Upper gastrointestinal evaluation of Chinese patients with non‐cardiac chest pain

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Abstract
Aims: To test the usefulness of upper gastrointestinal investigations and quality of life assessment in Chinese patients with non‐cardiac chest pain.Methods: Seventy‐eight consecutive patients with non‐cardiac chest pain underwent upper endoscopy. Eight patients had upper gastrointestinal pathology (10%). The remaining 70 patients received acid perfusion test, oesophageal manometry and 24‐h ambulatory oesophageal pH (n=65)/manometry (n=61), and the results were compared with those of healthy controls (n=20). Symptoms and quality of life (SF‐36) were assessed by standard validated questionnaire.Results: Significant acid reflux symptoms were present in five (5/70, 7%) patients. Abnormal 24‐h oesophageal pH, indicating gastro‐oesophageal reflux, was found in 19 (19/65, 29%) patients. The percentage of simultaneous contractions was higher and the percentage peristalsis was lower in patients with non‐cardiac chest pain when compared with normal subjects by 24‐h ambulatory manometry. Patients with non‐cardiac chest pain had a lower SF‐36 score when compared to controls.Conclusions: Typical acid reflux symptoms are uncommon in Chinese patients with non‐cardiac chest pain, but abnormal 24‐h pH results, indicating gastro‐oesophageal reflux, were found in 29% of patients. Ineffective contractions were more frequently found in patients with non‐cardiac chest pain by 24‐h ambulatory manometry, which may have a bearing on the impaired quality of life in such patients. Upper gastrointestinal investigations are useful for the evaluation of Chinese patients with non‐cardiac chest pain.