Taste, smell changes linked to symptoms in globus patients without evidence of reflux

Changes of taste and smell (TSCs), as well as psychological comorbidities, occur frequently in globus patients with no evidence of pathologic acid reflux, reports a study.

In this prospective analysis, 116 patients who met the Rome IV diagnostic criteria for globus underwent 24-hour pH monitoring, with results showing no evidence of pathologic acid reflux. In addition, 125 healthy controls were included.

All participants completed several questionnaires, including the Taste and Smell Survey, the Glasgow Edinburgh Throat Scale, the Hamilton Anxiety Scale (HAMA), and the Hamilton Depression Scale (HAMD). Finally, the authors performed multiple logistic regression to explore the potential risk factors for globus.

Globus patients without evidence of pathologic acid reflux showed a 58.62-percent change in taste and 31.03-percent change in smell, while their levels of anxiety and depression were 51.72 percent and 44.83 percent, respectively.

A significant difference was observed in the taste (z, ‒4.954; p<0.001) and smell (z, ‒4.552; p<0.001) scores between globus patients and healthy controls. The globus group also had a higher HAMA score (9.52 vs 3.12; t, 6.867; p<0.001) and HAMD score (9.79 vs 3.16; t, 6.416; p<0.001) than controls.

Furthermore, the Glasgow Edinburgh Throat Scale was significantly associated with the taste score (Spearman ρ=0.782; p<0.001), smell score (Spearman ρ=0.582; p=0.001), HAMA (Spearman ρ=0.676; p<0.001), and HAMD (Spearman ρ=0.672; p<0.001) in the globus group.

Likewise, the taste score significantly correlated with HAMA (Spearman ρ=0.532; p=0.004) and HAMD (Spearman ρ=0.681; p<0.001), while the smell score significantly correlated with HAMD (Spearman ρ=0.392; p=0.035). In multivariate analysis, TSCs, anxiety, and depression independently predicted the risk of globus, with depression showing the highest degree of association (odds ratio, 3.244).

“The obtained results indicated that there is a strong relationship between TSCs, psychological comorbidities, and globus,” the authors said. “Therefore, awareness of this high prevalence of TSCs and psychological disorder may help to better understand the severity of throat symptoms.”