Gas Pain (Trapped Wind) in the Chest

What is gas pain in the chest?

Gas pain in the chest results from gas trapped in the bowel (colon) in the upper abdomen.

Synonyms:

Symptoms

  • A constant pain on one side of the chest, more commonly on the left side, often accompanied by pain in the upper abdomen, middle back or shoulder blade on the same side.
  • The pain can range from mild discomfort to debilitating pain, which can be newly appearing, occasional or chronic.
  • The pain can be aggravated by sitting and deep breathing and relieved by lying down or walking; the pain usually disappears during sleeping.
  • Other possible symptoms include bloating and tenderness in the upper abdomen, constipation, nausea, excessive belching, excessive gas and constipation.

Causes, Risk Factors and Triggers

Gas pain is common in individuals with irritable bowel syndrome (IBS). Other causes include:

  • Psychological stress, anxiety
  • Foods that can cause gas: legumes (beans, peas, lentils), cereals (oatmeal, barley), fruits (apples, pears, mango, figs, bananas), vegetables (broccoli, cabbage, cauliflower), carbonated beverages
  • Foods that can cause constipation: white bread and rice, fried foods, chocolate, snacks, soft drinks, energy drinks
  • Artificial sweeteners: isomalt, maltitol, mannitol, sorbitol, xylitol
  • Decreased bowel motility after surgery (ileus)
  • Colonoscopy

Diagnosis

A doctor can often make a diagnosis of trapped wind in the chest by a physical examination. In uncertain cases and to exclude other health condition, an ultrasound, X-ray, CT or MRI of the chest or abdomen can be performed.

Differential Diagnosis

Health conditions similar to trapped wind in the chest:

Conditions with pain in the middle of the chest or upper abdomen:

  • Gastroesophageal reflux disease (GERD), possibly associated with an ulcer in the stomach or duodenum or hiatus hernia
  • Costochondritis–an inflammation of the joints between the sternum and ribs with tenderness near the sternum
  • Heart anxiety neurosis (a psychosomatic pain)
  • Heart-related chest pain (squeezing pain, which lasts less than 5 minutes in angina pectoris and more than 15 minutes in heart attack
  • Pericarditis–an inflammation of the heart sac
  • Acute pancreatitis
  • Abdominal adhesions–bands of scar tissue that pull the diaphragm down
  • Pneumomediastinum–air in the chest cavity

Conditions with pain on the sides of the chest, upper abdomen or middle back:

  • Muscle strain or contusion
  • Serratus anterior muscle pain on either side of the chest after repeating running or lifting heavy objects
  • Pleurisy–an inflammation of the lung membrane, often associated with pneumonia
  • Liver disease (pain on the right side) or spleen disease (pain on the left side)
  • Gallbladder attack
  • Kidney stones or other kidney disorder
  • Spontaneous pneumothorax
  • Rib fracture

Treatment

The following can provide instant pain relief from trapped gas:

  • Passing gas or having a bowel movement
  • A mild laxative such as magnesium citrate
  • Lying down and massaging the upper abdomen on the affected side
  • Drugs that relieve muscle spasm (antispasmodics): dicyclomine [1], hyoscyamine, propantheline and chlordiazepoxide/clidinium bromide [2]

Prevention

To prevent gas pain in the chest:

  • Avoid unnecessary stress and try to cope with necessary stress.
  • Avoid foods that irritate you (check above under causes).
  • Be physically active (walking can help).
References

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