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Published on: August 18, 2016
Noncardiac chest pain.
Ronnie Fass1, Tomás Navarro-Rodriguez
1The Neuroenteric Clinical Research Group, Section of Gastroenterology, Department of Medicine, Southern Arizona VA Health Care System, Tucson, AZ 85723-0001, USA. Ronnie.Fass@va.gov
Journal of Clinical Gastroenterology
|March 28, 2008
Summary
Noncardiac chest pain (NCCP) affects many adults, often stemming from esophageal issues like GERD or hypersensitivity. While pain modulators show promise, aggressive reflux treatments and other interventions have limited effectiveness for NCCP relief.
Area of Science:
- Gastroenterology
- Pain Management
Background:
- Noncardiac chest pain (NCCP) is a prevalent condition affecting a significant portion of the adult population.
- The exact causes and mechanisms underlying NCCP are not fully understood.
- Esophageal dysfunction, including gastroesophageal reflux disease (GERD), esophageal dysmotility, and visceral hypersensitivity, are recognized contributors to esophageal pain.
Purpose of the Study:
- To review the underlying mechanisms of noncardiac chest pain (NCCP).
- To evaluate the effectiveness of current therapeutic strategies for GERD-related NCCP.
- To assess the role of pain modulators and other interventions in managing NCCP.
Main Methods:
- Literature review of studies on noncardiac chest pain (NCCP) and its esophageal causes.
- Analysis of treatment outcomes for GERD-related NCCP.
- Evaluation of the efficacy of pain modulators, botulinum toxin, endoscopic GERD treatments, and antireflux surgery.
Main Results:
- Gastroesophageal reflux disease (GERD), esophageal dysmotility, and visceral hypersensitivity are key mechanisms for esophageal pain in NCCP.
- Aggressive antireflux treatment is a primary strategy for GERD-related NCCP.
- Patients with NCCP, with or without esophageal motor disorders, respond to pain modulators.
- Interventions like botulinum toxin, endoscopic GERD treatment, and antireflux surgery demonstrate limited efficacy in alleviating NCCP symptoms.
Conclusions:
- While GERD, dysmotility, and hypersensitivity are implicated in NCCP, current treatments have limitations.
- Pain modulators offer a potential therapeutic avenue for NCCP patients.
- Further research is needed to elucidate NCCP pathophysiology and develop more effective treatments.
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