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Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
Globus Hystericus is an obsolete term in modern times. In olden days it was used for “Hysterical” patients complaining of difficulty in swallowing!

In retrospect, I feel that all these patients had a motility disorder of the oesophagus. The reason is as follows:

Oesophagus can be seen best by Endoscopy which can diagnose all the diseases of this organ very accurately. The snag is that the motility disorder of this organ will be missed by this procedure.

Similarly, routine barium meal studies, 24 hrs pH monitoring etc. cannot diagnose motility disorders. The only investigation which can diagnose this disorder hundred per cent is "manometry" studies which are not being done by any private institution in Mumbai.

Thus "Video" Barium meal is a simple non-invasive method of picking up patients having a motility disorder (specially in the upper oesophagus and the adjoining area) provided you send your patient to a centre which has video facility. An average radiologist will not be able to do the procedure. The results are fairly accurate.

So next time, when you see a patient complaining of dysphagia and having all normal reports, do not send him away without asking for this investigation. GTN, Nifedipine and other drugs are now shown to give such patients some relief from this distressing complaint.

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