Can Reflux Esophagitis Cause Chest Tightness and Shortness of Breath?

Reflux esophagitis occurs when stomach contents flow back into the esophagus, leading to irritation and inflammation. The most common symptoms associated with this condition are heartburn and acid regurgitation. Patients often describe a sensation of acidic material rising from the stomach into the mouth, accompanied by a burning discomfort that extends from the stomach up through the chest — commonly referred to as heartburn.

However, not everyone with reflux esophagitis experiences classic symptoms like heartburn or acid regurgitation. Some individuals may instead present with atypical symptoms such as chest pain. This is because stomach acid, which has a very low pH, can irritate the lining of the esophagus when it flows backward, triggering spasms or contractions in the esophageal muscles. These contractions can mimic the sensation of chest pain or tightness, often leading patients to seek evaluation from a cardiologist.

Unlike the stomach, which has a protective mucosal lining to guard against acid damage, the esophagus lacks this defense mechanism. As a result, exposure to gastric acid can cause significant discomfort and even lead to a feeling of breathlessness or pressure in the chest area.

It's important to note that while gastroesophageal reflux disease (GERD) or reflux esophagitis can indeed cause chest discomfort, any instance of chest pain should first be evaluated by a cardiac specialist to rule out more serious heart-related conditions. Only after heart issues have been excluded should GERD be considered as a potential cause of chest tightness or shortness of breath.

In summary, although chest symptoms are not the most commonly recognized signs of reflux esophagitis, they can occur and should be taken seriously. Proper diagnosis and treatment can help alleviate these symptoms and improve overall quality of life.