We have observed a stiffening of the gastric wall in mice following oral administration of viscous methyl cellulose (MC) solution as a vehicle for food chemicals, an effect which has not previously been reported. To further investigate this effect, young male ICR mice (n 48) were divided into four groups (one control and three experimental groups) of twelve mice each. Experimental groups I, II and III were administered 0·2 ml of 0·5 % (w/v) MC viscous solution/d via a stomach tube for 2, 3 and 4 weeks, respectively. Stomachs were collected following 12 h fasting. The weight of the stomach and mucosa of seven mice per group was measured, and the mucosa was used for the measurement of 8-oxo-2′-deoxyguanosine (8-oxodG). Stomach tissue slices from the remaining five mice per group were stained with haematoxylin and eosin to measure mucosal thickness, and were immunostained with an HIK1083 antibody to determine the number of gastric gland mucous cells. The mucosal thickness of the groups administered the MC solution for 3 and 4 weeks, and the size of the HIK1083-immunostained area of the groups administered the MC solution for 2, 3 and 4 weeks were significantly increased (P< 0·01) compared with those of the control group. The amount of 8-oxodG was not significantly affected. These results indicate that oral administration of viscous MC solution leads to the thickening of the gastric mucosa, which may be related to an increase in the number of gland mucous cells.

Globus pharyngeus is a symptom commonly encountered in ENT practice. The usual complaint is that of the sensation of a ball or lump in the throat generally unaccompanied by dysphagia. This sensation is often more pronounced when taking an ‘empty swallow’. The precise mechanism of this remains enigmatic in many cases. Irritant factors such as gastroesophageal reflux, postnasal drip and excessive throat clearing may be contributory factors as may be stress and psychological influences. Although gastric type mucosa occupying the cervical oesophagus has been long recognised, mainly in the specialised gastrointestinal literature, there appears to be more limited awareness of the condition in ENT practice and the clinical significance of such heterotopia is not well established. We present five recent cases of globus pharyngeus encountered in our ENT practice in which rigid pharyngoesophagoscopy and biopsy revealed heterotopic gastric mucosa within the postcricoid and cervical oesophagus constituting a so-called gastric ‘inlet patch’. One case re-presented with invasive adenocarcinoma within a short time. Herein we compare and contrast inlet patch with columnar lined oesophagus, discuss the potential clinical significance of inlet patch and comment upon further management of the condition.

We present a series of four patients presenting with symptoms leading to a provisional diagnosis of globus pharyngeus. On further investigation, they were all found to have small areas of abnormal mucosa in either their hypopharynx or proximal oesophagus, which on biopsy were reported as containing gastric-type mucosa. Following anti-reflux treatment, all patients eventually reported a cessation of symptoms. All but one patient was followed up with repeat endoscopies. We highlight the fact that biopsies reporting gastric epithelium at this anatomical site are in keeping with the diagnosis of heterotopic gastric mucosa. We review the literature and report the high incidence and natural history of this condition.

Heterotopic gastric mucosa can only be diagnosed on endoscopy and is easily missed, even during such an investigation. We raise the question of whether this condition may be one of a number of factors in the aetiology of globus pharyngeus.

The presence of heterotopic gastric mucosa in the upper oesophagus has been reported to occur in up to 10 percent of individuals but it is usually asymptomatic. We present two pateints with symptomatic oesophageal heterotopic gastric mucosa and discuss the aetiology, pathogenesis, and management of the condition.