Although it is not a frequent cause, research reports some cases where treating constipation has eased chest pain from no clear causes.

Researchers have shown that constipation has an association with cardiovascular events. For example, straining too hard with a bowel movement may increase blood pressure.

Additionally, gas in the colon can spread to the chest and present as heart pain.

This article examines if constipation causes chest pain. It also discusses the links between constipation and shortness of breath, heart problems, and how to relieve chest pain relating to constipation.

A person with a hand on the chest due to chest pain from constipation.Share on Pinterest
Studio Firma/Stocksy

Scientific evidence suggests that constipation is not a common cause of chest pain.

However, some case reports have noted instances of chest pain — with no other clear cause — in children that had been resolved following constipation treatment. The authors also present a case report for an adult who developed severe chest pain from constipation following heart surgery.

Additionally, gas may accumulate in the left upper part of the colon, which may radiate to the chest and appear as heart pain. Constipation may contribute to such gas accumulation.

Sometimes, shortness of breath can accompany chest pain, and this typically indicates a more serious condition. A person experiencing both should seek medical attention immediately.

That said, 2021 research states that doctors do not generally recognize constipation as a cause of acute respiratory distress syndrome, a condition that involves severe shortness of breath. However, there have been case reports that seem to link the two.

Chest pains relating to constipation may stem from gas or other intestinal problems. In contrast, they may also be due to a heart attack or another medical condition.

When chest pains may indicate a heart attack, a person should call 911 or go to the emergency room for treatment. In these cases, constipation is an issue that a doctor can address once the immediate danger is over.

One of the main symptoms that may indicate a heart attack is chest discomfort or pain. According to the Centers for Disease Control and Prevention (CDC), most heart attacks present as discomfort or pain in the center or left side of the chest. It may last longer than a few minutes or disappear and return.

The discomfort may feel like squeezing, pressure, or fullness. Additionally, a person may experience the following symptoms:

  • feeling lightheaded, weak, or faint
  • discomfort or pain in the neck, jaw, or back
  • discomfort or pain in one or both arms or shoulders
  • shortness of breath

If a person’s pain does not resemble the pain of a heart attack and they do not have other symptoms that indicate a heart attack, they can address the constipation. However, when chest pain happens, and an individual does not know the cause, it is best to get medical attention quickly.

Learn more about the causes of chest pain.

An older study from 2016 investigated whether bowel movement frequency links to cardiovascular-related deaths. Among more than 45,000 Japanese participants, it found that people with low-frequency bowel movements had a greater risk of cardiovascular death than those with high-frequency bowel movements.

Cardiovascular refers to the heart and blood vessels. Low frequency refers to defecation once every 2–3 days, while high frequency involves defecation more than once per day.

Explaining the link

Research from 2019 explains the factors that may underlie the link between constipation and cardiovascular events. Examples of these events include disorders in heart rhythm and congestive heart failure, a condition where the heart does not pump adequately.

The factors below may account for this link:

  • Microbiota changes: Constipation causes adverse changes in the microbiota, the bacterial community in the gut. Earlier investigations suggest an association between microbiota gut changes and certain health conditions, including:
    • high blood pressure
    • worsening of atherosclerosis — fatty deposits in the inner walls of arteries that can increase the risk of cardiovascular events
    • cardiovascular disease
  • Aging: As individuals get older, they have a higher risk for both constipation and cardiovascular disease.
  • Increased stress: Chronic (long-term) constipation has links with increased stress. This can raise blood pressure and affect heart rate.

Treating the underlying heart problems may be the first step to alleviating chest pain for certain people.

Sheila Rustgi, MD, Gastroenterologist at Columbia Doctors and Assistant Professor of Medicine at Columbia University, gave recommendations about relieving chest pain relating to constipation.

There are a few different ways to address this. “One way is to use laxatives to soften the stool and reduce the stool burden, so the intestines aren’t working hard and causing cramping,” she said. “If pain is an issue, I don’t recommend stimulant laxatives, such as bisacodyl (Dulcolax), because they can cause worse cramping.”

If the pain persists even with softer stools, a person can use medications targeted for irritable bowel syndrome. “This includes drugs, such as linaclotide (Linzess) or lubiprostone (Amitiza), which are approved for irritable bowel syndrome with constipation,” Rustgi adds. “These are daily medications that improve the frequency of bowel movements and reduce pain.”

Constipation-related gas pains may trigger chest pain. Additionally, constipation has associations with cardiovascular events due to its adverse effects on the microbiome as well as stress and aging.

Since chest pain is one of the main symptoms of a heart attack, a person should take it seriously. If the pain feels similar to pressure or squeezing and other heart attack symptoms, such as weakness, accompany it, the individual should go to the emergency room. Once the danger is over, a doctor can address the constipation.