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Therapeutic approaches for functional Globus Pharyngeus: A systematic review of studies from 2000 to 2025
Objective
To systematically review therapeutic interventions for functional globus pharyngeus in adults.
Methods
Following PRISMA 2020 (PROSPERO CRD420251185872), PubMed/MEDLINE, Google Scholar, and ClinicalTrials.gov were searched for interventional studies (2000–2025; last search March 2026). Eligible studies enrolled adults with functional globus by Rome III/IV criteria or exclusion of structural pathology. Two reviewers independently screened and extracted data; disagreements were resolved by discussion. Risk of bias was assessed with RoB 2 and ROBINS-I.
Results
Fifteen studies (eight RCTs, seven nonrandomized; N = 784) were included: five pharmacological, four behavioural/psychological, two peripheral neuromodulation, two traditional Chinese medicine, one observational reassurance, and one surgical series. SSRIs and low-dose tricyclic antidepressants outperformed acid-suppressive comparators in controlled trials. Psychological interventions produced comparable benefit with fewer adverse effects. Transcutaneous electroacupuncture and auricular vagus nerve stimulation showed short-term improvement in two small studies. Reassurance and clinical attention yielded symptom reduction comparable to active interventions. Partial epiglottectomy in refractory patients with epiglottic–tongue base contact was associated with symptom resolution in small uncontrolled series, raising questions about the boundaries between functional and anatomically driven globus.
Conclusions
The most consistent — though preliminary — evidence supports centrally acting medications and structured psychological interventions; peripheral neuromodulation is promising but requires replication. The possibility that an anatomical variant contributes to symptoms in a refractory subgroup warrants prospective evaluation. The evidence supports a biopsychosocial framework and underscores the need for larger trials with standardised criteria, validated outcomes, attention-matched controls, and long-term follow-up.