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World J Gastroenterol. Aug 14, 2013; 19(30): 4958-4965
Published online Aug 14, 2013. doi: 10.3748/wjg.v19.i30.4958
Published online Aug 14, 2013. doi: 10.3748/wjg.v19.i30.4958
Low-dose amitriptyline combined with proton pump inhibitor for functional chest pain
Se Woo Park, Hyuk Lee, Hyun Jik Lee, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 120-752, South Korea
Ji Eun Kim, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 120-752, South Korea
Author contributions: Park SW performed the majority of experiments; Lee HJ, Park JC, Shic SK, Lee SK and Lee YC provided vital reagents and were also involved in editing the manuscript; Kim JE provided statistical support; Lee HJ co-ordinated and provided the collection of all the human material; Lee H and Park SW designed the study and wrote the manuscript.
Correspondence to: Hyuk Lee, MD, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. leehyuk@yuhs.ac
Telephone: +82-2-22281978 Fax: +82-2-3936884
Received: January 16, 2013
Revised: June 15, 2013
Accepted: June 28, 2013
Published online: August 14, 2013
Processing time: 208 Days and 19.3 Hours
Revised: June 15, 2013
Accepted: June 28, 2013
Published online: August 14, 2013
Processing time: 208 Days and 19.3 Hours
Core Tip
Core tip: Hypersensitivity and psychological problems have an important role in the pathogenesis of functional chest pain (FCP). In this regard, the principal treatment of FCP has moved towards hypersensitivity modulation and antidepressant agents on the basis that the underlying mechanisms were increased pain perception or visceral hyperalgesia in addition to psychologic causes. This is the first study to report that adding low-dose amitriptyline to a conventional dose of proton pump inhibitor (PPI) is more effective than a double-dose of PPI in patients with FCP resistant to a conventional dose of PPI treatment.