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Noncardiac chest pain (NCCP)
What is NCCP?
NCCP is recurring sub sternal chest pain of noncardiac origin. There is a high prevalence of NCCP in the community, with females more likely to have it. The pain may be described as squeezing or burning in nature and may radiate to the back, neck, arms, and jaws. The source of pain is usually the oesophagus
Discuss the causes of NCCP?
GORD, oesophageal dysmotility
Discuss the diagnosis?
A cardiac evaluation should be undertaken if appropriate.
An OGD is usually requested. However, it is likely to be normal. It may pick up erosive oesophagitis in 10-15% cases. An empiric PPI trial is much more effective
24 hr pH study- PPI trial will provide the same answers
Manometry- only achalasia is treatable and a good history will reveal the diagnosis of achalasia so manometry does not add much to diagnosis.
Discuss the management?
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