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Clinical distinct features of noncardiac chest pain in young patients

Tae Ho Seo1, Jeong Hwan Kim, Jung Hyeon Lee

  • 1Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.

Journal of Neurogastroenterology and Motility
|June 11, 2010
PubMed

Insights

Gastroesophageal reflux disease (GERD) is a common cause of noncardiac chest pain (NCCP) in young adults. A proton pump inhibitor (PPI) test effectively predicted GERD-related NCCP in this population.

Area of Science:

  • Gastroenterology
  • Digestive Health
  • Clinical Medicine

Background:

  • Noncardiac chest pain (NCCP) is a prevalent global condition, often linked to gastroesophageal reflux disease (GERD).
  • While NCCP prevalence may decrease with age, limited data exists on its occurrence in younger individuals.
  • This study addresses the under-researched area of GERD and its diagnostic efficacy in young NCCP patients.

Purpose of the Study:

  • To determine the prevalence of GERD in patients under 40 presenting with noncardiac chest pain.
  • To evaluate the effectiveness of a proton pump inhibitor (PPI) test in diagnosing GERD-related NCCP in this demographic.
  • To assess the utility of the PPI test in aiding clinical judgment for young NCCP patients.

Main Methods:

  • Thirty patients under 40 with weekly NCCP underwent symptom diaries, esophago-gastro-duodenoscopy (EGD), and 24-hour esophageal pH monitoring.
  • Esophageal manometry was also performed for comprehensive assessment.
  • A 14-day lansoprazole trial (30 mg twice daily) was administered, with symptom improvement >50% considered a positive PPI test.

Main Results:

  • GERD was diagnosed in 30% of young NCCP patients via EGD and/or pH monitoring.
  • A significant difference was observed in PPI test positivity between GERD-related (89%) and non-GERD-related (24%) NCCP (p=0.002).
  • Esophageal motility disorders were identified in 10% of patients, with 10% having non-GERD-related causes.

Conclusions:

  • GERD affects 30% of young individuals experiencing noncardiac chest pain.
  • The PPI test demonstrated high predictability for GERD-related NCCP in this cohort.
  • The PPI test can be a valuable tool for physicians managing young patients with NCCP.
Abstract

Keywords:
Gastroesophageal reflux diseaseNoncardiac chest painProton pump inhibitorYoung adult

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