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EspañolWhat causes acid reflux chest pain? Related conditions and treatments
Overview: What does acid reflux chest pain feel like?
Acid reflux or gastroesophageal reflux disease (GERD) happens when stomach contents back up into the esophagus, the tube that runs from your throat to your stomach. Typically, a muscle called the lower esophageal sphincter keeps the stomach closed off from the esophagus right after eating, but sometimes it doesn’t work how it should. Stomach acid burns and irritates the esophagus lining, so it’s no surprise that heartburn and regurgitation, where swallowed food comes back up into the mouth, are the most common symptoms of acid reflux. Other common symptoms of GERD might include nausea, difficulty swallowing, belching, sour taste, and stomach pain. However, some people have atypical symptoms or warning signs like hoarseness, chronic cough, sore throat, atypical symptoms, and lightheadedness. Chest pain is one of the most worrisome atypical symptoms of chronic acid reflux, but it’s relatively common. Rather than the more typical burning sensation, the acid causes intense pain right below the breastbone. It can feel like angina or a heart attack, especially if the pain travels to the arms, neck, or jaw. What confuses the picture, even more, is that intense exercise can bring on acid reflux, which can then cause chest pain. Because it feels so much like symptoms of a heart attack, people with acid reflux chest pain often go to the emergency room.
Key takeaways:
Acid reflux chest pain is a common symptom that may be caused by gastroesophageal reflux disease (GERD).
Typically, acid reflux chest pain does not require immediate medical attention, but chest pain is a serious symptom. It is advisable to get emergency treatment for people at risk of heart attack or for people who have not been diagnosed with acid reflux chest pain.
Acid reflux chest pain generally does not require treatment. However, treatment is necessary to prevent recurrence. Acid reflux chest pain typically resolves without treatment in a few minutes to a few hours.
Treatment of acid reflux chest pain may include lifestyle modifications, dietary changes, over-the-counter antacids, stomach acid reducers, drugs that speed the emptying of the stomach, and surgery in the most extreme cases.
Acid reflux chest pain can be managed with dietary changes, sleep position changes, and lifestyle changes.
Use coupons for acid reflux chest pain treatments, like Prilosec (omeprazole), Prevacid (lansoprazole), and Tagamet HB (cimetidine).
What causes acid reflux chest pain?
The causes of acid reflux chest pain are poorly understood. Chest pain is a common but atypical symptom of acid reflux. It is also the most common cause of chest pain not related to any heart problem, a cluster of medical conditions healthcare professionals call noncardiac chest pain. Like heartburn, acid reflux chest pain is caused by stomach acid coming in contact with the lining of the esophagus, but the pain is more intense. No one knows why some people with GERD experience heartburn while others experience chest pain. One possibility is that people with GERD often develop a lower pain threshold in the esophagus, making their pain more intense.
Should I be worried about acid reflux chest pain?
Acid reflux chest pain is frightening. It can feel like a heart attack, so it makes perfect sense to worry about it. However, acid reflux chest pain is not life-threatening and does not have serious complications like angina, ischemia, or a heart attack. In most people, it can be successfully controlled with stomach acid reducers.
Although acid reflux chest pain is not a health threat, it can significantly lower a person’s quality of life. People with acid reflux chest pain may often miss work, experience interruptions in their daily activities, and worry excessively about their condition. Some people don’t believe the diagnosis and may go from doctor to doctor and take heart medications they don’t need. Treatment for acid reflux usually fixes the problem.
Should you go to the emergency room if acid reflux is not dangerous? If the chest discomfort feels like a heart problem, the answer is yes for most people. It is a definite yes for people who haven’t been diagnosed with acid reflux or have risk factors for heart problems such as older age, obesity, sedentary lifestyle, or smoking. Even though you may know it may be due to GERD, you don’t know. For younger people who don’t have risk factors for heart problems and have been diagnosed with acid reflux chest pain, follow the instructions or advice given by the healthcare provider treating the acid reflux.
RELATED: 24 causes of chest pain in adults—and how to treat it
How is the cause of acid reflux chest pain diagnosed?
Chest pain is taken very seriously by healthcare professionals, so a primary care physician or emergency room physician will conduct a complete physical examination, take vital signs such as pulse and blood pressure, get a full medical history, get blood tests, and perform an electrocardiogram (ECG) reading of the heart. If there is no problem with the ECG or blood tests, the healthcare provider may bring in a cardiologist specializing in heart diseases for more testing.
