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Clinically distinct characteristics in patients younger than 40 years old with non-cardiac chest pain
Journal of Gastroenterology and Hepatology, 05/16/2012
Ko SY et al. – In young non–cardiac chest pain (NCCP) patients, the prevalence of GERD was relatively low compared to average–aged NCCP, but the difference was insignificant. The PPI test was very effective in diagnosing gastroesophageal reflux disease (GERD) in the NCCP patients in both age groups. Therefore, in young NCCP patients, if there is a negative response to a two–week proton pump inhibitor (PPI) trial, the possibility of extra–esophageal disease origin needs to be considered.
Methods- 96 patients with NCCP ≥ 1/week were classified into the young–aged (≤ 40 years, n=38) and the average–aged groups (> 40 years, n=58).
- Typical reflux symptoms were assessed.
- The patients were defined into GERD group and non–GERD group according to reflux esophagitis on esophagogastroduodenoscopy and/or pathologic acid exposure on 24–h esophageal pH monitoring.
- Then the patients were treated with 30 mg of lansoprazole bid for 14 days.
- Nine patients (23%) in young–aged group and 22 patients (38%) in average–aged group were diagnosed with GERD–related NCCP (P= 0.144).
- The proportion of typical reflux symptoms was higher in GERD group compared to non–GERD group in both age groups.
- A PPI test improved symptoms in GERD group irrespective of age, but this improvement was not observed in non–GERD group.