of the gut-brain axis with visceral hypersensitivity 4.
Clinical Implications
When evaluating a patient with IBS who reports globus sensation:
- Do not assume it requires extensive esophageal workup - the globus is likely part of the DGBI spectrum
- Screen for psychological comorbidities - anxiety and depression are present in the majority of these patients 3
- Consider this when explaining the diagnosis - it reinforces the concept of IBS as a gut-brain interaction disorder affecting multiple GI regions 4
- Treatments targeting central mechanisms may help both symptoms - gut-directed psychotherapy, tricyclic antidepressants, and other neuromodulators address the underlying pathophysiology 4, 5
Important Caveat
While globus can occur with IBS, if dysphagia is present, this is NOT globus by definition and requires structural evaluation 3. True globus is the sensation of a lump without actual swallowing difficulty or structural abnormality.