Oesophageal sensitivity to acid in patients with non-cardiac chest pain: is the oesophagus hypersensitive?
During the past decade, gastro-oesophageal reflux disease has been shown to be the most common identifiable cause of non-cardiac chest pain of oesophageal origin. The development of combined pH-pressures recording systems has also contributed to a better understanding of the underlying mechanisms of pain perception. Beside typical gastro-oesophageal reflux disease, many patients with non-cardiac chest pain appear to have an hypersensitivity to acid or mechanical stimuli, or both. Despite new insights into the pathophysiology of gastro-oesophageal reflux disease, therapy is limited to the suppression of noxious stimuli by antisecretory drugs or surgery. New therapeutic approaches using drugs affecting visceral perception, and well-controlled placebo trials are urgently needed.
Galmiche
J P
JP
Department of Gastroenterology and Hepatology, University of Nantes, France.
Scarpignato
C
C
D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology*; D005744:Gastric Acid; D005764:Gastroesophageal Reflux / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008991:Monitoring, Physiologic