What causes sharp pain in the chest while lying down?

Question

Hello doctor,

I am a 35-year-old man, and I have been struggling with GERD for about two years. Recently, I have noticed a new symptom: a sharp pain in my chest and upper back after I eat, especially if I lie down. It feels different from typical heartburn, and sometimes it even radiates to my shoulder. I am concerned it might be something like esophageal spasms or even a hiatal hernia. How can I differentiate these symptoms from regular GERD, and should I consider additional tests or imaging?

Kindly suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your symptoms are concerning. These symptoms are not for regular GERD (gastro-esophageal reflux disorder), these can be due to esophageal spasms, a hiatal hernia esophagitis, or cardiac-related pain.

Pain in the upper abdomen or chest radiating to the back or shoulder, often triggered by fatty meals can indicate gallstones or cholecystitis (inflammation of the gallbladder).

To differentiate and to be confirmed, you can do the following tests:

1. Electrocardiogram (ECG).

2. Upper endoscopy.

3. Barium swallow.

4. Esophageal manometry.

5. Abdominal ultrasound.

In the meantime:

Continue GERD medications such as proton pump inhibitors (PPI)- Omeprazole, Esomeprazole, Pantoprazole, Lansoprazole, etc, or H2 blocker (whatever you are on).
Avoid spicy, fatty, carbonated food, and caffeine.
Avoid lying down within two to three hours after having food.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.