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

Journal of Neurogastroenterology and Motility 2019년 25권 4호 p.487 ~ 498
 ( Fass Ronnie ) - Case Western Reserve University MetroHealth Medical Center Esophageal and Swallowing Center

 ( Shibli Fahmi ) - Case Western Reserve University MetroHealth Medical Center Esophageal and Swallowing Center
 ( Tawil Jose ) - Gedyt-Gastroenterologia Diagnostica y Terapeutica Departamento de Trastornos Funcionales Digestivos

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.

키워드

Alternative medicine; Chest pain; Endoscopy; Neuromodulators; Proton pump inhibitors
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