Are Diarrhea and Chest Pain Together Just a Coincidence, or Is There a Connection?

Most gastrointestinal (GI) problems don't make your chest hurt, and most problems related to your chest or lungs don't give you diarrhea. But there are a few instances where the two symptoms might overlap, says Supriya Rao, MD, a gastroenterologist at Tufts Medicine in Boston, Massachusetts.

Learn what might be happening when you're dealing with both at the same time, and what you should do about it.

Causes of chest pain and diarrhea

Some potential causes of diarrhea and chest pain that happen together include:

1. Anxiety

Digestive issues and chest pain that hit together could stem from anxiety, says Dr. Rao. It's not uncommon to experience tightness or discomfort in your chest from heart palpitations when you're anxious. At the same time, you might feel queasy or get some abdominal cramping that can result in diarrhea, per the Mayo Clinic. You might also feel restless or tired fatigue and experience a headache, tense muscles, shakiness, sweating, or trouble concentrating.

2. Irritable bowel syndrome (IBS)

While there's not much newer research behind this, one March 2007 study in the Journal of Clinical Gastroenterology found about 80 percent of people with IBS get chest pain along with other typical symptoms like diarrhea, constipation, pain, gas, and bloating.

"Sometimes people with IBS can also have chest pain because the nerve endings in their esophagus [the tube that connects the throat to the stomach] are hypersensitive," adds Dr. Rao.

3. Whipple disease, in rare cases

It's extremely rare, but sometimes chest pain and diarrhea can be caused by Whipple disease—a bacterial infection that affects multiple organ systems including the GI tract and the cardiovascular system, says Dr. Rao.

The most common symptoms of Whipple disease include watery diarrhea, abdominal pain, fever, and weight loss. If the infection invades the heart muscle (which happens in around 50 to 75 percent of people), it can lead to inflammation that causes heart pain, according to the National Library of Medicine.

The bacteria that cause Whipple disease aren't well understood, per the Mayo Clinic, but the disease appears to be most likely to affect farmers and other people who work outside and often come into contact with sewage or wastewater.

Can diarrhea and chest pain ever mean a heart attack?

Probably not, according to Dr. Rao. That said, the crushing chest pain caused by a heart attack can often hit with other GI symptoms, including heartburn-like pain, nausea, or vomiting, per the Mayo Clinic. And for some people, the chest pain of a heart attack can be mistaken for heartburn-like pain.

Other signs of a heart attack (alongside chest pain) include the following, per the Mayo Clinic:

• Pain that radiates toward the shoulder, arm, or jaw
• Shortness of breath
• Heart palpitations
• Lightheadedness
• Feeling anxious or sweaty

Sometimes it can be hard to tell the difference between chest pain from a heart attack and chest pain caused by heartburn or GERD, according to the American Heart Association (AHA), because both can radiate toward your shoulder or jaw. But there are a few key differences:

• Heartburn is more likely to cause chest pain after eating, especially if you're lying down, whereas a heart attack can happen any time and in any position.
• Heartburn can also give you a sour taste in your mouth (caused by regurgitated food). A heart attack won't.
• Heartburn will usually ease up when you take an antacid. Heart attack pain doesn't go away.

If you're not sure what's causing your chest pain, and it's severe and comes with other symptoms like fainting, vomiting, or shortness of breath, call your doctor and go to the emergency room to play it safe.

Other causes of diarrhea

Diarrhea (without chest pain) is a hallmark symptom of many different GI problems. Common causes of diarrhea include the following, according to the Cleveland Clinic:

• Infection: Stomach bugs, which usually last for a day or two, can cause gastrointestinal discomfort and symptoms like abdominal pain and diarrhea, cramping, nausea or vomiting, fatigue, and a fever.
• Food poisoning: Ingesting harmful toxins or bacteria in food or drinks can cause a GI infection that can give you diarrhea.
• Medications: Antibiotics, antacids with magnesium, and certain cancer drugs can give you diarrhea.
• Food sensitivity or intolerance: If your diarrhea tends to strike after eating a certain food, like dairy or wheat, you could have a sensitivity or intolerance.
• Inflammatory bowel disease (IBD): Chronic conditions like ulcerative colitis and Crohn's disease can inflame the lining of your GI tract and cause diarrhea and other symptoms.

