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Last updated: 30 March, 2020 15:59pm

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Globus (Feeling Something Stuck In The Throat) – Information for GPs

Referral Criteria / Commissioning position

Refer to secondary care for:

  • additional sinister features to rule out malignancy – 2WW

Unless sinister features are present there is little benefit to referral.

An ENT referral allows nasendoscopy.  Without sinister features this is likely to confirm Laryngo Pharyngeal Reflux (LPR) or pick up some source of irritation around the vocal cords, such as smoking.

Red flag symptoms

  • Persistent sore throat especially with otalgia associated with constant hoarseness >3 weeks– risk factors include smoker or drinker
  • Neck lump > 3 weeks
  • Recent onset Dysphagia
  • Odynophagia
  • Regurgitation
  • Unilateral pain in head or neck and/or otalgia but normal otoscopy
  • Objective weight loss

Investigations prior to referral

Unless sinister features – trial of an alginate raft-forming suspension (as per the current BNF guidance) for a least three months with a PPL

Information to include in referral letter

The GP referral letter should contain:

  • Specific information for condition – length of time and timing of the condition, any other features of LPR such as
    • cough
    • hoarseness
    • catarrh
  • Treatments and interventions tried including the results
  • Relevant past medical/surgical history
  • Drug history (prescribed and non-prescribed)
  • Current regular medication
  • BMI
  • Smoking status
  • Alcohol consumption
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