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Related Experiment Videos

Noncardiac Chest Pain.

Wai-Man Wong1, Ronnie Fass

  • 1Southern Arizona VA Health Care System, 3601 South Sixth Avenue (1-111G-1), Tucson, AZ 85723, USA. Ronnie.fass@med.va.gov

Current Treatment Options in Gastroenterology
|July 9, 2004
PubMed
Summary

Noncardiac chest pain (NCCP) management involves treating gastroesophageal reflux disease (GERD) with proton pump inhibitors (PPIs) and using pain modulators for non-GERD related NCCP. Newer therapies and future medications offer additional treatment options for this common condition.

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Area of Science:

  • Gastroenterology
  • Pain Management
  • Psychosomatic Medicine

Background:

  • Noncardiac chest pain (NCCP) is a prevalent condition with substantial morbidity and economic impact.
  • Key factors in NCCP pathogenesis include psychological influences, gastroesophageal reflux disease (GERD), altered pain perception, and esophageal dysmotility.

Purpose of the Study:

  • To review current and emerging therapeutic strategies for noncardiac chest pain.
  • To outline effective diagnostic and treatment approaches for GERD-related and non-GERD-related NCCP.

Main Methods:

  • Literature review of established and novel treatments for NCCP.
  • Analysis of pharmacological and non-pharmacological interventions.

Main Results:

  • Proton pump inhibitor (PPI) therapy is the primary treatment and diagnostic strategy for GERD-related NCCP.
  • Tricyclic antidepressants, trazodone, and SSRIs are effective for non-GERD-related NCCP, with cognitive behavioral therapy also beneficial.
  • Emerging treatments include botulinum toxin, theophylline, and 5-HT4 receptor agonists for specific NCCP subtypes.

Conclusions:

  • Current management effectively addresses GERD-related NCCP with PPIs and non-GERD NCCP with pain modulators and CBT.
  • Future research directions include developing novel visceral analgesics and agents targeting central and peripheral sensitization pathways.

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