Chest pain and discomfort
Chest pain and discomfort are often caused by digestive problems rather than heart problems. Another term for chest pain that isn’t due to a heart problem is non-cardiac chest pain. Acid reflux, for example, creates a sharp, painful sensation in the chest. Seek emergency help if you experience shortness of breath or tightness in your chest.
Our gastroenterologist can determine whether digestive issues are causing your chest pain or discomfort.
Is your chest pain an emergency?
Seek immediate medical advice for the following symptoms:
- Tightness in the chest
- Shortness of breath
- Pain that spreads and doesn’t go away after a few minutes
These are signs of a heart attack and require immediate assistance. If you experience these symptoms, call 999 or go to the nearest emergency room.
Chest pain symptoms caused by digestive problems
While it isn’t always clear what is causing your chest pain and discomfort, some key signs would indicate your pain is due to a digestive problem rather than a heart problem.
Signs include:
- Chest pain after eating
- Pain in your chest while you eat
- Accompanied by digestive symptoms
If you experience the following digestive symptoms alongside your chest pain, it suggests your pain is due to a digestive problem. It would be best if you discussed your symptoms with a doctor to rule out other causes of your chest pain first.
Symptoms that could indicate digestive problems include:
- Hiccups
- Abdominal pain
- Constipation
- Nausea and vomiting
- Belching and burping
- Hoarseness of voice
- Swallowing problems
- Acid reflux (a burning sensation in your chest)
- Blood in your stools – stools may be dark or black
Causes of non-cardiac chest pain and discomfort
Acid reflux, heartburn and indigestion
Acid reflux often causes a burning sensation in your chest, known as heartburn. You may also experience an unpleasant taste in your mouth. Individuals with indigestion (dyspepsia) will often feel uncomfortably full after eating and may feel sick (nausea) and bloated.
Gastro-oesophageal reflux disease
Gastro-oesophageal reflux disease (GORD) refers to excessive acid reflux. Acid and bile flow back up from the stomach via the food pipe (oesophagus) due to a relaxed or weak sphincter. Left untreated, this can lead to Barrett’s oesophagus, which has similar symptoms to acid reflux. GORD is the most common reason for non-cardiac chest pain.
Irritable bowel syndrome (IBS)
IBS usually causes abdominal pain, though it may also cause pain in your chest, back, and jaw. For people with IBS, trapped gas often causes chest pain.
Functional dyspepsia
Functional dyspepsia is what we call persistent symptoms of indigestion without a clear cause. You may experience a burning sensation in the lower chest, as well as bloating, nausea, and belching.
Swallowing disorders
Swallowing disorders affect the food pipe (oesophagus) and can make swallowing difficult. You may experience pain along your oesophagus, which you might feel in the chest, among other places. This can occur in certain conditions, such as achalasia or oesophageal spasm.
Additional digestive conditions that can cause non-cardiac chest pain
Below, we list other conditions that cause chest pain and discomfort, as well as where you are likely to feel that pain.
- Acute cholecystitis (Gallbladder inflammation) – upper chest pain on the right side
- Other gallbladder problems – possibly lower or upper chest pain on the right side
- Oesophageal hypersensitivity – higher chest pain coming from the throat area
- Oesophageal rupture – sudden, severe chest pain*
- Large hiatal hernia – lower chest pain
- Peptic ulcers – recurring discomfort
- Pancreatitis – lower chest pain
Always seek urgent care for sudden, severe chest pain.
Other causes of chest pain and discomfort:
- Angina
- Pleuritis
- A heart attack
- Chest wall injury
- Panic attacks or anxiety
- Lung conditions such as COPD
When to speak to a gastroenterologist
Once your doctor has ruled out a heart problem, they may investigate other causes. If you are experiencing other digestive symptoms, such as the ones listed above, a gastroenterologist is the best person to speak to.
Our gastroenterologists will ask you to list your symptoms, how long they have occurred, and the severity of each. We will also talk through your medical history and that of your close family to determine the most likely causes.
Diagnosing non-cardiac chest pain
First, we will need to figure out what is causing the pain to determine how to treat it. There are various tests we can perform to diagnose the cause of pain, such as an endoscopy to check your oesophagus and upper gastrointestinal (GI) tract.
Other tests we may perform include:
- Barium swallow
- Laryngoscopy – If the pain extends to your throat
- High-resolution oesophageal manometry
- Video fluoroscopy – If you are also experiencing trouble swallowing
The tests we choose to perform will depend on your other symptoms.
Treatment
For many conditions that cause chest pain and discomfort, we start with lifestyle changes to see how these affect symptoms. These can include eating slower, exercising regularly, and following a balanced diet. You are more likely to feel discomfort if you smoke, have anxiety or high stress levels, are overweight, or regularly take certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), e.g., ibuprofen.
We can simply monitor your condition if your symptoms improve. If your symptoms do not change or worsen, we may recommend medication. If your symptoms are severe, we may recommend other treatments, but it will ultimately depend on the cause of your symptoms.
If your symptoms are caused by GORD, we may recommend antacids, H2 blockers, or PPIs. Severe GORD may require an endoscopic procedure or surgery. Read our blog to learn more: What are my treatment options for GORD?
IBS treatment options vary but can include dietary changes, neuromodulators, such as amitriptyline, and relaxation techniques, such as cognitive behavioural therapy (CBT). Our specialist will discuss these options with you if IBS is causing your symptoms.
Lifestyle changes, acid-reducing medications, and neuromodulators can also treat functional dyspepsia. If medications are not effective, we may recommend endoscopic dilatation, Botox, per oral endoscopic myotomy (POEM), or laparoscopic Heller’s myotomy (LHR) for achalasia.
Book an appointment
If you are experiencing chest pain and discomfort, speak to one of our gastroenterologists to rule out a digestive problem.
At Digestive Health UK, our trusted specialists offer comprehensive consultations and assessments to diagnose your condition so we can recommend appropriate treatment options.
Book an appointment today.