Why does my chest hurt when swallowing food

Eating has become a very unpleasant experience for you. Every time you swallow your food, you get a sharp pain in your chest. What is causing this pain, and is there any way to treat it?

What is esophagitis?

If you have pain in your chest whenever you swallow, you may have a condition called esophagitis. This is an inflammation of the esophagus, the muscular tube that connects the throat to the stomach. Esophagitis has a number of possible causes, including acid reflux, infections, allergies, and reactions to some medicines. Not only would you have swallowing pain, but you might also have difficulty swallowing, food might get stuck in your esophagus, or you might get heartburn. Infants with esophagitis might experience feeding difficulties, too.

If you experience symptoms for more than a few days and don’t get better with antacids, they make eating difficult, or you also have flu symptoms, a doctor’s visit is recommended.

However, if the pain lasts more than a few minutes, you think food is stuck, you have a history of heart disease, you have shortness of breath, or you experience severe vomiting, you need emergency care as they are signs of a more serious condition.

How do you treat pain when swallowing?

Your doctor can recommend a number of treatments based on the exact cause of your esophagitis. If acid reflux is the cause, over-the-counter of prescription antacids could help. If an infection is the cause, medicine may help. If allergies are the cause, avoiding the allergen and taking medicine could help. If it’s caused by medication, an alternate drug might be available.

Esophageal cancer and throat pain when swallowing

More seriously, chest pain when swallowing might be a sign of esophageal cancer. If a tumor is large enough, it can restrict food passing by it. People with esophageal cancer may also feel like food is stuck in their throat, or they may even start choking on it.

The most common symptom of esophageal cancer is difficulty swallowing. People with this cancer might start eating smaller portions of food or switch to an all-liquid diet because of swallowing problems. Other symptoms include weight loss, hoarseness, a chronic cough, vomiting, and esophageal bleeding.

However, these symptoms don’t automatically mean someone has cancer. It’s important to get a diagnosis from a doctor to determine what, if anything, you might have.

“Most factors causing difficulty swallowing are benign," CEENTA ENT doctor Brett Heavner, MD, said. “However, if it persists for more than 2-3 weeks or you get to the point of not being able to eat at all, it needs to be evaluated.”

This blog is for informational purposes only. For specific medical questions, please consult your physician. Dr. Heavner practices in our Steele Creek office. To make an appointment with him or any of our ENT doctors, call 704-295-3000. You can also schedule an appointment online or through myCEENTAchart.

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What Heartburn Feels Like

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You get this problem when stomach acid moves into a tube called the esophagus, which carries food from your mouth to the stomach. When that happens, you could have a burning pain in your chest. Your throat might burn, and you could have a sour taste in your mouth or a cough. You may also hear it called GERD (gastroesophageal reflux disease), which is heartburn that happens often. But other conditions can have similar symptoms.

Angina

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It's easy to confuse heartburn with angina, which happens when not enough blood flows to your heart. But heartburn tends to happen after meals or when you're lying down. Angina is more common after you've been active. The feeling in your chest is more like "tightness" or "squeezing" than the burning pain of heartburn. Angina symptoms mean you're at risk for a heart attack. Call your doctor right away if you have chest pain or tightness.

Heart Attack

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While heartburn pain stays in your chest or throat, during a heart attack, a squeezing or aching pressure may spread to your arms, back, or jaw. Other heart attack symptoms include shortness of breath, a cold sweat, and feeling dizzy without warning. Women are more likely to also have an upset stomach or throw up. If you think you could be having a heart attack, call 911.

Gallstones

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Gallstones are pebble-like bits of cholesterol or digestive fluids (bile) that end up in your gallbladder. If you have gallstones, after a fatty meal you may have heartburn symptoms that can last for hours. You'll likely ache in the center or right side of your belly and could feel pain behind your shoulders or rib cage. If this happens to you, call your doctor or go to the ER. Gallstones often need to be removed right away.

Stomach Ulcer

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Sometimes a portion of the lining of your stomach or small intestine breaks down. An open sore, called an ulcer, forms. It can cause burning stomach pain and heartburn that's worse after you eat fatty foods. You'll also have lots of belching and bloating. Your pain may be worse at night and between meals. If you have an ulcer, your doctor can prescribe medication to ease your pain and help your ulcer heal.

Hiatal Hernia

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If the diaphragm, the muscle separating your stomach and esophagus, thins or weakens, part of your stomach may push upward. This allows the acid of your stomach to spill into the esophagus.  Acid and even food may come back up into your esophagus and throat. Hiatal hernias can raise your chances of heartburn.

Anxiety

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Your brain and gut are closely linked. If you feel stressed or anxious, your heart rate can go up and your breathing can get faster. The flood of hormones that causes this reaction can also upset your stomach. Besides heartburn, you can feel queasy, have diarrhea, or get constipated. Learning to manage your stress through counseling, meditation, or hypnosis may help.

Esophageal Spasm

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Your esophagus sends food from your throat to your stomach through tiny muscle squeezes. While rare, sometimes these muscles tighten up when they shouldn't. Esophageal spasms are most common if you're over the age of 60. They can cause intense chest pain, trouble swallowing, and you may feel like something's stuck in your throat. You'll need to see a doctor if you have these symptoms. A drug to relax your throat muscles may help.

Esophagitis

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If the lining of your esophagus gets inflamed, you may struggle to swallow. You can also get pain behind your breastbone and feel like something's "stuck" in your chest. These symptoms will probably be worse when you eat. If you have esophagitis, your doctor may prescribe a pain reliever so you're more comfortable. Your treatment depends on what's making your esophagus so sore. The most common cause of esophagitis is heartburn or GERD.

Esophageal Cancer

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Long-term heartburn raises your odds of getting esophageal cancer. If your heartburn keeps up despite treatment, your doctor will want to take a look inside your esophagus. They usually do this with a procedure called an endoscopy. Other symptoms of esophageal cancer include trouble swallowing and weight loss. Coughing and hoarseness are common, as is chest pain or pressure. If you have any of these symptoms, see your doctor right away.

Pleuritis

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The tissue that lines your chest and surrounds your lungs can get inflamed for many reasons. This condition is called pleurisy, or sometimes "pleuritis." Depending on where the inflammation is, it may feel like heartburn, but it will get worse when you breathe, cough, or sneeze. Some people also run a fever. If you have pleurisy, your doctor will need to treat its cause. They can also help you manage the pain.

Show Sources

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SOURCES:

Harvard Health Publishing: "Ask the doctor: What's the best way to tell heartburn from angina or a heart attack?" "Esophagitis."

Mayo Clinic: "Heartburn or Heart Attack: When to Worry," "Peptic Ulcer," "Hiatal Hernia," "Esophageal Spasms," "Esophageal Cancer," "Pleurisy," "Bile Reflux," "Gastroesophageal Reflux Disease (GERD)," "Heartburn," "Gallstones."

Virtua Health: "Could Heartburn or Gallstones Be Causing Your Pain After Eating?"

The American Institute of Stress: "Stress Effects."

Rady Children's Hospital, San Diego: "Understanding the Link Between Stress and Stomach Aches in Children."

American Cancer Society: "Signs and Symptoms of Esophageal Cancer."

American College of Allergy, Asthma & Immunology: "Eosinophilic Esophagitis."

Cleveland Clinic: "Gastroparesis," "Gastroparesis: Management and Treatment," "Heartburn Overview."

American Academy of Family Physicians: "Heartburn."

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