Why the study?
What are the effective treatments for noncardiac chest pain of esophageal origin?
What are the effective treatments for noncardiac chest pain of esophageal origin?
Proton pump inhibitors and pain modulators like sertraline are effective empirical therapies for noncardiac chest pain of esophageal origin, replacing invasive diagnostic studies.
May support empirical PPI and sertraline use in esophageal noncardiac chest pain; leaves open confirmatory RCTs before practice change.
Chest pain of esophageal origin is the most common atypical/extraesophageal manifestation of gastroesophageal reflux disease (GERD). We are increasingly recognizing the important role of the cardiologist in making the diagnosis. Studies continue to focus on the mechanisms of pain in this challenging group of patients. Factors that determine the development and persistence of visceral hypersensitivity are currently under investigation. Invasive diagnostic studies have been replaced by therapeutic trials or empirical therapies. Proton pump inhibitors have been demonstrated to be the most effective treatment for GERD-related noncardiac chest pain (NCCP). Pain modulators remain the primary therapy for non-GERD-related NCCP. Sertraline is the first selective serotonin reuptake inhibitor to demonstrate a significant improvement in chest pain symptoms.
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Ronnie Fass (2002) studied this question.
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