Chest Tightness and Throat Sensation: Causes and Solutions

Chest tightness + sensation of a foreign body in the throat?

Hello, I would like to ask a question.
I have been experiencing chest tightness and a sensation of a foreign body in my throat for over six months.
Initially, the symptoms were less noticeable, so I didn't pay much attention to them.
However, in the past few months, I have developed excessive stomach acid and gastroesophageal reflux, which have made the chest tightness and throat sensation much more pronounced.
There was an occasion when I took a deep breath and felt pain throughout my chest (a prickly sensation of a foreign body), making it difficult to take a deep breath (though this has only happened once).
Recently, my gastroesophageal reflux has improved somewhat, but the chest tightness and throat sensation have become more noticeable.
What could be the cause? Regarding the throat sensation: I can generally eat without issue, but when I eat larger pieces of food, it feels like they get stuck in my throat before going down.
The chest tightness is located around the middle of my chest; it's not a burning sensation, but rather a feeling of something being stuck.
I do not smoke or drink alcohol (someone in my household smokes, but I have not smoked for the past year).

Liao Xiaojie, 30~39 year old female. Ask Date: 2019/04/25

Dr. Chen Junwei reply Pulmonology

According to the latest statistics from the Ministry of Health and Welfare, the prevalence of gastroesophageal reflux disease (GERD) in Taiwan is as high as 20%, meaning that 1 in 5 people experiences issues related to GERD.
Why do modern individuals commonly face such gastrointestinal problems? Dr.
Tsai Bi-hui, a traditional Chinese medicine physician, explains that this is due to the significant work and life pressures faced by modern people, along with irregular meal times and a diet that often includes irritating and unhealthy foods.
Over time, these factors can easily lead to the occurrence of GERD, resulting in bothersome symptoms such as chest tightness, bloating, heartburn, and discomfort in the throat.
In addition to affecting daily life, it is noteworthy that among individuals who suffer from GERD for a long time, approximately 2% may progress to Barrett's esophagus, which increases their risk of developing esophageal cancer—a severity that should not be underestimated.
It is advisable to seek medical attention at healthcare facilities for appropriate evaluation and management.
Wishing you good health.

Reply Date: 2019/04/25

More Info

Chest tightness and the sensation of a foreign body in the throat can be distressing symptoms, and understanding their potential causes is crucial for effective management. Given your history of gastroesophageal reflux disease (GERD) and the recent exacerbation of symptoms, it is likely that these sensations are interconnected.

Possible Causes
1. Gastroesophageal Reflux Disease (GERD): GERD occurs when stomach acid frequently flows back into the esophagus, leading to irritation and inflammation. This can cause symptoms such as chest tightness, a sensation of a lump in the throat (globus sensation), and even pain during deep breaths. The acid can irritate the lining of the esophagus and throat, leading to discomfort that may feel like something is stuck.

2. Esophageal Spasms: These are contractions of the esophagus that can cause chest pain and a sensation of tightness. Stress, certain foods, or GERD can trigger these spasms, leading to discomfort that may mimic cardiac issues.

3. Anxiety and Stress: Psychological factors can also contribute to physical symptoms. Anxiety can manifest as chest tightness and a feeling of something stuck in the throat. If you have been feeling anxious or stressed, this could exacerbate your symptoms.

4. Musculoskeletal Issues: Sometimes, tightness in the chest can be related to muscle strain or tension in the chest wall. This can occur due to poor posture, heavy lifting, or even prolonged periods of stress.

5. Allergic Reactions or Postnasal Drip: Allergies can lead to postnasal drip, which may cause throat irritation and a sensation of something being stuck. This can also lead to coughing or throat clearing, which might contribute to chest discomfort.

Recommendations
1. Dietary Modifications: Since you mentioned that your symptoms have worsened with increased acid reflux, consider dietary changes. Avoiding spicy, fatty, or acidic foods, as well as large meals, can help reduce GERD symptoms. Eating smaller, more frequent meals may also be beneficial.

2. Medications: Over-the-counter antacids or proton pump inhibitors (PPIs) can help manage GERD symptoms. It’s advisable to consult with your healthcare provider about the best medication for your situation.

3. Lifestyle Changes: Elevating the head of your bed, avoiding lying down after meals, and maintaining a healthy weight can significantly reduce reflux symptoms. Additionally, practicing relaxation techniques such as deep breathing, yoga, or meditation may help alleviate anxiety-related symptoms.

4. Consult a Specialist: Given the duration and severity of your symptoms, it would be prudent to consult a gastroenterologist for a thorough evaluation. They may recommend an upper endoscopy to assess the esophagus and stomach for any abnormalities.

5. Follow-Up with a Cardiologist: Although your symptoms are likely related to GERD, it’s important to rule out any cardiac issues, especially since you experience chest pain. A cardiologist can perform necessary tests, such as an electrocardiogram (ECG) or stress testing, to ensure your heart is healthy.

Conclusion
In summary, your symptoms of chest tightness and throat sensation are likely linked to GERD and possibly exacerbated by anxiety or other factors. By addressing the underlying causes through lifestyle changes, dietary modifications, and appropriate medical treatment, you can alleviate your symptoms. It’s essential to maintain open communication with your healthcare providers to ensure a comprehensive approach to your health concerns.

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