title: [Gastroenterological diseases as triggers of chest pain].
abstract: BACKGROUND
  Non-cardiac chest pain is very common and gastroenterological diseases are one of the most important causes. The frequency distribution of the underlying causes depends on the sector of the healthcare system in which it is ascertained. In individual cases it must always be taken into consideration that detection of coronary heart disease, for example, does not exclude another origin of chest pain.
  
  
  OBJECTIVE
  This article provides a systematic review of gastroenterological diseases that can cause chest pain. Furthermore, a management algorithm was developed.
  
  
  METHODS
  This article is based on a selective search of the literature.
  
  
  CONCLUSIONS
  The most frequent cause is gastroesophageal reflux disease, which is also known as reflux-chest pain syndrome. If there are no clinical alarm signals, treatment is carried out with a proton pump inhibitor either as a diagnostic test or as a probatory therapy. If this initial management does not lead to satisfactory symptom control, extended diagnostics are indicated. In individual cases this concerns the detection or exclusion of a reflux disease, of motility disorders and structural damage to the esophagus as well as diseases of the upper abdominal organs, which can evoke chest pain. After exclusion of these morphologically and/or functionally defined diseases, a so-called functional chest pain is present. The essential mechanisms are altered pain processing, esophageal hypersensitivity and mental comorbidities. The treatment of functional chest pain often proves to be difficult.
authors.affiliation: Innere Medizin, Diakonie Klinikum, Jung-Stilling-Krankenhaus Siegen, Wichernstr. 40, 57074, Siegen, Deutschland. j.labenz@t-online.de.
authors.forename: J
authors.initials: J
authors.lastname: Labenz
authors.affiliation: I. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Labenz
mesh_terms: D000465:Algorithms; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D003937:Diagnosis, Differential; D004941:Esophagitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D019317:Evidence-Based Medicine; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D016896:Treatment Outcome
keywords: Chest pain, functional; Chest pain, non-cardiac; Esophageal motility disorders; Esophagitis; Gastroesophageal reflux disease