I am 24 years old male. I've had globus sensation since last 3 years without any heartburn. I've undergone endoscopy (nov, 2018) & esophageal manometry (March, 2018) after consulting a gastroenterologist. The manometry test came normal with normally functioning les while the endoscopy test was normal too. The doctor said that this acid reflux is temporary and is induced by stress. I've been taking pegs almost regularly since last 2 years with a few breaks. Just to have a second opinion, I consulted another gastroenterologist who conducted endoscopy again (he did it himself on feb, 2019) and said that I have a lax les. He did ask me to undergo chest ct scan from his preferred diagnostic centre which created a few doubts in my mind. My first doubt is: is it possible to check les function through just endoscopy (how can he conclude lax les, without doing a manometry or other tests)? Second, i've also started having mild lymph node swelling around my neck, with size lesser than 10 mm (after doing ultrasound. The report was normal saying mild bilateral lymphadenopathy). The second doctor said it's because of acid reflux and nothing else. Is this case possible?

Dr. AjithGeneral Physician26yrs exp

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To answer your questions first, you are right in assuming that les function cannot be checked during endoscopy. However, changes in the oesophagus as a result of acid reflux due to a lax les can be observed during endoscopy and that might be what your doctor has found. However since you have had one positive and one negative endoscopy outcome, it is better to go for a third one to reconfirm the finding. As for your second question, swelling of lymph nodes around the throat region can take place if you have acid reflux disease. Coming to the globus problem, it is not a well understood condition. It has many known causes and in some cases no known cause has been identified so far. If you want to find out more about it, just google globus pharyngis and you can read up all there is to know about it. Your lifestyle itself could be a contributing factor and you might have actually identified the primary cause for aggravation in your narrative by saying that you are a regular consumer of alcohol. There are probably other aggravating diet choices contributing to the problem so it might be worthwhile trying out some lifestyle modifications to see if the problem gets resolved by them. Identify those items in your diet that might be causing the problem and abstain from them to see if the condition gets resolved.  

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