Stomach and chest pain
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Understanding Stomach and Chest Pain: Causes and Connections
Digestive Tract and Chest Pain
Diseases of the digestive tract can often manifest as chest pain, which can be misleading and cause significant diagnostic challenges. The autonomic nerve supply of the esophagus is similar to that of the heart, making esophageal pain closely mimic cardiac pain. Studies indicate that about half of the patients referred for gastrointestinal investigation due to angina-like pain but without coronary artery disease are found to have an esophageal cause for their pain. Additionally, disorders of the stomach, duodenum, and biliary tree, as well as less common conditions involving the colon, pancreas, liver, or peritoneum, can also cause upper abdominal or chest pain.
Gastric Conditions Leading to Chest Pain
Gastric Anisakiasis
Gastric anisakiasis, a parasitic infection caused by consuming raw or inadequately cooked seafood, can present with severe chest and epigastric pain, nausea, and vomiting. This condition is characterized by the presence of anisakis larvae in the stomach lining, which can be identified and removed via endoscopy, leading to symptom resolution .
Gastric Volvulus
Gastric volvulus, a rare condition involving the abnormal rotation of the stomach, can also cause significant chest pain. This condition often presents with severe epigastric pain, vomiting, and difficulty in passing a nasogastric tube, known as Borchardt’s triad. It is a surgical emergency due to the risk of gastric ischemia and necrosis, but early diagnosis and endoscopic detorsion can be effective, especially in elderly patients.
Functional Gastrointestinal Disorders and Stress
Stress is a significant factor in the etiology of recurrent abdominal pain, which can also manifest as chest pain. The brain-gut axis plays a crucial role in this phenomenon, where stress-induced activation can cause pain in various body parts, including the chest. This stress-related pain pattern is often part of a broader negative stress reaction affecting multiple areas of the body.
Traditional Chinese Medicine (TCM) Perspective
From the perspective of Traditional Chinese Medicine (TCM), stomach pain, often referred to as "chest pain" due to its proximity to the heart, can be effectively treated with fewer side effects using differential treatment methods. TCM emphasizes the relationship between the spleen, stomach, and heart, suggesting that strengthening the spleen and stomach can alleviate chest pain syndrome .
Emergency Department Visits and Diagnostic Challenges
Chest and abdominal pain are among the most common reasons for emergency department visits. However, the percentage of visits for chest pain resulting in a diagnosis of acute coronary syndrome has decreased, highlighting the importance of considering non-cardiac causes. Advanced medical imaging is frequently used to diagnose or rule out serious conditions associated with these symptoms, reflecting the complexity and necessity of thorough evaluation in such cases .
Conclusion
Stomach and chest pain are interconnected in various ways, often complicating diagnosis and treatment. Conditions such as esophageal disorders, gastric anisakiasis, and gastric volvulus can present with chest pain, mimicking cardiac issues. Stress and functional gastrointestinal disorders further contribute to this complexity. Understanding these connections and utilizing appropriate diagnostic tools and treatment methods, including insights from TCM, can improve patient outcomes and reduce unnecessary investigations.
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