[23F] Experiencing chest pain when swallowing with associated symptoms

Patient Description

A 23-year-old female has been experiencing sharp chest pain when swallowing any liquid for the past week, rating the pain as 8 out of 10. The pain originates at the bottom of the throat and shoots to the diaphragm, accompanied by nausea, left side cramps, frequent burping, and a lack of appetite. The patient also reported vomiting red vomit, which may or may not be blood, and a sensation of food or liquid getting temporarily stuck in the throat. There is no reported weight loss, black stools, or difficulty breathing. The patient has a history of depression and anxiety, diagnosed 9 months ago, and is currently on Zoloft (50mg once daily) and Hydroxyzine (25mg three times daily). The patient also confirmed recent use of tobacco, alcohol, and recreational drugs but has no history of acid reflux or heartburn and no known drug allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing symptoms like chest pain, nausea, and burping.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In some cases, prescription medications or even surgery may be needed.
  • Esophagitis: This is inflammation that may damage tissues of the esophagus, the muscular tube that delivers food from your mouth to your stomach. Esophagitis can cause painful, difficult swallowing and chest pain.

    • Treatment typically involves medications to decrease stomach acid and lifestyle changes.
  • Esophageal Spasm: This is a rare disorder characterized by abnormal muscle contractions in the esophagus. You may feel pain or difficulty when swallowing, or you may feel like food is stuck in your throat.

    • Treatment can include medications to relax the muscles in the esophagus, pain relievers, and certain exercises.
  • Gastritis: This is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic). Symptoms include nausea, vomiting, a feeling of fullness in your upper abdomen after eating, and burping.

    • Treatment usually involves taking antacids and other drugs to reduce stomach acid, which can help relieve symptoms and promote healing.

Please note that these are potential explanations for your symptoms, but only a healthcare professional can provide a definitive diagnosis.

What you can do

You should make an appointment to see a healthcare provider as soon as possible. In the meantime, here are some things you can do to alleviate your symptoms:

  1. Avoid foods and drinks that can trigger reflux, such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  2. Try to eat smaller meals throughout the day rather than three large meals.
  3. Wait at least three hours after eating before lying down or going to bed.
  4. Elevate the head of your bed if you regularly experience heartburn at night or while trying to sleep.
  5. Don't smoke, and if you already do, try to quit.

What you should look out for

You should seek immediate medical attention if you:

  • Vomit large amounts of blood.
  • Have bloody or black, tarry stools.
  • Have difficulty breathing.
  • Have pain in the chest, neck, jaw, arms, or back.
  • Have severe pain or discomfort in your upper abdomen.
  • Are unable to swallow or feel like food is stuck in your throat.
  • Have a persistent, unexplained cough.
  • Are losing weight without trying.

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare professional for accurate information.

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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What could cause sharp chest pain when swallowing liquids?

Sharp chest pain when swallowing liquids could be caused by conditions such as esophagitis, esophageal spasms, or gastroesophageal reflux disease (GERD). These conditions can lead to inflammation or abnormal muscle contractions in the esophagus, causing pain during swallowing.


Is vomiting red vomit a sign of a serious condition?

Vomiting red vomit could indicate the presence of blood, which may be a sign of a serious condition such as a bleeding ulcer or esophageal tear. It is important to seek medical attention to determine the cause and receive appropriate treatment.


How can anxiety and depression affect digestive symptoms?

Anxiety and depression can exacerbate digestive symptoms by affecting the gut-brain axis, leading to increased stomach acid production, muscle tension, and changes in digestion. Stress management and mental health support can help alleviate these symptoms.


What lifestyle changes can help alleviate symptoms of GERD or esophagitis?

Lifestyle changes that can help alleviate symptoms of GERD or esophagitis include avoiding trigger foods and drinks, eating smaller meals, not lying down immediately after eating, elevating the head of the bed, and quitting smoking. These changes can reduce acid reflux and inflammation in the esophagus.


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