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The systematic review and meta-analysis by Wang et al¹ focuses on an important issue: assessing the contribution of GERD in noncardiac chest pain (NCCP) by administering short-term, high-dose PPIs. Noncardiac chest pain is a common condition with significant morbidity and economic implications. Unfortunately, the studies included in the meta-analysis were small, and their findings may not be generalizable.

It was not reported by Wang et al¹ if the subjective improvement in symptoms of NCCP was followed by an objective evaluation, either additional endoscopic examinations or 24-hour pH monitoring. Another concern is that many patients with NCCP may not have chest pain on a daily basis, because of which ambulatory 24-hour pH monitoring is of limited utility. Because the inclusion criteria for the studies included in the meta-analysis was also based on 24-hour pH monitoring, some patients with infrequent episodes of pain might have been excluded. Considering the cost of 24-hour . . . [Full Text of this Article]

AUTHOR INFORMATION
Ravi K. Bobba, MD; Edward L. Arsura, MD

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