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Published in: Current Treatment Options in Gastroenterology 4/2016

01-12-2016 | Motility (H Parkman and R Schey, Section Editors)

How to Diagnose and Treat Functional Chest Pain

Author: Jose M. Remes-Troche, M.D.

Published in: Current Treatment Options in Gastroenterology | Issue 4/2016

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Opinion statement

Chest pain that is not explained by reflux disease or cardiac, musculoskeletal, mucosal, or motor esophageal abnormalities is classified as functional chest pain (FCP). Although several mechanisms are involved, esophageal hypersensitivity plays a major role and it could be considered a biomarker for FCP. Psychologic comorbidity such as anxiety, neuroticism, depression, and somatization is common. When the diagnosis of FCP is suspected, patients should undergo evaluation with esophageal motility testing, endoscopy, 24-h esophageal pH monitoring, and in some cases, sensory tests. Once the diagnosis of FCP has been established, treatment options rely on controlling patients’ symptoms. Medical treatment has focused predominantly on medications that target pain, such as antidepressants and other pain neuromodulators. Non-pharmacologic interventions with complementary behavioral treatments, such as cognitive behavioral therapy, biofeedback, and hypnosis, have recently been recognized as useful in FCP patients. The latest findings on the evaluation and treatment of FCP are outlined herein.
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Metadata
Title
How to Diagnose and Treat Functional Chest Pain
Author
Jose M. Remes-Troche, M.D.
Publication date
01-12-2016
Publisher
Springer US
Published in
Current Treatment Options in Gastroenterology / Issue 4/2016
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-016-0106-y

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