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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 per cent of individuals but it is usually asymptomatic. We present two patients with symptomatic oesophageal heterotopic gastric mucosa and discuss the aetiology, pathogenesis, and management of the condition.