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Painful swallowing

Definition

Swallowing pain refers to a strong feeling of uncomfortable squeezing and burning while swallowing, which may be felt high in the neck or lower down behind the breastbone. Such pain may be a symptom of a serious disorder.

See also: Swallowing difficulty

Alternative Names

Swallowing - pain or burning; Odynophagia; Burning feeling when swallowing

Considerations

Swallowing is a complex act that involves the mouth, throat area, and esophagus (the tube that transports food to the stomach).

Problems at any point, from the mouth to the esophagus, can result in burning or intense pain with swallowing.

This may be accompanied by chest pain, the feeling that food is stuck in the throat, or heaviness or pressure in the neck or upper chest.

Common Causes

• Infection
  • Cytomegalovirus
  • Gum disease
  • Herpes simplex
  • Human immunodeficiency virus (HIV)
  • Pharyngitis
  • Thrush (a fungal infection caused by candida)
  • Tooth infection or abscess
• Mouth or throat ulcers
• Inflammation of the esophagus
• Something stuck in the throat (for example, fish or chicken bones)
• Problems with the esophagus (listed below) may cause difficulty swallowing:
  • Achalasia
  • Esophageal spasms
  • Nutcracker esophagus

Home Care

Eat slowly and chew food thoroughly. If a person suddenly shows signs of choking and difficulty breathing, the Heimlich maneuver should be performed immediately.

You may have an easier time swallowing liquids or pureed foods than solids. Avoid very cold or very hot foods if you notice that they worsen the problem.

Call your health care provider if

Call your provider if the problem continues, even if the symptoms come and go.

Tell your doctor about any other symptoms that go along with the painful swallowing, including:

• Abdominal pain
• Chills
• Cough
• Fever
• Heartburn
• Nausea or vomiting
• Sour taste in the mouth
• Weight loss
• Wheezing

What to expect at your health care provider's office

The doctor will examine you and ask questions about your medical history and symptoms, including:

• Do you have pain when swallowing solids, liquids, or both?
• Is the pain constant or does it come and go?
• Is the pain getting worse?
• Do you have difficulty swallowing?
• Do you have a sore throat?
• Does it feel like there is a lump in the throat?
• Have you inhaled or swallowed any irritating substances?
• What other symptoms do you have?
• What other medical problems do you have?
• What medications do you take?

The following tests may be done:

• Barium swallow and upper GI series
• Chest x-ray
• Esophageal pH monitoring
• Esophageal manometry
• Esophagogastroduodenoscopy (EGD)
• HIV testing
• Neck x-ray
• Throat culture

Review Date:11/13/2007
Reviewed By:Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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