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Non‐cardiac chest pain: Prevalence of reflux disease and response to acid suppression in an Asian population
Author(s) -
Mohd Hanizam,
Qua ChoonSeng,
Wong ChoonHeng,
Azman Wan,
Goh KheanLee
Publication year - 2009
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2008.05702.x
Subject(s) - medicine , chest pain , reflux , gerd , ambulatory , esophageal ph monitoring , coronary artery disease , disease , gastroenterology
Background: Gastroesophageal reflux disease is thought to be the commonest cause of ‘non‐cardiac chest pain’. The use of proton‐pump inhibitors resulting in improvement in the chest pain symptom would support this causal association. Objectives: To determine the prevalence of gastroesophageal reflux disease in non‐cardiac chest pain and the response of chest pain to proton‐pump inhibitor therapy. Methods: Patients with recurrent angina‐like chest pain and normal coronary angiogram were recruited. The frequency and severity of chest pain were recorded. All patients underwent esophagogastroduodenoscopy and 48‐h Bravo ambulatory pH monitoring before receiving rabeprazole 20 mg bd for 2 weeks. Results: The prevalence of gastroesophageal reflux disease was 66.7% (18/27). The improvement in chest pain score was significantly higher in reflux compared to non‐reflux patients ( P = 0.006). The proportion of patients with complete or marked/moderate improvement in chest pain symptoms were significantly higher in patients with reflux (15/18, 83.3%) compared to those without (1/9, 11.1%) ( P < 0.001). Conclusion: The prevalence of gastroesophageal reflux disease in patients with ‘non‐cardiac chest pain’ was high. The response to treatment with proton‐pump inhibitors in patients with reflux disease, but not in those without, underlined the critical role of acid reflux in a subset of patients with ‘non‐cardiac chest pain’.