While chest pain is often linked to heart disease, it can sometimes occur when swallowing. Some of the causes of pain during swallowing may be harmless, but in some cases, it could point to more serious health concerns.

Causes of Chest Pain While Swallowing

Gastroesophageal Reflux Disease (GERD)

GERD is a condition in which stomach acid and food contents flow back into the esophagus. This reflux can lead to a burning sensation in the chest (heartburn) when the stomach acid irritates the esophagus. You might also experience chest pain or the feeling of something being stuck when swallowing.

Esophagitis

Esophagitis refers to inflammation, swelling, or irritation of the esophagus, the muscular tube that connects the throat to the stomach. This condition can result from stomach acid rising into the esophagus and causing irritation.

Factors that can contribute to esophagitis include:

• Alcohol use
• Smoking
• Chest surgery or radiation treatments
• Eating disorders like bulimia nervosa
• Infections
• Lying down after eating a large meal
• Certain medications
• Obesity

Hiatal Hernia

A hiatal hernia occurs when the upper part of the stomach bulges into the chest cavity through the diaphragm. Small hiatal hernias may not cause noticeable symptoms, but larger ones can result in issues such as:

• Difficulty swallowing
• Regurgitation (the backward flow of body fluids)
• Shortness of breath
• Vomiting blood
• Blood in stools

Esophageal Stricture

Esophageal stricture is the abnormal narrowing of the esophagus, which makes swallowing difficult. This can be caused by GERD, injury during procedures like endoscopy, or swallowing substances that damage the esophagus lining.

Common symptoms of esophageal stricture include:

• Chest pain during swallowing
• Chest pressure
• Heartburn
• Food regurgitation

Primary Esophageal Motility Disorders (PEMD)

PEMD refers to a group of disorders that affect the movement of food through the esophagus. These conditions can disrupt the normal process of swallowing and moving food to the stomach.

Types of PEMD include:

• Spastic EMD: A rare disorder causing uncoordinated contractions in the esophagus.
• Achalasia: A disorder where the esophagus has trouble moving food, both solid and liquid.
• Esophageal Scleroderma: An autoimmune condition where the smooth muscle in the esophagus breaks down and is replaced by scar tissue.

Symptoms of PEMD often include:

• Chest pain
• Difficulty swallowing
• Heartburn
• Weight loss

Esophageal Perforation

Esophageal perforation or rupture is a serious condition where a tear or hole forms in the esophagus. If left untreated, this can lead to food or fluid leaking into the chest cavity (mediastinum), which can be life-threatening.

This condition may be caused by:

• Injury during medical procedures involving the esophagus
• Swallowing hazardous chemicals
• Physical trauma to the chest or esophagus
• Tumors
• Repeated vomiting

Symptoms of esophageal perforation include:

• Trouble swallowing
• Chest pain
• Fever and chills
• Low blood pressure and rapid heartbeat
• Pain in the neck, chest, or abdomen
• Vomiting
• Rapid breathing or shortness of breath

Chest pain when swallowing can result from minor causes, such as swallowing food that is too large, or from more serious medical issues affecting the throat and esophagus. If you experience chest pain when swallowing along with other concerning symptoms, it’s important to consult a doctor for proper evaluation and treatment.

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