Stabbing Chest Pain When Swallowing: 5 Causes, Gastroenterologist explains. - Oh My Gut (2024)

Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.

Stabbing pain in the chest while swallowing is a sign of esophageal inflammation or ulcer. The most common cause is medication-induced esophagitis, esophageal infections, and GERD.

Less common causes include esophageal ulcers, esophageal cancer, esophageal hypersensitivity, radiation, and others.

1. Medication-induced esophagitis.

Cause:

Swallowing a pill that is irritant for the esophagus. It is common when you:

  • swallow a pill without water.
  • Swallow a pill at bedtime.
  • Are older than 50 years old.
  • Having an existing esophageal disease.

The pill gets stuck in the esophagus. It will cause esophageal inflammation if the drug is irritant. Consequently, the stuck pill will cause stabbing pain in the chest when you swallow.

Common medications include (reference):

  • Pain-relieving medications (aspirin, ibuprofen, naproxen, diclofenac, and other non-steroidal anti-inflammatory drugs).
  • Some antibiotics such as tetracycline and doxycycline.
  • Potassium chloride (for potassium deficiency).
  • Others such as Bisphoshphnates (for osteoporosis), quinidine (for heart diseases).

How common:

Drug-induced esophagitis is a common and overlooked condition. It is a more frequent cause of painful swallowing than famous diseases as GERD (reference).

Symptoms (how to suspect Pill esophagitis):

  • History of swallowing an irritant pill without water (or without enough amount of water.
  • Swallowing a pill at bedtime before the onset of the painful swelling in the chest.
  • The symptoms usually start suddenly. Often few hours after the pill intake.
  • Retrosternal stabbing chest pain.
  • The pain is maximum during swallowing (odynophagia).
  • Difficulty swallowing (dysphagia).
  • Symptoms are often intermittent and self-limiting within a few days.
  • Nausea or vomiting.
  • Rarely, it may lead to complications such as ulcer, bleeding from the esophagus, or esophageal perforation.

Learn More.

Consult your doctor if you have extreme pain, bloody vomit, blackish stool, or persistent vomiting that is not going away.

2. Infections of the esophagus.

The esophagus can be infected, especially in patients with low immunity. Infections induce symptoms similar to pill esophagitis with a severe stabbing pain in the chest. But the symptoms are often more prolonged. It also can be associated with fever.

Causes of infectious esophagitis:

  • Candidal esophagitis (fungal infection): the most common cause (reference).
  • Herpes simplex virus esophagitis.
  • Cytomegalovirus (CMV).
  • Epstein-Barr virus (EBV).
  • Varicella-zoster virus (VZV).
  • Bacteria infections (the least common).

Esophagal infection often affects people with:

  • Debilitating diseases
  • Poor oral intake
  • Low immunity (as HIV-infected patients).

Symptoms:

  • Painful swallowing.
  • Stabbing chest pain (greatest when swallowing).
  • Dysphagia (difficulty swallowing).
  • Presence of risk factors such as debilitating disease, decreased oral intake, HIV infection).
  • Systemic symptoms such as fever and muscle aches.
  • Nausea or vomiting.

3. GERD (Gastroesophageal reflux disease).

GERD is a widespread disease. It occurs due to the reflux of gastric acid into the esophagus.

When the reflux is significant, it causes inflammation of the esophagus. The condition is called Reflux esophagitis (reference).

Symptoms:

  • Heartburn.
  • Chest pain (stabbing during swallowing, vague in-between).
  • Dysphagia (difficulty swallowing).
  • Regurgitation of an acidic material into the esophagus and/or throat.
  • Globus sensation.
  • Water brush (increased salivation).
  • Less common: chronic cough, asthma, hoarseness of voice, sore throat.

Severe GERD can lead to a condition called barret’s esophagus. The mucosa of the esophagus becomes lined with atypical cells.

Barret’s esophagus is a complication of reflux esophagitis. It may also manifest with stabbing pain in the chest when swallowing.

MORE: Causes of Heartburn That is Not Going Away.MORE: How Long Does GERD Take to Heal.

4. Esophageal ulcers.

Esophageal ulcers are a breakdown in the lining of the mucosa. It usually presents with severe pain in the chest during swallowing.

We consider esophageal ulcers a complication of different diseases rather than a separate condition.

Common causes of esophageal ulcers:

  • GERD (reflux esophagitis): The most common cause of esophageal ulcers (reference).
  • Repeated induced vomiting (as with bulimia nervosa).
  • Pill-induced esophagitis.
  • Esophageal infections
  • Esophageal cancers.
  • Acid-rich foods, alcoholo, and caffeinated drinks.

5. Esophageal cancer.

Esophageal cancer is the 8th-most common cancer and the 6th-most common cause of death worldwide.

Painful swallowing or stabbing chest pain can be a sign of esophageal cancer.

Who is at higher risk of esophageal cancer? (reference).

  • Being older in age (more than 85% of cases are above the age of 55).
  • Family history of esophageal cancer.
  • Alcoholo, smoking.
  • Infection with Human Papillomavirus.
  • Barret’s esophagus (a complication of GERD).
  • Obesity.
  • Others,Learn More.

