Diagnosis and Management of Functional Chest Pain in the Rome IV Era

J Neurogastroenterol Motil. 2019 Oct 30;25(4):487-498. doi: 10.5056/jnm19146.

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.

Keywords: Alternative medicine; Chest pain; Endoscopy; Neuromodulators; Proton pump inhibitors.

Publication types

  • Review