Chest Pain

Constipation Can Be a Real Pain in the Chest

Can Constipation Cause Chest Pain

Chest pain can be a seriously frightening symptom. Sufferers may immediately assume the worst, particularly those already at risk for a heart attack.

However, while chest pain should be taken seriously, it doesn’t always indicate a heart problem. Other causes include acid reflux, spasms of the esophagus, and, yes, even constipation.

Gas pain is often a symptom of constipation. While gas pains usually occur in the abdomen, they can be felt in the chest as well.

The straining that often accompanies difficult-to-pass bowel movements can also affect the muscles and nerves in the chest. So, yes, constipation can cause chest pain. Keep reading to learn more about the relationship between these two symptoms.

What is chest pain? 

The obvious answer is “pain that occurs in the chest,” but this pain may manifest in different ways in different people.

The pain can be sharp or aching, stabbing or burning, or may feel more like pressure. It can radiate out to other areas of the upper body, such as the back, the neck, and the upper abdomen.

When is chest pain an emergency? 

Before discussing the types and causes of chest pain, it is first important to recognize when chest pain should be considered an emergency.

Harvard Medical School recommends seeking immediate medical attention when you have severe chest pain that has been building in intensity for several minutes and you do not feel relief from the pain after resting.

Additionally, if you are also experiencing symptoms such as shortness of breath, nausea, or lightheadedness, your chest pain should be considered an emergency.

Non-emergent but clinically relevant chest pain – which indicates you should go visit your doctor, but not necessarily rush to the ER – is pain that recurs and lasts for multiple days. If you don’t know why you’re having this pain, it’s important to seek a diagnosis.

How common is chest pain? 

Chest pain is common in the United States, accounting for 6-8 million Americans a year visiting the emergency room, about 6% of all ER visits.

Somewhere between 50 and 70 percent of those people are admitted to the hospital for observation or treatment, making chest pain one of the most common reasons for hospitalization. Overall, nearly 8 billion dollars are spent per year on evaluating those patients’ chest pain.

Are there different kinds of chest pain? 

Doctors differentiate between two main types of chest pain: cardiac and non-cardiac. Cardiac chest pain is, as the name implies, related to problems with the heart and is also called angina.

On the other hand, non-cardiac chest pain may be caused by the lungs, gastrointestinal system, chest wall, or even certain psychological conditions.

According to a 2010 study by Dr. Kontos, Dr. Diercks, and Dr. Kirk, gastrointestinal problems are the most common cause of chest pain, accounting for about 42% of the chest pain suffered by their adult research subjects.

Coronary artery disease – a type of cardiac chest pain – was the second most common cause at 31%.

In turn, gastrointestinal chest pain may be a symptom of one of several conditions. Gastroesophageal reflux disease, or acid reflux, causes a specific type of pain that is commonly known as heartburn.

Problems with the esophagus, such as spasms, rupture, or inflammation, can also cause chest pain. Indigestion, also called functional dyspepsia, can do the same.

How is constipation and acid reflux related? 

A common treatment for severe acid reflux is a class of medicines called protein pump inhibitors (PPIs), including such brand names as Nexium and Prilosec. One side effect of these medications is constipation.

If you are experiencing constipation after treating your heartburn chest pain with a PPI, you can speak with your doctor and try some of the lifestyle changes discussed below to help alleviate constipation.

It’s also possible that bowel obstructions can increase the pressure within the entire gastrointestinal system, forcing even more stomach acid up into the esophagus in people who are already prone to experiencing heartburn. In this case, constipation can make existing chest pain worse.

How does my doctor determine what is causing my chest pain? 

If the pain is not immediately life-threatening, doctors will often begin by taking a chest pain patient’s history to determine if he or she has risk factors that may point toward serious heart problems.

The doctor will then perform a physical examination to first rule out the most dangerous causes of the pain.

The doctor may then order additional tests, including an electrocardiogram to show the electrical activity within the heart, and different types of scans, such as a chest x-ray or CT scan. Certain blood tests can also be helpful for determining the cause of chest pain.

Is non-cardiac chest pain always benign? 

Once a heart attack or other cardiac cause is ruled out, it is tempting to think that other causes are not so serious.

However, chest pain can also be a symptom of a pulmonary embolism (blood clot in the lung) or pneumothorax (air leaking from the lungs into the chest). These are acute, life-threatening conditions that need to be treated immediately.

Other times, long-lasting non-cardiac chest pain can be a symptom of a more chronic condition such as tuberculosis, pancreatitis, or shingles.

While not all chest pain is a sign of an emergency or a serious condition, it is important to consult a doctor who can provide a solid diagnosis.

What is constipation? 

Constipation is the condition of having rare, difficult to pass, or incomplete bowel movements. This is commonly accompanied by abdominal pain and a feeling of bloating.

While constipation is not a disease in itself, it can be a symptom of a larger disease or the result of diet or medication side effects.

How common is constipation? 

Constipation is extremely common, and up to 30% of adults will experience it at some point in their lives.

It is especially common in elderly adults, who are at higher risk due to decreased physical activity, insufficient fiber intake, and increased medication use.

It is also common in children as they make dietary transitions, such as from milk or formula to solid food.

What causes constipation? 

Primary constipation is the most common kind and is caused by dietary and behavioral choices.

