PMID- 22077344
OWN - NLM
STAT- MEDLINE
DCOM- 20120412
LR  - 20181201
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 35
IP  - 1
DP  - 2012 Jan
TI  - Systematic review: the treatment of noncardiac chest pain.
PG  - 5-14
LID - 10.1111/j.1365-2036.2011.04904.x [doi]
AB  - BACKGROUND: Treatment of noncardiac chest pain (NCCP) remains a challenge. This 
      is in part due to the heterogeneous nature of this disorder. Several conditions 
      are associated with NCCP including gastro-oesophageal reflux disease (GERD), 
      oesophageal dysmotility, oesophageal hypersensitivity as well as others. AIM: To 
      determine the currently available therapeutic modalities for NCCP. METHODS: We 
      performed a systematic review of the literature that was published between 
      January, 1980 and March, 2011. We identified 734 studies; 68 of them met entry 
      criteria. RESULTS: Patients with GERD-related NCCP should receive proton pump 
      inhibitors (PPI) twice daily for at least 8 weeks. Smooth muscle relaxants are 
      only recommended for temporary relief of NCCP with motility disorders. Botulinum 
      toxin injection of the distal oesophagus may be effective in the treatment of 
      NCCP and spastic oesophageal motility disorders. Studies assessing the value of 
      tricyclic antidepressants, trazodone and selective serotonin reuptake inhibitors 
      in NCCP are relatively small, but suggest an oesophageal analgesic effect in NCCP 
      patients that is limited by their side effects profile. The usage of theophylline 
      to treat patients with non-GERD-related NCCP should be weighed against its 
      potential toxicity. Use of complementary medicine has been scarcely studied in 
      NCCP. Patients with coexisting psychological morbidity or those not responding to 
      any medical therapy should be considered for psychological intervention. 
      Cognitive behavioural therapy and hypnotherapy may be useful in the treatment of 
      NCCP. CONCLUSIONS: Patients with GERD-related noncardiac chest pain should be 
      treated with at least double dose PPI. The primary treatment for non-GERD-related 
      noncardiac chest pain, regardless if oesophageal dysmotility is present, is pain 
      modulators.
CI  - (c) 2011 Blackwell Publishing Ltd.
FAU - Hershcovici, T
AU  - Hershcovici T
AD  - The Neuroenteric Clinical Research Group, Southern Arizona VA Health Care System, 
      Tucson, AZ 85723-0001, USA.
FAU - Achem, S R
AU  - Achem SR
FAU - Jha, L K
AU  - Jha LK
FAU - Fass, R
AU  - Fass R
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20111113
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Chest Pain/*drug therapy/etiology
MH  - Diagnosis, Differential
MH  - Esophageal Motility Disorders/complications/drug therapy
MH  - Gastroesophageal Reflux/complications/drug therapy
MH  - Humans
MH  - Pain Measurement
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Severity of Illness Index
EDAT- 2011/11/15 06:00
MHDA- 2012/04/13 06:00
CRDT- 2011/11/15 06:00
PHST- 2011/11/15 06:00 [entrez]
PHST- 2011/11/15 06:00 [pubmed]
PHST- 2012/04/13 06:00 [medline]
AID - 10.1111/j.1365-2036.2011.04904.x [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2012 Jan;35(1):5-14. doi: 
      10.1111/j.1365-2036.2011.04904.x. Epub 2011 Nov 13.