MDCalc

Rome IV Diagnostic Criteria for Globus

Official Rome IV criteria for the diagnosis of globus.

Use in patients with symptoms suggestive of globus, such as a persistent or intermittent non-painful sensation of a lump or foreign body in the throat, for at least 6 months.

Patients with any of the following features must be evaluated clinically for other diagnoses even though globus may be present:

  • Dysphagia.

  • Odynophagia.

  • Sore throat.

  • Unexplained iron deficiency anemia.

  • Unintentional weight loss.

  • Palpable cervical lymphadenopathy on exam.

  • Persistent vomiting.

Must have the following:

For 3 months prior with symptom onset ≥6 months ago with a frequency of at least once a week

Occurrence of the sensation between meals, absence of dysphagia or odynophagia, and absence of a gastric inlet patch in the proximal esophagus

Diagnostic Result

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Advice

If diagnostic criteria are not met (negative):

Symptoms are unlikely to be caused by globus. Consider further assessment for other diseases, or a different functional GI disorder.

If meets diagnosis (positive):

Likely diagnosis of globus.

Management

Management of globus may include:

  • Education and patient reassurance.

  • Neuromodulator.

  • Behavioral therapy (e.g. cognitive behavioral therapy, hypnosis).

Critical Actions

This calculator should only be used in patients who do not have signs or symptoms suggestive of a structural/mechanical, metabolic or systemic cause of their symptoms based on clinical history, physical exam and initial work-up.