Reviewer ’s report  
 
Title: High -resolution manometry in patients with and without globus pharyngeus and/or 
symptoms of laryngopharyngeal reflux  
 
Version: 0 Date: 11 Jun 2017  
 
Reviewer: Charles Coc k 
 
Reviewer's report:  
 
The authors describe high -resolution manometry findings in patients with and without gl obus 
pharyngeus and/or symptoms of laryngopharyngeal reflux.  
The title of the article should reflect the above e.g. High -resolution manometry in patients with 
and without globus pharyngeus and/or symptoms of laryngopharyngeal reflux.  
 
The study contains i nteresting findings showing:  
1. Subjects with globus pharyngeus symptom have increased UES resting pressure and residual 
pressure when compared to subjects without globus pharyngeus and  
2. Subjects with LPR symptoms have decreased LES resting pressure when  compared to 
subjects without LPR symptoms  
 
In my view the findings make sense, but regardless have not previously been described well.  
The study and description can substantially improved by:  
1. Clarifying definitions more: the definition (Rome III) of g lobus pharyngeus must exclude 
reflux disease, but reflux was not measured. The authors should state the definition was met 
with the exception of that for reflux disease, which was not objectively assessed.  
2. Describing in more details the technical aspect s of the high -resolution manometry used: 
solid -state versus water -perfused, frequency of recording (relevant to interpretation of UES), 
when UES pressures were recorded (beginning vs end of study), boluses used etc. 
Consideration may also be given to using  more up to date descriptions of UES metrics (see 
Nativ -Zeltzer Neurogastroenterol 2016; 28:721 -31, Cock Curr Reports Gastroenterol 2017; 
19(3):11. doi: 10.1007/s11894 -017-0552 -2). 
3. Describing the "non -globus group" (NG) better. The definition of mild ch est discomfort used 
is too vague - do they have heartburn or chest pain? (as a reason for having manometry).  
4. Using less abbreviations, especially in the discussion.(Some of these had not previously been 
described in text?)  
5. Rewriting (or reconfigurin g) the discussion to be shorter and start with a description of the 
findings of the study.  
6. Description of figures in the text should be clearer e.g when describing figure 1. (Are these 
correct order?) Also figure 3 is described in text, but no figure 3 is included. Please include 
headings for figures and tables.  
Are the methods appropriate and well described?  
If not, ple ase specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some l anguage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary fr om an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication o f this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has app lied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare t hat I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: High -resolution manometry in patients with and without globus pharyngeus and/or 
symptoms of laryngopharyngeal reflux  
 
Version: 0 Date: 11 Jun 2017  
 
Reviewer: Charles Coc k 
 
Reviewer's report:  
 
The authors describe high -resolution manometry findings in patients with and without gl obus 
pharyngeus and/or symptoms of laryngopharyngeal reflux.  
The title of the article should reflect the above e.g. High -resolution manometry in patients with 
and without globus pharyngeus and/or symptoms of laryngopharyngeal reflux.  
 
The study contains i nteresting findings showing:  
1. Subjects with globus pharyngeus symptom have increased UES resting pressure and residual 
pressure when compared to subjects without globus pharyngeus and  
2. Subjects with LPR symptoms have decreased LES resting pressure when  compared to 
subjects without LPR symptoms  
 
In my view the findings make sense, but regardless have not previously been described well.  
The study and description can substantially improved by:  
1. Clarifying definitions more: the definition (Rome III) of g lobus pharyngeus must exclude 
reflux disease, but reflux was not measured. The authors should state the definition was met 
with the exception of that for reflux disease, which was not objectively assessed.  
2. Describing in more details the technical aspect s of the high -resolution manometry used: 
solid -state versus water -perfused, frequency of recording (relevant to interpretation of UES), 
when UES pressures were recorded (beginning vs end of study), boluses used etc. 
Consideration may also be given to using  more up to date descriptions of UES metrics (see 
Nativ -Zeltzer Neurogastroenterol 2016; 28:721 -31, Cock Curr Reports Gastroenterol 2017; 
19(3):11. doi: 10.1007/s11894 -017-0552 -2). 
3. Describing the "non -globus group" (NG) better. The definition of mild ch est discomfort used 
is too vague - do they have heartburn or chest pain? (as a reason for having manometry).  
4. Using less abbreviations, especially in the discussion.(Some of these had not previously been 
described in text?)  
5. Rewriting (or reconfigurin g) the discussion to be shorter and start with a description of the 
findings of the study.  
6. Description of figures in the text should be clearer e.g when describing figure 1. (Are these 
correct order?) Also figure 3 is described in text, but no figure 3 is included. Please include 
headings for figures and tables.  
Are the methods appropriate and well described?  
If not, ple ase specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some l anguage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary fr om an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication o f this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has app lied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare t hat I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: High -resolution manometry in patients with and without globus pharyngeus and/or 
symptoms of laryngopharyngeal reflux  
 
Version: 0 Date: 11 Jun 2017  
 
Reviewer: Charles Coc k 
 
Reviewer's report:  
 
The authors describe high -resolution manometry findings in patients with and without gl obus 
pharyngeus and/or symptoms of laryngopharyngeal reflux.  
The title of the article should reflect the above e.g. High -resolution manometry in patients with 
and without globus pharyngeus and/or symptoms of laryngopharyngeal reflux.  
 
The study contains i nteresting findings showing:  
1. Subjects with globus pharyngeus symptom have increased UES resting pressure and residual 
pressure when compared to subjects without globus pharyngeus and  
2. Subjects with LPR symptoms have decreased LES resting pressure when  compared to 
subjects without LPR symptoms  
 
In my view the findings make sense, but regardless have not previously been described well.  
The study and description can substantially improved by:  
1. Clarifying definitions more: the definition (Rome III) of g lobus pharyngeus must exclude 
reflux disease, but reflux was not measured. The authors should state the definition was met 
with the exception of that for reflux disease, which was not objectively assessed.  
2. Describing in more details the technical aspect s of the high -resolution manometry used: 
solid -state versus water -perfused, frequency of recording (relevant to interpretation of UES), 
when UES pressures were recorded (beginning vs end of study), boluses used etc. 
Consideration may also be given to using  more up to date descriptions of UES metrics (see 
Nativ -Zeltzer Neurogastroenterol 2016; 28:721 -31, Cock Curr Reports Gastroenterol 2017; 
19(3):11. doi: 10.1007/s11894 -017-0552 -2). 
3. Describing the "non -globus group" (NG) better. The definition of mild ch est discomfort used 
is too vague - do they have heartburn or chest pain? (as a reason for having manometry).  
4. Using less abbreviations, especially in the discussion.(Some of these had not previously been 
described in text?)  
5. Rewriting (or reconfigurin g) the discussion to be shorter and start with a description of the 
findings of the study.  
6. Description of figures in the text should be clearer e.g when describing figure 1. (Are these 
correct order?) Also figure 3 is described in text, but no figure 3 is included. Please include 
headings for figures and tables.  
Are the methods appropriate and well described?  
If not, ple ase specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some l anguage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary fr om an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication o f this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has app lied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare t hat I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant