Chest Pain After Eating: Is It Related to Fish Bones?

Is there a correlation between left chest pain and fishbone ingestion?

Hello Doctor: About a week ago, I had an eel rice bowl.
At that time, I did not feel any sensation of something stuck in my throat or esophagus, and there were no unusual symptoms that night.
However, the next day at noon, I went to an all-you-can-eat shabu-shabu restaurant.
After eating and drinking to my fill, I went to a department store to watch a movie.
After sitting down in the theater and bending over to place my backpack, I suddenly felt a pain in the area marked with a red circle on my left chest (please refer to the following link for a diagram I drew): https://upload.cc/i1/2019/07/31/pDwevf.jpg.
The pain lasted for about 10 minutes before returning to normal.
During a health check-up one or two years ago, I was diagnosed with mild gastroesophageal reflux and mild fatty liver.
I wonder if there is any correlation?
In the past week, I experienced a brief recurrence of pain in the same area (for about 2-3 minutes), but I have not had any chest pain since then.
My esophagus and throat feel fine, and I do not have a fever.
I would like to ask the doctor:
1.
What could have caused the pain in the theater that lasted for over 10 minutes?
2.
Could it be that a fish bone pierced or injured my esophagus? How can I differentiate?
3.
Do I need to undergo any examinations?
P.S.
I am very afraid that I might have been pierced by a fish bone.
I have seen cases online where a fish bone penetrated the esophagus and caused complications in the heart and lungs, leading to death, which has been causing me anxiety.
I kindly ask the doctor for clarification.
Thank you!

Scott, 30~39 year old female. Ask Date: 2019/07/31

Dr. Chen Shidian reply Gastroenterology and Hepatology

Fishbone injuries to the gastrointestinal tract typically result in acute episodes requiring emergency treatment.
A small number of elderly individuals may experience delayed onset due to swallowing difficulties or sensory impairment, but these cases are generally exceptions.
If your condition persists, you should seek a preliminary examination at a hospital, including an X-ray.

Reply Date: 2019/07/31

More Info

Chest pain after eating can be concerning, especially when there is a history of consuming fish or other foods that may contain bones. In your case, the pain you experienced in the left chest area after eating may not necessarily be related to fish bones, especially since you did not feel any discomfort immediately after consuming the fish dish a week prior.
1. Possible Causes of Chest Pain: The pain you felt could be attributed to several factors. Given your history of gastroesophageal reflux disease (GERD) and mild fatty liver, it is possible that the pain was related to acid reflux, which can cause discomfort in the chest area, especially after a heavy meal. Bending over or sitting in certain positions can exacerbate this discomfort, as it may increase pressure on the stomach and esophagus, leading to reflux symptoms. Additionally, the pain could have been musculoskeletal, especially if it occurred while bending down to place your bag. Muscle strain or tension can often mimic cardiac pain, particularly in the chest area.

2. Fish Bones and Esophageal Injury: While it is theoretically possible for a fish bone to cause injury to the esophagus, this typically presents with immediate symptoms such as sharp pain, difficulty swallowing, or a sensation of something stuck in the throat. If a fish bone were to penetrate the esophagus, it would likely cause more severe and persistent symptoms, including significant pain, fever, or signs of infection. The fact that your symptoms were transient and resolved quickly suggests that it is less likely to be related to a fish bone injury.
3. When to Seek Medical Attention: Given your concerns, it is understandable to feel anxious about the possibility of a serious injury from a fish bone. However, if you are not experiencing ongoing pain, difficulty swallowing, or other alarming symptoms such as fever or significant weight loss, it may not be necessary to seek immediate medical attention. However, if the chest pain recurs, worsens, or is accompanied by other symptoms such as shortness of breath, dizziness, or radiating pain, it would be prudent to consult a healthcare provider. They may recommend diagnostic tests such as an endoscopy to visualize the esophagus or imaging studies to rule out other potential causes of your symptoms.

In summary, while your experience of chest pain after eating may understandably raise concerns about fish bones, the nature of your symptoms suggests that they are more likely related to gastroesophageal reflux or musculoskeletal issues rather than an esophageal injury. Monitoring your symptoms and consulting with a healthcare provider if they persist or worsen would be the best course of action. It's also important to manage your anxiety regarding this issue, as stress can exacerbate gastrointestinal symptoms.

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