On the dietary side, drinking too little water or eating too little fiber makes stools more difficult to pass. In addition, lack of exercise slows down digestion, making constipation more likely.

Secondary constipation occurs when there is a known cause in the form of a disease, medical condition, or medication side effect.

Constipation can be a symptom of irritable bowel syndrome, celiac disease, and hypothyroidism, just to name a few. A number of medications – most notable opiates, in recent years – also have constipation as a side effect.

What is irritable bowel syndrome? 

When constipation is chronic – that is, it happens at least three days a month for at least three months – and no other cause can be determined, doctors often make a diagnosis of irritable bowel syndrome (IBS).

Though the causes of IBS still aren’t entirely clear, it’s not an uncommon condition, affecting 10-15% of the population in first-world countries. When constipation is the primary symptom, the condition is known as IBS-C.

There is currently no cure for IBS-C, though the symptoms – including constipation – are treatable. Doctors may advise dietary changes, increasing fiber and avoiding foods that are hard to digest. IBS-C is not life-threatening, and unlike other causes of constipation, it does not appear to get worse with age.

It’s important to note that the presence of abdominal pain helps to diagnose constipation that is a symptom of irritable bowel syndrome, so if you’re already experiencing chronic constipation, be sure to let your doctor know if you’re experiencing chest pain, as well.

How does constipation cause chest pain? 

People who experience constipation may also experience gas pain. It is normal to pass gas during the process of digestion – up to 20 times a day, as reported by the Mayo Clinic.

However, if there is a blockage in the lower gastrointestinal tract, as happens with constipation, the gas may become trapped and cause pain or a cramping sensation as it presses against the walls of the intestines.

Typically, these gas pains occur in the abdomen, where the intestines are located. However, there are a number of anecdotal reports of gas pain radiating up into the lower chest.

The abdomen and the chest share many of the same nerves, and pain can travel along the length of those nerves.

As stated above when discussing acid reflux, the straining caused by constipation can aggravate heartburn.

There is also some evidence that excessive straining can overwork the chest muscles or pinch nerves in the thoracic spine.

All of these scenarios can result in different types of chest pain.

How do I know if constipation is causing my chest pain? 

Because constipation-related chest pain is caused by gas, paying attention to what you eat can give you a clue.

Gas is produced when bacteria in the large intestine break down certain types of carbohydrates, including fiber and starch. Beans and peas, fruits, vegetables, and whole grains are all known to cause gas due to their high fiber content.

If you know which foods are likely to give you gas, pay attention to when you eat versus when you experience abdominal or chest pain.

Consider keeping a food diary and also noting down the time, duration, and severity of your pain. Look for patterns that might illuminate the cause of that pain.

Since the pain that comes with gas is temporary, constipation-related chest pain should be temporary, as well.

However, if you want to be sure that your chest pain is a result of constipation and not a more serious condition, consult your doctor.

This is especially important if your chest pain is frequent or severe and does not appear to be related to what you eat.

What treatments are best for constipation-related chest pain? 

If your chest pain truly is being caused by constipation, treatments that relieve constipation should also relieve your pain.

The first line of recommended treatments is a simple increase in physical exercise, as well as in the water and fiber that you ingest.

This may seem counterintuitive since fiber-containing foods cause more gas, but fiber helps to bulk up and soften stools, making them easier to pass.

If you have secondary constipation that is a symptom of another medical condition or a side effect of medication, particularly opioids, increased fiber intake might not be effective. In these cases, you’ll want to talk to your doctor about treatment.

While it may be tempting to immediately take a laxative for quick relief, the American Academy of Family Physicians recommends that such medications should only be used after non-pharmacologic treatments – such as water, fiber, and exercise – have already been tried.

A patient who overuses laxatives, particularly the stimulant kind, puts his or her digestive system at risk for becoming dependent on them to pass any bowel movements.

Are there particular exercises that are good for relieving constipation? 

While doctors recommend all kinds of regular physical exercise for preventing and relieving constipation, there is anecdotal evidence that yoga and massage can specifically target the digestive system.

If you’re feeling constipated, check out this video from Sitting Solution that demonstrates some natural movements that can help stimulate your digestion.

Is constipation related to heart disease?

A 2016 study showed that older adults, aged 40-79, who experienced constipation were also more likely to die from heart disease.

While constipation itself does not cause heart disease, Dr. Adolph Hutter with Harvard Medical School points out that patients who strain to produce a bowel movement put stress on their cardiovascular system.

Think of treating your constipation as a way to take care of your heart. If this worries you, take the time to discuss your concerns with your doctor, particularly if you’re experiencing chest pain along with your constipation. Your doctor can help determine whether it’s cardiac or non-cardiac pain.

What should I do if I suspect that my chest pain is related to constipation?

As long as your chest pain doesn’t fit the criteria for an emergency (increasing in severity over the span of a few minutes, not relieved by resting), a good first step might be to increase your water and fiber intake.

For maximum effect, you should add physical exercise to your daily routine, if you haven’t already. If this is ineffective at relieving your constipation, you might try a gentle over-the-counter laxative.

Be sure to use your common sense. If your chest pain is constantly present or gets worse, or if diet and behavior changes don’t help with your constipation, go see your doctor.

Tell your doctor about all the symptoms you’re experiencing – constipation and chest pain included – and he or she will find the right treatment for you.

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