Although gastroesophageal reflux disease is the main cause of noncardiac chest pain, proton pump inhibitors (PPIs) benefit a minority of patients.
Dr Nikosa Viazis and colleagues conducted a prospective study evaluated the effect of PPI and selective serotonin reuptake inhibitors on the different subtypes of noncardiac chest pain characterized by impedance-pH monitoring.
All noncardiac chest pain patients underwent impedance-pH monitoring and on the basis of the results.
|After 12 weeks of therapy, complete resolution of chest pain was noted in 89% in Group 1|
|European Journal of Gastroenterology & Hepatology|
Those in Group 1 had abnormal distal esophageal acid exposure received PPIs twice daily, those in Group 2 had a positive symptom index for chest pain received citalopram 20 mg and PPI once daily, and those in Group 3 had a negative symptom index for chest pain received citalopram 20 mg once daily.
Therapy was administered for 12 weeks and treatment success was defined as complete disappearance of chest pain.
From 2015 to 2016, 63 patients were included.
After 12 weeks of therapy, complete resolution of chest pain was noted in 89% in Group 1, 72% in Group 2, and 67% in Group 3 patients.
Dr Viazis' team comments,, "Combined impedance-pH monitoring identifies different subtypes of noncardiac chest pain patients who can receive tailored management."
"Targeted therapy with PPIs and/or citalopram offers complete symptom relief in the great majority of them."