Review article: the current treatment of non-cardiac chest pain
| Autor: | Carla Maradey-Romero, L. Gerson, Jason Abdallah, Ronnie Fass, N. George |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Chest Pain Sildenafil medicine.medical_treatment Disease Chest pain Group psychotherapy 03 medical and health sciences chemistry.chemical_compound Therapeutic approach 0302 clinical medicine medicine Humans Pharmacology (medical) Esophageal Motility Disorders Intensive care medicine Hepatology business.industry Gastroenterology medicine.disease Review article chemistry 030220 oncology & carcinogenesis GERD Etiology Physical therapy Gastroesophageal Reflux 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | Alimentary pharmacologytherapeutics. 43(2) |
| ISSN: | 1365-2036 |
| Popis: | Summary Background Non-cardiac chest pain is one of the most common functional gastrointestinal disorders. By recognising that gastro-oesophageal reflux disease (GERD), oesophageal dysmotility and oesophageal hypersensitivity are the main underlying mechanisms of NCCP, a more directed therapeutic approach has been developed. Aim To determine the value of the current therapeutic modalities for NCCP. Methods Electronic (Pubmed/Medline/Cochrane central) and manual search. Results Double-dose PPI treatment for two months is a reasonable first choice approach in patients with NCCP because GERD is the most common aetiology. Studies evaluating the role of medical therapy in NCCP patients with hypercontractile oesophageal motility suggest a limited value to muscle relaxants like calcium channel blockers (nifedipine, diltiazem), nitrates and sildenafil. While most trials evaluating pain modulators are small and many are not placebo-controlled, these type of medications appear efficacious in both patients with NCCP due to oesophageal dysmotility and those with functional chest pain. Cognitive behavioural therapy has been extensively studied in patients with functional chest pain with good results. Other psychological techniques such as hypnotherapy, group therapy or coping skills have been scarcely studied but appear to be effective in NCCP patients. Conclusion Medical, endoscopic and surgical therapeutic options are available for the treating physician, although some patients with non-cardiac chest pain may require a multimodal therapeutic approach. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text