[Thoracic pain from the viewpoint of the gastroenterologist: diagnosis and therapy].

Non-cardiac-chest-pain is frequently associated with esophageal diseases. Gastroesophageal reflux disease (GERD) is present in 60%, esophageal motility disorder in 40-50%, tumours in 5-10% and achalasia in 5% of such cases. Diagnosis is based on endoscopy and in patients with no endoscopy findings on 24-h esophageal pH-monitoring. GERD can present with various symptoms and can best be managed with proton pump inhibitors (PPI). Considering increased mortality and morbidity operation should only be performed in special situations. Esophageal motility disorders most frequently produce retrosternal pain. Pain in achalasia may not respond to standard therapy. Motility disorders and achalasia are diagnosed by perfusion manometry and videofluoroscopy. If a tumour is suspected diagnosis is made by endoscopy (biopsy, endosonography) and radiology.