Whenever you swallow foods or liquids, they pass from the back of your throat to your stomach through a long tube called the esophagus. Whenever you burp, the air rises through the esophagus to reach the back of your throat. However, your esophagus is not just a passive conduit that allows the back-and-forth transfer of foreign objects. It is a physiologically active, muscular organ that contracts to push materials in the appropriate direction, and it contains nerve fibers that send and receive messages to and from your brain.
Disorganized Esophageal Motion
The wave-like muscular activity that propels material through your esophagus is normally coordinated to provide the most efficient "stripping" of food and fluid toward your stomach. In fact, at least three successive waves of contraction follow each swallow to ensure esophageal emptying. Several disorders of muscular activity, collectively called esophageal motility disorders, can interfere with esophageal emptying. Some of these disorders, such as a condition called "nutcracker esophagus," are characterized by painful esophageal spasms.
Esophageal Narrowing
If one portion of your esophagus becomes narrowed or inflamed, a problem that sometimes occurs with chronic gastroesophageal reflux disease, or GERD, you could feel pain whenever you swallow or burp. You could also experience the sensation that food is sticking in your esophagus. Some immune disorders, such as scleroderma, can cause stiffness or constriction of your esophagus, leading to painful, difficult swallowing.
Esophageal Injuries
If you recently swallowed something sharp-edged or irritating, if you just went through a bout of vomiting or if you had a vitamin pill or medication stick in your esophagus, you may have injured its inner wall. Many of these injuries are minor and self-resolving, but they can cause pain with swallowing or burping for several days. GERD can cause chronic or recurrent injury to the lower part of your esophagus. A 2010 study in "Journal of Gastroenterology and Hepatology" demonstrates a link between GERD and chest pain, and a review in "American Family Physician" reports that up to 50 percent of people with chest pain that is not due to heart disease have gastroesophageal reflux disease.
Precautions
Chest pain associated with swallowing or burping is a worrisome symptom. Serious conditions, such as GERD, dysmotility syndromes, immune disorders or even cancer can present this way. If you can recall a distinct episode when you might have injured your esophagus, such as having a pill lodge in your throat, it is reasonable to wait several days to see if you get better. However, if your pain lasts more than just a few days, if food is sticking in your esophagus or if your pain seems to be getting worse, see your doctor as soon as possible.
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