Recognize and treat chest pain caused by gastroesophageal reflux

Chest pain due to gastroesophageal reflux is often persistent and can easily be confused with an acute cardiovascular event if accompanying signs are not carefully observed.

Associate Professor, Dr. Nguyen Lan Hieu, Director of Hanoi Medical University Hospital, said that the phenomenon of stomach acid reflux irritates the esophageal mucosa, causing this organ to spasm. Because the esophagus is located right behind the sternum, very close to the heart, patients easily fall into confusion for fear of having a heart attack.

Identification signs

Reflux pain often appears in the middle of the chest, behind the sternum, and can spread slightly to the throat or upper back. The patient feels burning, heaviness, gnawing or choking. Typical accompanying symptoms include belching, belching, heartburn, bitter mouth, dry cough at night, hoarseness in the morning.

This state often occurs after eating too much, eating fatty, spicy, sour foods, drinking coffee, alcohol, or when the patient bends over or lies down immediately after eating. The discomfort tends to ease when you sit up straight, take a small sip of water, or do gentle exercise.

Reflux can get worse if you maintain habits such as eating late close to bedtime, lack of exercise, belly fat, wearing clothes that are too tight, smoking, prolonged stress or arbitrarily using anti-inflammatory pain relievers.

Management and treatment: Patients should prioritize adjusting their lifestyle before taking medication.

Posture and activities: Do not lie down immediately within 2-3 hours after eating. When sleeping, raise the head of the bed 15–20 cm (or use a pillow to gently lift from the back if you have cervical spine disease).

Diet: Divide meals into small portions, chew thoroughly; Limit fried foods, carbonated drinks, coffee, chocolate, and mint. Control your weight and reduce belly fat to reduce pressure on your stomach.

Currently, there are many groups of drugs used to treat reflux, such as fast-acting acid neutralizers, histamine H2 receptor antagonists that help reduce acid secretion, and proton pump inhibitors (PPIs) that help sharply reduce the amount of stomach acid. However, patients need to consider and follow the doctor's regimen before using to avoid side effects.

Patients should immediately go to a medical facility if they experience severe pain, a feeling of tightness in the chest, pain spreading to the arms or jaw, accompanied by difficulty breathing, sweating, low blood pressure or rapid heartbeat. Cases with a history of cardiovascular disease, hypertension, diabetes, stent placement or coronary artery bypass surgery should absolutely not be subjective because this can be a sign of acute myocardial infarction.