Chest Pain Causes: Upper Gastrointestinal and GERD

Often, people who are suffering from gastrointestinal reflux disease (GERD) will experience heartburn and chest pain. Though these symptoms can be alarming, they are generally not life-threatening.

Heartburn is the most common of the GERD symptoms. Indeed, for many people with GERD, heartburn and acid reflux are the only noticeable symptoms of GERD:

• Acid reflux occurs when the lining of the esophagus is exposed to stomach acid. Acid reflux causes a bad taste in the mouth and a burning sensation at the back of the throat.
• Heartburn is a painful, burning feeling in the chest that is caused when gastric contents escape into the esophagus, the tube that connects the mouth to the stomach.

Many people who have been diagnosed with GERD report only mild GERD symptoms. However, some people with the condition report no symptoms.

Common GERD Symptoms

As stated above, heartburn and acid reflux are the most common symptoms of GERD. However, GERD patients can exhibit a number of other symptoms, including:

• bad breath
• belching
• dental enamel erosion
• excessive saliva production
• gum inflammation
• hoarseness
• laryngitis
• painful swallowing
• sore throat
• sour taste in the mouth
• swallowing difficulties
• throat inflammation.

If you are experiencing any of these symptoms, talk to your doctor about GERD.

GERD: Chest Pain and Heartburn

One of the most common symptoms of GERD is heartburn, which can cause chest pain. Chest pain caused by heartburn varies in intensity and can be very severe. Sometimes, it is hard for people to tell if their chest pain is caused by heartburn or something more serious, such as a heart attack.

If you are having chest pain, look out for the following warning signs, which could indicate a heart condition:

• chest pain coupled with shortness of breath, sweating, nausea and/or dizziness
• chest pressure or tightness when you perform physical activities or when you are under stress
• pain that spreads to the back, neck, jaw, shoulders and/or arms, especially the left arm
• sudden pressure, tightening or crushing pain in the middle of the chest that lasts for more than a few minutes.

If you experience any of these symptoms, or if your heartburn seems different, call 911 or seek emergency treatment immediately, as you could be having a heart attack.

Causes of GERD

GERD can be caused by a number of factors. Some GERD patients produce too much stomach acid. In other patients, the lower esophageal sphincter, the muscular ring that surrounds the esophagus where it joins the stomach, doesn't function properly. In addition, GERD can be caused by:

• hiatal hernias (a condition in which part of the stomach protrudes through the diaphragm and into the chest)
• emptying of the stomach
• esophageal contractions.

GERD Diagnosis

If your doctor thinks you have GERD, he will likely perform a physical exam and gather a history of your symptoms. Once he has done this, he will likely perform one or more of the following tests to make a GERD diagnosis:

• A barium swallow is used to take X-rays of the esophagus, stomach and duodenum.
• To make a GERD diagnosis, your doctor will need to determine whether your symptoms are caused by GERD or another condition. To do this, he can use a Bernstein test, in which a fine acid is dropped into the esophagus.
• During an esophageal mamometry, a small tube is inserted down the throat to the lower esophageal sphincter to measure the strength of the esophageal muscles at rest.
• An esophagogastroduodenoscopy uses a thin tube called an endoscope to view the lining of the throat and examine it for damage.

GERD Treatment

If you are diagnosed with GERD, your doctor will likely recommend you make some lifestyle changes, particularly in regard to your diet. Since reflux symptoms are worse following meals, it is recommended that patients eat small meals earlier in the evening. This will keep the stomach from becoming over filled and will also give the person time to digest food before lying down for bed.

As certain foods can cause GERD symptoms to worsen, your doctor will likely ask you to avoid such foods and beverages as:

• alcohol
• carbonated beverages
• chocolate
• citrus juices
• fatty foods
• peppermint
• tomatoes.

Your doctor will also likely suggest you avoid smoking or quit smoking if you smoke.

Antacids can help alleviate GERD symptoms, as can some prescription medications. In extreme cases of GERD, surgery may be necessary. Talk to your doctor about the best treatment options for you and your lifestyle.

Resources

Marks, Jay W. (reviewed June 4, 2003). Gastrointestinal Reflux Disease (GERD, Acid Reflux). Retrieved October 23, 2007, from the MedicineNet.com Web site: http://www.medicinenet.com/gastroesophageal_reflux_disease_gerd/article.htm.

Mayo Clinic Staff (April 30, 2007). Heartburn or chest pain: When is it a heart attack? Retrieved October 23, 2007, from the Mayo Clinic Web site: http://www.mayoclinic.com/health/heartburn-gerd/DG00016.