Ask The Doctor: Chest Pain an... Health Article
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Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.
Question:
What would cause me to have chest pains when I eat a full meal?
Answer:
Any new chest pain should be evaluated by your doctor.
Although many possibilities exist, I usually first consider these three reasons:
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Gallstones and other gallbladder problems
When we eat a heavy meal, blood flow increases to the digestive tract, with some decrease in blood flow to other parts of the body. If a person has narrowed coronary artery diseases, the decrease in blood flow to the heart could cause angina. Most likely, chest pain would be present at other times, especially with physical exertion or intense emotion.
The most likely of the three causes is esophageal reflux. The symptoms of this very common disorder get worse when anything puts extra pressure on or within the stomach. Acid more easily washes back up the esophagus, which can result in a burning or squeezing sensation. People with reflux should eat smaller meals, particularly in the evening.
The gallbladder contracts soon after eating to help with digestion of fats. Gallbladder action is more vigorous after a heavy, fatty meal. Although symptoms from gallstones can occur at any time, with a heavy meal a gallstone is more likely to move down into the bile duct and temporarily get stuck. Pain from a stuck gallstone (called biliary colic) often starts in the upper part of the right side of the belly and travels to the back. Pain in the front of the chest also may occur.