Clinic of Internal Medicine-Gastroenterology, University Hospital Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Kollarova 2, 03601, Martin, Slovakia.
Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovakia.
Dig Dis Sci. 2024 Dec;69(12):4405-4415. doi: 10.1007/s10620-024-08694-1. Epub 2024 Nov 1.
Globus pharyngeus could be described as a benign sensation of lump or foreign object in the throat. The etiology of the globus as a solitary syndrome is still unknown, but it is proposed that stress could have an important role in symptom emergence.
To evaluate the autonomic nervous regulation in patients with globus compared to healthy controls in reaction to stress.
Patients included in the study were diagnosed based on ROME IV criteria for Disorders of Gut Brain Interaction. Besides globus, the patients did not suffer any other substantial medical condition. As a control group, measurement of healthy volunteers was performed. Both groups underwent the same stress protocol assessment in the same laboratory settings. The protocol consist of two types of stressors: cold pressor test and mental arithmetic test to test different types of autonomic reactivity.
Baroreflex sensitivity was significantly decreased in patients compared to controls in all phases of the protocol. Low-frequency band of systolic blood pressure variability was significantly increased during both stress phases in patients compared to controls. High-frequency band of heart rate variability was significantly decreased in patients compared to controls during the both of the stress phases.
The results of this study shows discrete abnormalities in complex autonomic reflex control which are predominantly manifested in response to stressful stimuli indicating altered neurocardiac regulation as a reaction to stress associated with globus pharynegus. This fact could have an important role in the personalized management of globus patients such as biofeedback.
咽球感可被描述为喉咙中有异物或肿块的良性感觉。作为一种孤立综合征的球感的病因尚不清楚，但有人提出，压力可能在症状出现中起重要作用。
评估与健康对照组相比，患者在应激反应中的自主神经调节。
根据罗马 IV 标准诊断为肠脑相互作用障碍的患者被纳入研究。除了球感外，患者没有其他实质性的健康问题。作为对照组，对健康志愿者进行了测量。两组均在相同的实验室环境中接受相同的应激方案评估。该方案包括两种类型的应激源：冷加压试验和心算试验，以测试不同类型的自主反应性。
与对照组相比，患者在方案的所有阶段的压力反射敏感性均显著降低。与对照组相比，患者在两个应激阶段的收缩压变异性低频带均显著增加。与对照组相比，患者在两个应激阶段的心率变异性高频带均显著降低。
本研究的结果显示，自主反射控制的离散异常主要表现为对应激刺激的反应，表明与咽球感相关的应激时神经心脏调节改变。这一事实可能在咽球感患者的个体化管理中具有重要作用，例如生物反馈。
