Diagnosis and Management of Functional Chest Pain in the Rome IV Era
- Author:
Ronnie FASS
1
;
Fahmi SHIBLI
;
Jose TAWIL
Author Information
- Publication Type:Review
- Keywords: Alternative medicine; Chest pain; Endoscopy; Neuromodulators; Proton pump inhibitors
- MeSH: Biopsy; Chest Pain; Complementary Therapies; Diagnosis; Endoscopy; Humans; Manometry; Neurotransmitter Agents; Proton Pump Inhibitors; Proton Pumps; Thorax
- From:Journal of Neurogastroenterology and Motility 2019;25(4):487-498
- CountryRepublic of Korea
- Language:English
- Abstract: Functional chest pain accounts for about a third of the patients with noncardiac chest pain. It is a very common functional esophageal disorder that remains even today a management challenge to the practicing physician. Based on the definition offered by the Rome IV criteria, diagnosis of functional chest pain requires a negative workup of noncardiac chest pain patients that includes, proton pump inhibitor test or empirical proton pump inhibitor trial, endoscopy with esophageal mucosal biopsies, reflux testing, and esophageal manometry. The mainstay of treatment are neuromodulators that are primarily composed of anti-depressants. Alternative medicine and psychological interventions may be provided alone or in combination with other therapeutic modalities.
