Meta-analysis: the epidemiology of noncardiac chest pain in the community

Ford, Alexander C; Suares, Nicole C; Talley, Nicholas J.

doi:10.1111/j.1365-2036.2011.04702.x

Cited by 46 publications

(40 citation statements)

References 42 publications

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“…Markedly higher prevalence of NCCP was observed for subjects who also reported GERD (OR, 4.71; 95% CI, 3.32-6.70) and increased according to frequency of GERD symptoms. 6 Similar results were also reported in a Korean study. 7 GERD was reported in 61.6% of subjects with chest pain.…”

Section: Gerd Is the Most Common Cause Of Nccp (Gerdrelated Nccp)supporting

confidence: 85%

“…Given the high prevalence of GERD in patients with NCCP and excellent efficacy of PPI in them, 6,17 empirical PPI treatment for 2-3 months could be cost-effective in management of NCCP. In addition, NCCP patients with typical reflux symptoms are more likely to have GERD-related NCCP than those without typical reflux symptoms.…”

Section: Ppi Test Can Be Used To Confirm the Diagnosis Of Gerd-relatementioning

confidence: 99%

“…In a recent meta-analysis including 16 studies from 14 separate populations, pooled prevalence of NCCP was 13% (95% CI, 9-16%). 6 However, significant heterogeneity was present among reported studies. In a Korean population study (n=1,417), 7 the prevalence of chest pain was 7.9%.…”

Section: Introductionmentioning

confidence: 99%

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Noncardiac Chest Pain: Update on the Diagnosis and Management

Rhee

2015

Korean J Gastroenterol

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Noncardiac chest pain (NCCP) is defined as recurring, angina-like, retrosternal chest pain of noncardiac origin. Although patients with NCCP have excellent long-term prognosis, most suffer persistently from their symptoms. Several pathophysiological mechanisms have been suggested, including gastroesophageal reflux disease (GERD), esophageal motility disorder, esophageal hypersensitivity, and psychological comorbidity. Among them, GERD is the most common cause of NCCP. Therefore, GERD should first be considered as the underlying cause of symptoms in patients with NCCP. Empirical proton pump inhibitor (PPI) treatment with a preferably double dose for more than 2 months could be cost-effective. PPI test can also be used for diagnosis of GERD-related NCCP, but it should be considered for patients with NCCP occurring at least weekly and its duration should be at least 2 weeks. However, upper endoscopy and esophageal pH monitoring are necessary when the diagnosis of GERD is uncertain. Esophageal impedance-pH monitoring could further improve the diagnostic yield. Patients with GERD-related NCCP should preferably be treated with a double dose PPI until symptoms remit (may require more than 2 months of therapy for optimal symptom control), followed by dose tapering to determine the lowest PPI dose that can control symptoms. However, treatment of patients with non-GERD−related NCCP is challenging. An empirical treatment of antidepressants could be considered. If there are specific esophageal motility disorders, smooth muscle relaxants or endoscopic treatment may be considered in selected cases. If none of these traditional treatments is effective, a psychology consultation for cognitive behavioral therapy should be considered. (Korean J Gastroenterol 2015;65:76-84) Key Words: Diagnosis; Gastroesophageal reflux disease; Noncardiac chest pain (NCCP); Therapy CC This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Gerd Is the Most Common Cause Of Nccp (Gerdrelated Nccp)supporting

confidence: 85%

Section: Ppi Test Can Be Used To Confirm the Diagnosis Of Gerd-relatementioning

confidence: 99%

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Noncardiac Chest Pain: Update on the Diagnosis and Management

Rhee

2015

Korean J Gastroenterol

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“…Chest pain is a common clinical problem. A recent meta-analysis estimated a global prevalence of 13 % (95 % CI 9-16), identifying higher rates in studies performed in Australia, where the pooled prevalence was 16 % (95 % CI 0.2-50) [ 2 ] . The prevalence of NCCP has not been studied worldwide, for instance there is lack of information from certain regions such as Africa or Centro America.…”

Section: Introductionmentioning

confidence: 99%

Non-Cardiac Chest Pain of Non-Esophageal Origin

Almansa

Achem

2013

Chest Pain With Normal Coronary Arteries

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Chest pain is a common clinical problem that can be caused by a broad spectrum of diseases other than coronary artery disease or acid re fl ux. The diagnosis of non cardiac, non esophageal chest pain can be challenging. The chronic occurrence of chest pain interferes with the daily life routine, mood and productivity of those affected by this condition and therefore implies an enormous socio-economic burden in the community. This chapter offers an overview of some of the most relevant conditions that need to be considered in the differential diagnosis of a patient presenting with chest pain, once that a cardiac and/or an esophageal origin of the symptom has been properly excluded.

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“…In a pooled meta-analysis, the global prevalence of NCCP was reported at 13 % [1]. Patient history and symptoms are not sufficient to distinguish between cardiac and non-cardiac causes of chest pain [2].…”

Section: Introductionmentioning

confidence: 99%

Non Cardiac Chest Pain (NCCP)

Js¹,

Whorwell²

2016

GHOA

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Non-cardiac chest pain (NCCP) is a common clinical problem however the pathophysiology remains poorly understood. Until the pathophysiology is more clearly understood, certain patients with NCCP continue to experience chest pain and seek frequent medical attention. This mini-review will discuss the underlying pathophysiology of NCCP including gastro-oesophageal reflux, oesophageal dysmotility and visceral hypersensitivity. Furthermore, it aims to highlight the current treatment options based on the current literature.

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Meta-analysis: the epidemiology of noncardiac chest pain in the community

Abstract: SUMMARY BackgroundPrevalence of, and risk factors for, noncardiac chest pain in the community have not been well studied.

Cited by 46 publications

References 42 publications

Noncardiac Chest Pain: Update on the Diagnosis and Management

Noncardiac Chest Pain: Update on the Diagnosis and Management

Non-Cardiac Chest Pain of Non-Esophageal Origin

Non Cardiac Chest Pain (NCCP)

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