Symptoms of esophageal cancer:

  • Difficulty swallowing (dysphagia)
  • Weight loss without trying.
  • Stabbing pain in the chest while swallowing (odynophagia)
  • constant feeling of pressure or burning.
  • Worsening indigestion or heartburn
  • Coughing or hoarseness

6. Other (rare causes).

  • Eosinophilic esophagitis: chronic, immune-mediated inflammation of the esophagus. It is characterized by infiltration of the esophageal mucosa with eosinophils.Learn More.
  • Esophageal motility disorders:Corkscrew esophagus, achalasia, diffuse esophageal spasm.Learn More.
  • Radiation-induced esophagitis.
  • Psychological disturbances.Learn More.
  • Esophageal Perforation.
  • Ingestion of corrosive substances.
  • Evidence-based
  • Written by a doctor.

MD, Associate Lecturer of Gastroenterology and hepatology. An IBS sufferer, gut health enthusiast and writer.

Stabbing Chest Pain When Swallowing: 5 Causes, Gastroenterologist explains. - Oh My Gut (2)

Dr. I. FarahatAuthor

  • March 21, 2024

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Stabbing Chest Pain When Swallowing: 5 Causes, Gastroenterologist explains. - Oh My Gut (2024)

FAQs

What gut problems cause chest pain? ›

Peptic Ulcers: Peptic ulcers are open sores that develop on the inner lining of the stomach or the small intestine. When these ulcers irritate the stomach lining, they can cause chest pain. Gallbladder Issues: Conditions such as gallstones or inflammation of the gallbladder can lead to referred pain in the chest area.

What causes severe chest pain when swallowing? ›

The esophagus is the muscular tube that delivers food from your mouth to your stomach. Esophagitis can cause painful, difficult swallowing and chest pain. Many different things can cause esophagitis. Some common causes include stomach acids backing up into the esophagus, infection, oral medicines and allergies.

Which digestive disorder is associated with chest pain and acid reflux? ›

Gastroesophageal reflux disease (GERD) is a condition that develops when there is a retrograde flow of stomach contents back into the esophagus. It can present as non-erosive reflux disease or erosive esophagitis.

What are the symptoms of gastric chest pain? ›

Tightness, squeezing, pressure, or heaviness in the chest, which can be accompanied by other symptoms. May be associated with symptoms such as bloating, belching, flatulence, and abdominal discomfort. May be associated with breathlessness, sweating, nausea, lightheadedness, vomiting, and palpitations.

Can inflamed intestines cause chest pain? ›

Research has shown that people with ulcerative colitis or Crohn's are more likely to have a heart attack than people without IBD. During a Crohn's flare-up, this risk seems to further increase. Inflammation of the digestive system likely plays a role in the development of heart-related problems.

What bacteria causes chest pain in the stomach? ›

Helicobacter pylori (H. pylori) is a type of bacteria that infects your stomach. It can damage the tissue in your stomach and the first part of your small intestine (the duodenum). This can cause pain and inflammation.

What are the symptoms of esophageal hypersensitivity? ›

CPG Esophageal hypersensitivity can present with symptoms similar to GERD, including heartburn and chest pain. Some patients have globus sensation, which is a constant discomfort or sensation in the region of the neck that does not impair swallowing.

Can pain when swallowing be serious? ›

Most often, the pain feels like a strong sensation of squeezing or burning. Painful swallowing may be a symptom of a serious disorder.

What does it mean when you swallow food and it hurts going down? ›

Causes of pain when swallowing. The medical term for painful swallowing is odynophagia. Pain when swallowing can occur due to various causes, such as infections, inflammation, and obstruction of the throat, mouth, or food pipe.

What does IBS chest pain feel like? ›

The chest pain that can accompany IBS can be almost indistinguishable from cardiac chest pain especially as it can radiate to the left arm, neck and jaw. It also often responds well to glyceryl trinitrate (GTN).

What does GERD chest pain feel like? ›

GERD can cause chest pain that mimics a heart attack. Described as a squeezing pressure behind the breast bone, GERD-related chest pain can last for hours. And like a heart attack, it can also radiate down your arm to your back.

What is esophageal chest pain syndrome? ›

If you have esophageal spasms you may have chest pain that feels like: Squeezing, tightening, pressure or heaviness, especially behind your breastbone (sternum). Heartburn (a burning sensation in your chest). Pain on your right side, left side or middle that radiates to your neck, left arm or back.

How do you know if chest pain is from stomach? ›

Abdominal pain can feel like a sharp or dull pain that's intermittent or continuous. Chest pain, on the other hand, can feel like a tight, burning sensation in the upper abdomen or below the breastbone. Some people also describe it as pressure or a jabbing pain that radiates to the back or shoulders.

What are the sharp pains in my chest? ›

What is a sharp pain in the chest that is not a heart attack? Many things may cause chest pain besides a heart attack, including other heart conditions, such as angina or pericarditis, a panic attack, a hernia, acid reflux, cholecystitis, a collapsed lung, a blood clot in the lung, or pneumonia.

Can inflammation in the stomach cause chest pain? ›

In severe cases of gastritis, patients may also complain of chest pains, shortness of breath, weakness, or inability to tolerate any foods or liquids by the mouth along with high grade fever. Severe gastritis requires immediate medical attention. Gastritis causes abdominal pain, nausea and other symptoms.

Can gut issues cause heart issues? ›

Recent research adds evidence, finding that changes in certain types of gut bacteria are associated with: High blood pressure. Lower levels of HDL or “good” cholesterol. Heart disease.

Can digestive enzymes cause chest pain? ›

Signs that you might be experiencing an allergic reaction to ingredients in a digestive enzyme supplement include: Difficulty breathing or talking or wheezing. Swelling of the mouth, face, lips, tongue or throat. Chest tightness.

References

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