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News

Risk factors of unexplained chest pain and normal endoscopy

Risk of peptic ulcer, esophagitis, pancreatitis or gallstone is increased in unexplained chest pain with normal upper endoscopy, shows May's issue of Alimentary Pharmacology & Therapeutics.

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No studies have examined the risk of upper gastrointestinal diseases among patients with unexplained chest or epigastric pain, and a normal upper endoscopy.

Dr Nørgård and colleagues from Denmark examined the relative risk of peptic ulcer, esophagitis, pancreatitis or gallstone in unexplained chest or epigastric pain patients.

The team focused this Danish 10-year cohort study on 386 unexplained chest or epigastric pain patients, diagnosed in 1992 to 1993.

The investigative team selected 10 age- and gender-matched controls per patient from Denmark's Civil Registration System.

The relative risk less than 1 year after endoscopy for gallstones was 14
Alimentary Pharmacology & Therapeutics

Kaplan-Meier analysis and Cox's regression analysis was used to calculate the risk of hospitalization for peptic ulcer, esophagitis, pancreatitis or gallstone.

The team found that the adjusted relative risks among unexplained chest or epigastric pain patients less than1 year after upper endoscopy for peptic ulcer was 2.

The investigators noted that the adjusted relative risk for esophagitis was 8.

The relative risk less than 1 year after upper endoscopy for pancreatitis was 9, and 14 for gallstones.

The team found that the relative risk among unexplained chests or epigastric pain patients over 1 year after upper endoscopy for peptic ulcer was also 2.

The relative risk for esophagitis more than 1 year after endoscopy was 2.

The investigators observed that the relative risk more than 1 year after endoscopy for pancreatitis and gallstones was 4 and 3, respectively.

Dr Nørgård's team concludes, “Unexplained chest or epigastric pain is positively associated with all study outcomes especially in the first year after upper endoscopy.”

“This indicates that peptic ulcer, oesophagitis, pancreatitis or gallstone could be underlying early unexplained chest/epigastric pain symptoms.”

“However, the long-term association remained strong for pancreatitis and gallstone, suggesting a genuine excess risk.”

Aliment Pharmacol Ther 2007: 25(10): 1203-10
27 April 2007

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