The high frequency of esophageal disorders in Iranian patients with non-cardiac chest pain
Gastroenterology and Hepatology from Bed to Bench,
Vol. 11 No. Supplement 1 (2018),
11 December 2018
,
Page s32-s38
https://doi.org/10.22037/ghfbb.v0i0.1531
Abstract
Aim: The aim of this study was to evaluate the prevalence of gastrointestinal disorders in non-cardiac chest pain (NCCP) Iranian patients.
Background: Gastro-esophageal reflux disease (GERD) is the most common cause of NCCP, which accounts for about one third of cases.
Methods: This was a descriptive study on consecutive NCCP patients who referred to the gastroenterology clinic at the Taleghani Hospital, Tehran, Iran from 2015 to 2017. Medical history, physical examination and esophageal test including upper gastroenterology (UGI) endoscopy, esophageal manometry and 24 hour ambulatory esophageal pH monitoring were done for each participant.
Results: The study included 102 patients, of which 58.9% were women, and the mean age of patients was 41.5 ± 11.2 years. The most common symptoms associated with chest pain were regurgitation in 28.4%, dysphagia in 23.5% and heartburn in 19.6% patients. UGI endoscopy was abnormal in 29.4% cases, esophageal manometry was abnormal in 61.7% cases and ambulatory pH monitoring was abnormal in 37.2% patients. Using UGI endoscopy and combined 24-h pH monitoring determined the prevalence of GERD 44.1% , and based on manometry the most frequent causes of NCCP was ineffective esophageal motility (IEM) in 19.6% patients with NCCP.
Conclusion: Detecting etiology of NCCP allows healthcare providers to assure patients of the benign nature of their condition and provide appropriate treatment. It can also help prevent excessive hospital and physician visits as well as the costly and potentially risky testing which often results.
Keywords: Non-cardiac heartburn, Gastro-esophageal reflux disease, Esophageal dysmotility, Functional chest pain.
(Please cite as: Abdi S, Sahraie R, Malekpour H, Ashatri S, Jahani-Sherafat S, Iranshahi M, et al. The high frequency of esophageal disorders in Iranian patients with non-cardiac chest pain. Gastroenterol Hepatol Bed Bench 2018;11(Suppl. 1):S32-S38).
- Non-cardiac heartburn
- gastro-esophageal reflux disease
- esophageal dysmotility
- functional chest pain
How to Cite
References
Kachintorn U. How do we define non-cardiac chest pain? J Gastroenterol Hepatol 2005;20:S2-5.
Eslick GD, Jones MP, Talley NJ. Non-cardiac chest pain: prevalence, risk factors, impact and consulting--a population-based study. Aliment Pharmacol Ther 2003;17:1115-24.
McDevitt-Petrovic O, Kirby K, Shevlin M. The prevalence of non-cardiac chest pain (NCCP) using emergency department (ED) data: a Northern Ireland based study. BMC Health Serv Res 2017;17:549.
Wong WM, Lam KF, Cheng C, Hui WM, Xia HH, Lai KC, et al. Population based study of noncardiac chest pain in southern Chinese: prevalence, psychosocial factors and health care utilization. World J Gastroenterol 2004;10:707-12.
Fass R, Dickman R. Non-cardiac chest pain: an update. Neurogastroenterol Motil 2006;18:408-17.
Ortiz-Garrido O, Ortiz-Olvera NX, Gonzalez-Martinez M, Moran-Villota S, Vargas-Lopez G, Dehesa-Violante M, et al. Clinical assessment and health-related quality of life in patients with non-cardiac chest pain. Rev Gastroenterol Mex 2015;80:121-9.
Fass R, Achem SR. Noncardiac chest pain: epidemiology, natural course and pathogenesis. J Neurogastroenterol Motil 2011;17:110-23.
Van Handel D, Fass R. The pathophysiology of non-cardiac chest pain. J Gastroenterol Hepatol 2005;20:S6-13.
Kim YJ, Shin EJ, Kim NS, Lee YH, Nam EW. The Importance of Esophageal and Gastric Diseases as Causes of Chest Pain. Pediatr Gastroenterol Hepatol Nutr 2015;18:261-7.
Dimache M, Turcan E, Natase M. [Noncardiac chest pain and gastroesophageal reflux disease]. Rev Med Chir Soc Med Nat Iasi 2010;114:342-8.
Kim JH, Rhee PL. Recent advances in noncardiac chest pain in Korea. Gut Liver 2012;6:1-9.
Yamasaki T, Fass R. Noncardiac chest pain: diagnosis and management. Curr Opin Gastroenterol 2017;33:293-300.
Nazemalhosseini Mojarad E, Farahani RK, Haghighi MM, Aghdaei HA, Kuppen PJ, Zali MR. Clinical implications of BRAF mutation test in colorectal cancer. Gastroenterol Hepatol Bed Bench. 2013;6:6-13.
Karbalaei R, Piran M, Rezaei-Tavirani M, Asadzadeh-Aghdaei H, Heidari MH. A systems biology analysis protein-protein interaction of NASH and IBD based on comprehensive gene information. Gastroenterol Hepatol Bed Bench. 2017;10:194-201.
Pestechian N, Rasekh H, Rostami-Nejad M, Yousofi HA, Hosseini-Safa A. Molecular identification of Giardia lamblia; is there any correlation between diarrhea and genotyping in Iranian population? Gastroenterol Hepatol Bed Bench. 2014;7:168-72.
