What Treatment for Functional Chest Pain?

December 2, 2013



A 28-year-old woman is evaluated for chest pain, which is considered to be esophageal in nature. Her workup has included a normal upper endoscopy, a normal barium swallow, and a normal 24-hour pH/impedance study. She has tried a twice-daily PPI for several weeks without improvement in her symptoms.

Which of the following treatments would be recommended next?