Another cause of diarrhea is COVID-19. For some people, GI symptoms like nausea, vomiting, and diarrhea are the first symptoms they feel once they've contracted the virus, even before typical symptoms like fever, fatigue, and cough, per the University of Nebraska. Digestive issues and chest pain can be symptoms of "long COVID," or the lingering symptoms that some people experience more than four weeks after getting COVID-19, according to the Mayo Clinic.

Other causes of chest pain

Chest pain or discomfort can stem from many causes. While most are minor and relatively harmless, others can be serious, so it's important to let your doctor know when red flags pop up. Common causes of chest pain include the following, per the Mayo Clinic:

• Anxiety or panic attack
• Heartburn or GERD
• Sore muscles or injured ribs
• Shingles
• Gallbladder or pancreas problems
• Angina, or chest pain caused by reduced blood flow to the heart
• Pericarditis, or heart inflammation caused by an infection
• Pulmonary hypertension, or high blood pressure in the lungs
• Pulmonary embolism, or a blood clot in the lungs
• Heart attack

If your chest pain is sharp, severe, or persistent, call your doctor and go to the nearest emergency room. Sometimes it can be hard to tell whether you're dealing with something dangerous (like a heart attack) or relatively minor (like anxiety or heartburn). The only way to know for sure is to get it checked out ASAP.

Treatment for diarrhea and chest pain

Whether felt separately or together, chest pain and diarrhea usually stem from an underlying cause. The best treatment for each will depend on what's driving your symptoms, says Dr. Rao.

If you're dealing with anxiety, for instance, talk therapy and/or medications (like anti-anxiety meds or antidepressants) can help you manage your mood, per the Cleveland Clinic. That, in turn, should help get your chest pain and GI issues under control.

Stomach upset and chest pain from IBS could be tamed with lifestyle and diet changes, like cutting out trigger foods or working with a therapist to cope with life stressors. Low doses of antidepressant medications—like SSRIs (selective serotonin reuptake inhibitors) and tricyclic antidepressants—can help, too. "They work well on those oversensitive nerve endings," to help reduce the sensation of pain in your esophagus and gut, says Dr. Rao.

In the very rare case that you're dealing with Whipple disease, you'll need to see a doctor and take a long course of antibiotics.

When to see a doctor

While mild chest pain that comes and goes isn't usually a serious issue, chest pain that is severe, sharp, or persistent could be serious or even life-threatening. If your chest pain doesn't ease up after a few minutes and comes with other symptoms like shortness of breath, vomiting, or fainting, call your doctor and seek immediate medical attention. And, if you have risk factors for heart disease, err on the side of considering chest pain to be potentially heart-related and get it checked out.

Likewise, if you're having regular bouts of diarrhea or other GI symptoms that also affect your chest, let your doctor know. You might have an underlying condition like anxiety or IBS that needs to be treated.

FAQ

Can you get diarrhea after drinking alcohol?

Booze can definitely give you diarrhea, especially when you drink a lot, per the International Foundation for Gastrointestinal Disorders. That's because alcohol is high in sugar, which draws water into your GI tract and can make your stools loose and watery.

If you get diarrhea after drinking alcohol, make sure to drink plenty of water, replenish your electrolytes with drinks like Pedialyte, and consider reducing the amount of alcohol you drink (or cutting it out completely) if it gives you GI issues.

Are there any foods you can eat to reduce chest pain and diarrhea?

While chest pain and diarrhea aren't often a sign of a serious heart condition, there are foods you can eat that will help protect both your gut and heart in the long term. In general, heart-healthy foods like whole grains, beans, fruits and veggies, and nuts and seeds are also good for your gut, says Dr. Rao.

Following a Mediterranean-style diet can help you get your fill. Experts have long known that it can reduce the risk for heart disease, while emerging research shows that the diet also supports healthy gut bacteria that play a key role in reducing gut inflammation, per a May 2023 report in Nutrients.

What are the best foods to eat when you have diarrhea?

The best foods for an upset stomach are light and bland because they're easier to digest. White toast, crackers, white rice, bananas, unsweetened applesauce, dry cereal, or baked chicken with the skin off are good choices, per the Cleveland Clinic. Electrolyte drinks like Pedialyte or Gatorade are also good if you've had diarrhea, because they'll help you stay hydrated and replenish lost electrolytes.

—reviewed by Jennifer Logan, MD, MPH