If doctors can find no evidence of a heart problem, they will refer the person to a gastroenterologist, a healthcare provider specializing in digestive system diseases. The gastroenterologist will use endoscopy to look for damage to the lining of the esophagus. An endoscope is a long tube attached to a camera. It allows the specialist to view the inside of the esophagus. The gastroenterologist may also test the strength of the muscles in the esophagus or insert a device that will measure acid levels in the esophagus for 24 hours. This is the most definitive way to diagnose GERD, but it may not be necessary for most people. Another diagnostic tool is treating GERD with a proton pump inhibitor, which reduces stomach acid. If the drug works, then it’s acid reflux.
How long does acid reflux chest pain last?
Acid reflux chest pain can last for minutes or hours. The pain can radiate to the arms, neck, back, and jaw.
How to stop acid reflux chest pain
Acid reflux chest pain treatments are the same as GERD treatments. Lifestyle changes, including dietary changes, weight loss, smoking cessation, avoiding certain foods, avoiding large meals, and sleeping in a partly upright position, are the core of acid reflux chest pain treatment. Some over-the-counter-medications, antacids and stomach acid reducers—H2 blockers and proton pump inhibitors—are the most common and effective treatments to prevent GERD. If they aren’t effective, a healthcare provider may add a prokinetic agent such as Reglan (metoclopramide). These drugs speed up the stomach emptying, reducing the chances of reflux. Surgery may be used in the most severe cases.
RELATED: What’s the best heartburn medicine for you?
Living with acid reflux chest pain
Living with acid reflux chest pain may be harder than living with more typical acid reflux. Chest pain is a frightening symptom. However, all of the standard advice for living with GERD can help people live with chest pain caused by GERD. The primary goal is to prevent acid reflux:
Take all medications as instructed
Maintain a healthy weight
Avoid fatty foods
Avoid large meals
Exercise, but not too intensely
Stop smoking
Do not lie down for at least three hours after eating food
Elevate the head at least six inches when lying down
RELATED: The best diet for GERD: 3 foods to eat—and 8 to avoid
Most importantly, don’t panic
Acid reflux chest pain is scary. Because acid reflux is often chronic, the chest pain will probably keep coming back. Many people with acid reflux chest pain find it hard to believe their chest pain is due to GERD. Chest pain attacks and the constant anxiety about them can significantly affect the quality of life. Repeated visits to the emergency room, repeated heart workups, taking inappropriate medications, missed work, and missed activities are not uncommon. Instead of panicking, follow all the instructions given by healthcare professionals. Take the prescribed anti-reflux medications, change your diet, lose weight, and make all the necessary lifestyle changes. Many people with acid reflux chest pain also have problems with anxiety or panic disorder problems, so see a mental health professional to help with those issues.
FAQs about the causes of acid reflux chest pain
How do I know if my chest pain is heart or reflux?
You don’t. Chest pain is a serious symptom, so get medical attention. If chest pain lasts for several minutes, go to the emergency room. If it is brief, schedule an appointment with a healthcare provider. Acid reflux chest pain may have other symptoms, such as heartburn or regurgitation. That may be a clue that the chest pain is due to reflux, but it’s not definitive.
Why do I suddenly have acid reflux?
Nearly everyone has a bout with heartburn every once in a while. It’s usually a result of overeating, indigestion, or indulging in certain types of foods like spicy foods. It’s a bit different if someone suddenly starts having heartburn regularly rather than once in a great while. This sudden onset of repeated acid reflux can be due to a variety of causes such as a hiatal hernia, pregnancy, or the side effects of certain medications.
Can a blocked artery cause acid reflux?
There is an association between coronary artery disease, blocked arteries to the heart, and acid reflux. People with coronary artery disease have higher rates of acid reflux, and people with acid reflux are more likely to develop coronary artery disease. What does this mean? It probably means that blocked arteries do not cause acid reflux, but that acid reflux is a risk factor for coronary artery disease. This is only a statistical relationship. No one really knows how GERD and coronary artery disease are linked.
What’s next? Additional resources for people with acid reflux chest pain
Test and diagnostics
Atypical manifestations of gastroesophageal reflux disease, Medscape General Medicine
Diagnosis and management of esophageal chest pain, Gastroenterology & Hepatology
Treatments
Diagnosis and management of esophageal chest pain, Gastroenterology & Hepatology
Gastroesophageal reflux disease, StatPearls
Gastroesophageal reflux disease: diagnosis and management, American Family Physician
Scientific studies and clinical trials
More information on related health conditions
GERD treatments and medications, SingleCare
Noncardiac chest pain, Cleveland Clinic
Noncardiac chest pain: epidemiology, natural course, and pathogenesis, Journal of Neurogastroenterology and Motility