Yamasaki T, Fass R. Reflux Hypersensitivity: A New Functional Esophageal Disorder. J Neurogastroenterol Motil 2017;23:495-503.
Fass R, Navarro-Rodriguez T. Noncardiac chest pain. J Clin Gastroenterol 2008;42:636-46.
Rostami Nejad M, Ishaq S, Al Dulaimi D, Zali MR, Rostami K. The role of infectious mediators and gut microbiome in the pathogenesis of celiac disease. Arch Iran Med. 2015;18:244-49.
Miwa H, Kondo T, Oshima T, Fukui H, Tomita T, Watari J. Esophageal sensation and esophageal hypersensitivity - overview from bench to bedside. J Neurogastroenterol Motil 2010;16:353-62.
Park SH, Choi JY, Park EJ, Lee JJ, Lee S, Na JO, et al. Prevalence of Gastrointestinal Diseases and Treatment Status in Noncardiac Chest Pain Patients. Korean Circ J 2015;45:469-72.
Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999;45:172-80.
Burgos-Santamaria D, Marinero A, Chavarria-Herbozo CM, Perez-Fernandez T, Lopez-Salazar TR, Santander C. Normal values for water-perfused esophageal high-resolution manometry. Rev Esp Enferm Dig 2015;107:354-8.
Kessing BF, Weijenborg PW, Smout AJ, Hillenius S, Bredenoord AJ. Water-perfused esophageal high-resolution manometry: normal values and validation. Am J Physiol Gastrointest Liver Physiol 2014;306:G491-5.
Spechler SJ, Castell DO. Classification of oesophageal motility abnormalities. Gut 2001;49:145-51.
Richter JE. Oesophageal motility disorders. Lancet 2001;358:823-8.
Sifrim D, Castell D, Dent J, Kahrilas PJ. Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux. Gut 2004;53:1024-31.
Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-20.
Gawron AJ, Pandolfino JE. Ambulatory reflux monitoring in GERD--which test should be performed and should therapy be stopped? Curr Gastroenterol Rep 2013;15:316.
Richter JE. Current Diagnosis and Management of Suspected Reflux Symptoms Refractory to Proton Pump Inhibitor Therapy. Gastroenterol Hepatol (N Y) 2014;10:547-55.
Jung HK. Epidemiology of gastroesophageal reflux disease in Asia: a systematic review. J Neurogastroenterol Motil 2011;17:14-27.
Mousavi S, Tosi J, Eskandarian R, Zahmatkesh M. Role of clinical presentation in diagnosing reflux-related non-cardiac chest pain. J Gastroenterol Hepatol 2007;22:218-21.
Kim JH, Rhee PL, Park EH, Son HJ, Kim JJ, Rhee JC. Clinical usefulness of subgrouping of patients with non-cardiac chest pain according to characteristic symptoms in Korea. J Gastroenterol Hepatol 2007;22:320-5.
Karlaftis A, Karamanolis G, Triantafyllou K, Polymeros D, Gaglia A, Triantafyllou M, et al. Clinical characteristics in patients with non-cardiac chest pain could favor gastroesophageal reflux disease diagnosis. Ann Gastroenterol 2013;26:314-8.
Beedassy A, Katz PO, Gruber A, Peghini PL, Castell DO. Prior sensitization of esophageal mucosa by acid reflux predisposes to reflux-induced chest pain. J Clin Gastroenterol 2000;31:121-4.
Taremi M, Soltan Dallal M, Gachkar L, MoezArdalan S, Zolfagharian K, Reza Zali M. Prevalence and antimicrobial resistance of Campylobacter isolated from retail raw chicken and beef meat, Tehran, Iran. Int J Food Microbiol. 2006;108:401-403.
Pandak WM, Arezo S, Everett S, Jesse R, DeCosta G, Crofts T, et al. Short course of omeprazole: a better first diagnostic approach to noncardiac chest pain than endoscopy, manometry, or 24-hour esophageal pH monitoring. J Clin Gastroenterol 2002;35:307-14.
Husser D, Bollmann A, Kuhne C, Molling J, Klein HU. Evaluation of noncardiac chest pain: diagnostic approach, coping strategies and quality of life. Eur J Pain 2006;10:51-5.
Min YW, Choi K, Pyo JH, Son HJ, Rhee PL. Impaired Esophageal Mucosal Integrity May Play a Causative Role in Patients With Nongastroesophageal Reflux Disease-Related Noncardiac Chest Pain. Medicine (Baltimore) 2015;94:e2295.
Eesteghamati A, Gouya M, Keshtkar A, Najafi L, Zali MR, Sanaei M, et al. Sentinel hospital-based surveillance of rotavirus diarrhea in Iran. J Infect Dis. 2009;200:S244-47.
Ortiz-Olvera NX, Gonzalez-Martinez M, Ruiz-Flores LG, Blancas-Valencia JM, Moran-Villota S, Dehesa-Violante M. [Causes of non-cardiac chest pain: multidisciplinary perspective]. Rev Gastroenterol Mex 2007;72:92-9.
Mohammad Alizadeh AH, Mousavi M, Salehi B, Molaei M, Khodadoostan M, Afzali ES, et al. Biliary brush cytology in the assessment of biliary strictures at a tertiary center in Iran. Asian Pac J Cancer Prev. 2011;12:2793-6.
- Abstract Viewed: 128 times
- PDF Downloaded: 107 times