Abstract
After excluding a cardiac cause, potent anti-reflux therapy should be administered to patients with non-cardiac chest pain since gastroesophageal reflux disease (GERD) is the most common underlying mechanism of this disorder. If GERD is an unlikely cause of patient’s symptoms, an esophageal motor disorder should be excluded. Spastic motility disorders can be treated with a smooth muscle relaxant (such as calcium channel blocker, nitrate, or phosphodiesterase 5 inhibitors). Alternatively, spastic motility disorders may respond to anti-spasmodics, pain modulators, botulinum toxin injection into the distal esophagus, and/or surgery. Patients with functional chest pain have recently seen an expanded treatment armamentarium including medications such as trazadone, tricyclic anti-depressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, pregabalin, and/or ramelteon.
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Ronnie Fass is a consultant for Takeda and Given Imaging; speaker for Takeda, Eisai, AstraZeneca, and Mederi Therapeutics; and receives research funding from Mederi Therapeutics. Carla Maradey-Romero declares no conflict of interest.
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Maradey-Romero, C., Fass, R. New Therapies for Non-cardiac Chest Pain. Curr Gastroenterol Rep 16, 390 (2014). https://doi.org/10.1007/s11894-014-0390-4
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DOI: https://doi.org/10.1007/s11894-014-0390-4