Why does it hurt in the middle of my chest when I drink water?

Generally, pain in the epigastric region while drinking water may be caused by multiple factors, including drinking too quickly, consuming water that is excessively hot or cold, minor esophageal mucosal injury, gastroesophageal reflux disease (GERD), and esophagitis. It is recommended to seek timely medical consultation for symptomatic treatment under a physician's guidance. A detailed explanation is as follows:

1. Drinking too quickly: A large volume of water passing rapidly through the esophagus in a short time may stimulate the smooth muscles of the esophagus and stomach, causing cramp-like pain, manifested as brief stabbing or distending pain in the epigastric region. Develop the habit of drinking slowly, swallow in small sips, and avoid excessive water intake at once to reduce sudden stimulation to the gastrointestinal tract.

2. Water that is excessively hot or cold: Water that is too hot may damage the mucous membranes of the esophagus and stomach, while water that is too cold may stimulate smooth muscle contraction; both may cause epigastric pain, especially when the stomach is empty. Drink warm water at a moderate temperature and avoid excessively hot or cold water to reduce mucosal irritation.

3. Minor esophageal mucosal injury: When eating too quickly, consuming hard foods, or having mild inflammation, small injuries may occur in the esophageal mucosa. Water flow during drinking may irritate these injured areas, causing pain, possibly accompanied by a mild foreign body sensation. In the short term, choose soft and warm foods, and avoid spicy, overly acidic, or hard foods. Medications such as Xinfuye Solution (Recovery New Liquid), Hydrotalcite Chewable Tablets, or Sucralfate Suspension may be used as directed by a physician to promote mucosal healing and protection.

4. Gastroesophageal reflux disease (GERD): Reflux of gastric contents into the esophagus may irritate the esophageal mucosa. The movement of liquid during drinking may exacerbate this irritation, leading to epigastric pain, often accompanied by acid regurgitation and heartburn. Avoid overeating, refrain from eating 2–3 hours before bedtime, and elevate the head of the bed slightly while sleeping. Medications such as Omeprazole Enteric-coated Capsules, Domperidone Tablets, and Rabeprazole Sodium Enteric-coated Tablets may be used as directed by a physician to suppress gastric acid secretion, promote gastric emptying, and reduce reflux.

5. Esophagitis: When the esophageal mucosa becomes inflamed, it may become congested and swollen. Drinking water directly stimulates the affected area, causing epigastric pain that may persist and worsen with swallowing. Severe cases may be accompanied by difficulty swallowing. Strictly avoid spicy, hot, or irritating foods, and choose liquid or semi-liquid diets. Medications such as Pantoprazole Sodium Enteric-coated Capsules, Bismuth Potassium Citrate Capsules, and Esomeprazole Magnesium Enteric-coated Tablets may be used as directed by a physician to strongly suppress gastric acid secretion, protect the esophageal mucosa, and alleviate inflammation.

During daily water consumption, attention should be paid to drinking methods and water temperature. If symptoms do not improve or worsen after adjustments, timely further interventions are necessary. Maintaining regular eating habits and avoiding excessive hunger or overeating can help reduce gastrointestinal irritation and support digestive tract health.