Pharmacological and other treatment modalities for esophageal pain

Abstract

Treatment of esophageal pain remains a major challenge for the clinician. Although many patients have heartburn and may respond to proton pump inhibitors, there in an unmet need for other treatment modalities in patients where there are no obvious pathological findings. Although analgesics are the mainstay in esophageal pain treatment, many patients are nonresponders to these drugs. The current concise review focuses on other systems affecting pain processing, where better understanding may serve as a framework for therapy. These are the parasympathetic nervous system, exercise, and personality profiles. Finally, treatment with analgesics for functional chest pain remains a challenge, and an overview of treatment with antidepressive drugs is provided.

Morphology of subcortical brain nuclei is associated with autonomic function in healthy humans

“…In contrast to the traditional derivation of autonomic activity, such as by HRV, both CSI and CVT yield superior temporal resolutions and have been associated with multiple neurophysiological functions, including pain processing and the neuro‐endocrine‐immune axis [Denver et al, ; Farmer et al, ; Ruffle et al, ]. Moreover, abnormal resting SNS and PNS activity has been reported in a number of clinical disorders such as functional chest pain [Hoff et al, ], irritable bowel syndrome (IBS) [Spaziani et al, ], inflammatory bowel disease [Bonaz et al, ], fibromyalgia [Martínez‐Martínez et al, ], Ehlers–Danlos syndrome [De Wandele et al, ] and diabetes mellitus [Vinik et al, ].…”