Current Treatment Options in Gastroenterology

, Volume 14, Issue 4, pp 429–443 | Cite as

How to Diagnose and Treat Functional Chest Pain

  • Jose M. Remes-TrocheEmail author
Motility (H Parkman and R Schey, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Motility

Opinion statement

Chest pain that is not explained by reflux disease or cardiac, musculoskeletal, mucosal, or motor esophageal abnormalities is classified as functional chest pain (FCP). Although several mechanisms are involved, esophageal hypersensitivity plays a major role and it could be considered a biomarker for FCP. Psychologic comorbidity such as anxiety, neuroticism, depression, and somatization is common. When the diagnosis of FCP is suspected, patients should undergo evaluation with esophageal motility testing, endoscopy, 24-h esophageal pH monitoring, and in some cases, sensory tests. Once the diagnosis of FCP has been established, treatment options rely on controlling patients’ symptoms. Medical treatment has focused predominantly on medications that target pain, such as antidepressants and other pain neuromodulators. Non-pharmacologic interventions with complementary behavioral treatments, such as cognitive behavioral therapy, biofeedback, and hypnosis, have recently been recognized as useful in FCP patients. The latest findings on the evaluation and treatment of FCP are outlined herein.


Functional chest pain Antidepressants Pain modulators Esophagus Hypersensitivity 


Compliance with Ethical Standards

Conflict of Interest

José Maria Remes-Troche has served as a member of the advisory board for Commonwealth, Allergan and Carnot; has received grant support for research from Sanfer and Asofarma; and also has served as speaker for Takeda, Allergan, Carnot, Menarini and Sanfer.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Recently published papers of particular interest have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC 2016

Authors and Affiliations

  1. 1.Digestive Physiology and Gastrointestinal Motility Laboratory, Medical-Biological Research Institute (IIMB)Universidad VeracruzanaVeracruzMexico
  2. 2.College of Medicine Miguel Aleman ValdesVeracruzMexico
  3. 3.Digestive Physiology and Motility LaboratoryUniversity of Veracruz, Veracruz, MéxicoVeracruzMexico

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