It is not uncommon to have chest pain during or after eating. The probable causes include swallowing large morsels of food, consumption of very hot drinks and foods, and acute acid reflux from the stomach into the esophagus. In the majority of cases of chest pain that occur while eating, no other signs and symptoms are evident. Also, the intensity of chest pain does not increase. The pain itself is short-lived and resolves on its own.
However, if the chest pain is recurrent, then the cause should be investigated. A chest pain that occurs with eating, and is accompanied by the following signs and symptoms, should be taken seriously and investigated promptly:
- Pain that increases in intensity and is unresponsive to antacids.
- Shortness of breath
- Intense nausea
- Projectile or bloody vomiting
- Dizziness and fainting (syncope)
- Severe abdominal pain
The most common causes of chest pain accompanied by the above mentioned symptoms are related to the gastrointestinal tract. However, patients who have a high risk of having cardiac problems should be aware of the difference between chest pain caused by cardiac and non-cardiac conditions.
Causes of Chest Pain After Eating
The majority of causes of chest pain that accompanies food intake are related to problems within the digestive tract. However, certain heart conditions can also cause chest pain that is precipitated by food intake. The following are some of the most probable digestive and cardiac (heart) causes of chest pain that is precipitated by eating. The respiratory causes have been discussed under pain in the chest with breathing.
Read more on chest pain during breathing.
Acid reflux from the stomach into the esophagus is one of the most common causes of chest pain that is precipitated by eating. The chest pain caused by acid reflux is a burning pain that is often referred to as “heartburn”. Heartburn may also be accompanied by other signs and symptoms such as nausea (mild), waterbrash, regurgitation of stomach contents, and bloating of the stomach. Acid reflux may either be acute or chronic.
Chest pain caused by acute acid reflux can occur after consumption of a large meal, alcohol, and lying down or exercising right after eating a meal. Acid reflux that occurs chronically is technically referred to as gastroesophageal reflux disease (commonly abbreviated as GERD). Chest pain in gastroesophageal reflux disease may occur constantly. The pain may also intensify at night while sleeping.
Without treatment, gastroesophageal reflux disease can cause many complications.
Esophageal ulcers are mostly formed as a consequence of gastroesophageal reflux disease and Helicobacter pylori infection. The esophageal ulcers are characterized by an eroded esophageal lining, which results in constant chest pain when food passes through the esophagus. Chest pain may also be caused by other complications of gastroesophageal reflux disease and Helicobacter pylori infection, such as Barrett’s esophagus or esophageal cancer.
The junction between the lower esophagus and the stomach is formed by the lower esophageal sphincter (abbreviated as LES). During the act of swallowing, the lower esophageal sphincter normally relaxes to allow the food in the esophagus to pass into the stomach.
In achalasia, the lower esophageal sphincter remains closed even when food accumulates in the esophagus. This causes a buildup of food in the esophagus and chest pain. Similarly, other motility disorders affecting the esophagus may also cause chest pain upon consumption of food.
A rupture or tear in the esophagus is a medical emergency. Esophageal tears can be caused by severe vomiting after a meal. Chest pain occurs constantly in the case of esophageal tears. Eating or drinking only serves to exacerbate the pain.
Gastritis and peptic ulcers
Problems with the stomach and the duodenum in the abdominal cavity could also result in chest pain after eating. Due to the location of the stomach and the duodenum in the upper abdominal cavity, pain emanating from these structures could also be perceived as chest pain. Gastritis and peptic ulcers in the stomach may cause pain in the stomach after eating. Conditions that are characterized by hyperacidity, such as the Zollinger-Ellison syndrome, may also cause pain in the duodenum.
The chest cavity is separated from the abdominal cavity by a large dome-shaped sheet of muscle known as the diaphragm. The esophagus in the thoracic cavity passes through a hole in this diaphragm to reach the stomach in the abdominal cavity. Sometimes, the upper part of the stomach may protrude through the hole in the diaphragm and enter the thoracic cavity. This condition is referred to as hiatal hernia. Pain caused by hiatal hernia often intensifies after eating. The pain persists even after meals and subsides only when the stomach becomes empty.
Any obstruction in the stomach or the small intestine causes food to accumulate in the esophagus. Food intake in this condition can cause severe nausea accompanied by projectile vomiting.
Diseases of the gallbladder and the biliary tract
Diseases of the biliary tract, such as gallstones, cholangitis, and biliary sclerosis can cause chest pain after eating. Gallstones formed in the gallbladder may get stuck within the bile duct, causing the flow of bile into the intestine to stop. This causes pain that gets worse after consumption of fatty foods.
Inflammation of the pancreas (technically referred to as pancreatitis) is also characterized by the onset of pain after eating. The pain is usually localized to the upper middle abdomen, but can also radiate to the lower chest and the back regions.
The term “angina” refers to chest pain caused by lack of sufficient blood supply to the heart. In people with cardiovascular conditions, angina could be the cause of chest pain that occurs after eating. The pain can be a burning pain sensation, a stabbing pain sensation, or a crushing pain sensation. Nausea, dizziness and shortness of breath may also occur.
Myocardial infarction (commonly known as heart attack) refers to pain caused by a complete cessation of blood supply to the heart muscle. The chest pain may radiate to other areas such as the left arm, neck, back, and the jaw. Profuse sweating may also accompany the pain symptoms. Myocardial infarction is a medical emergency that requires immediate treatment.
Pericarditis and Myocarditis
Pericarditis refers to inflammation of the sac-like tissue (known as the pericardium) that surrounds the heart. Myocarditis refers to inflammation of the heart muscle. An infection is the most common cause of both pericarditis and myocarditis.
Thoracic aorta dissection
Aorta is the major artery that receives blood from the heart for further distribution to other regions of the body. Thoracic aorta dissection is caused by tears in the wall of the aorta. These tears allow the blood to flow between the layers of the aortic wall. This forces apart the layers of the wall of the blood vessel (dissection).
Read more on chest pain when sleeping.