The sensation of chest discomfort triggers a serious concern of the possibility of a heart attack. It's advisable to seek medical attention to determine if the cause of the discomfort is cardiac. However, there are problems in the digestive system, specifically involving the esophagus, that cause a feeling of pressure in the chest. The esophagus, which is the section of the digestive tract that transports food from the mouth to the stomach, is located very close to the heart in the torso.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease is a common and treatable disease of the esophagus. The cause is an abnormality in the function of the lower esophageal sphincter. Improper closure of this valve results in the backflow of stomach acid into the esophagus. The symptoms are heartburn, chest pain and regurgitation (the bringing up of stomach acid into the esophagus). A higher incidence of GERD is associated with obesity, pregnancy, having a hiatal hernia, smoking and the diagnosis of diabetes, asthma and connective tissue disorders. The reflux of stomach acid causes irritation to the lining of the esophagus. If untreated, the irritation leads to chronic inflammation. Esophageal strictures are a complication of chronic esophageal inflammation. The development of scar tissue causes a narrowing of the esophagus, and swallowing is impaired. Erosion of the lining of the esophagus results from exposure to stomach acid. Ulcers form, and bleeding, pain, and difficulty swallowing occur. Untreated GERD can lead to a condition called Barrett's esophagus. This condition is characterized by changes in the tissue that lines the esophagus and an increased risk of developing esophageal cancer.
Nonprescription medications, such as antacids and medications that reduce and block acid production, are the first course of treatment for GERD. For persistent heartburn, a physician orders prescription-strength acid-blocking and reducing agents. Prokinetic agents are prescribed to tighten the esophageal sphincter and increase the stomach's emptying time. In cases of GERD not controlled by medications, surgical intervention is necessary
Achalasia
Achalasia is an esophageal contraction disorder. Chest pain, difficulty swallowing, and regurgitation of undigested food are symptoms of this disruption in the normal rhythmic contraction of the esophagus. Medications such as nitroglycerin and calcium channel blockers are prescribed to reduce the pressure in the lower esophageal sphincter. Manual dilation of the esophagus to widen the sphincter provides relief, but repeated dilation procedures are often necessary.
Esophageal Hypersensitivity
Esophageal hypersensitivity is a response to exposure of stomach acid to the esophagus, characterized by the symptoms of heartburn and chest pain. People who experience this type of heartburn appear to have an increased sensitivity to the reflux of stomach acids.
