Published online Aug 14, 2013. doi: 10.3748/wjg.v19.i30.4958
Revised: June 15, 2013
Accepted: June 28, 2013
Published online: August 14, 2013
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.