Odynophagia is painful swallowing.
After chewing, swallowing is an important step in the process of digestion. When there is pain while swallowing solids or liquids it is called odynophagia.
Pain can occur in the mouth, in the throat or in the esophagus while swallowing in this condition.
Odynophagia is a symptom. The finding of the underlying cause is important for the treatment.
Let us discuss some common causes of painful swallowing.
Table of Contents
Causes of odynophagia
Causes of odynophagia are many. They mainly include the following causes.
| Salivary gland infections |
| Sore throat |
| Common cold |
| Sore tongue |
| Aphthous ulcer |
| Toothache |
| Fungal infection like candidiasis |
| Gastroesophageal reflux disease |
| HIV |
| Cancer of oral cavity or esophagus |
Salivary gland infection
This is one of the most common causes of painful swallowing. Salivary glands, mainly parotid glands, get infected most commonly.
Most common cause of parotid gland infection is viral infection. Most commonly seen in children. Main cause of parotid gland infection in children is mumps.
It presents as painful swallowing, fever, and sore throat. There is swelling on the parotid gland. One or both sides of the glands may be affected.
Other salivary glands like submandibular glands are affected most commonly by bacterial infections.
Sore throat
Sore throat occurs most commonly because of viral infection. Sometimes it can be bacterial infection like Streptococcus infection.
It presents with cough, painful swallowing and fever. Throat pain may occur at rest or when coughing and increase while swallowing food.
It generally resolves with or without treatment. The streptococcal throat infection may have complications like nephritic syndrome or rheumatic heart disease. Bacterial throat infection needs treatment with antibiotics.
Unvaccinated children and people may suffer from causes like diphtheria and Haemophilus influenzae infection causing throat pain while swallowing.
Common cold
Sometimes the cause of odynophagia is as simple as the common cold. It usually resolves in a week with or without treatment.
Most common cause of common cold is viral infections. It spreads from one person to another through air or hands touching surfaces harbouring the virus.
Sore tongue
This is also a common cause of painful swallowing. Sore tongue may be due to mild infections or vitamin deficiency, tobacco abuse.
Sometimes this condition is because of cancer of the tongue.
Aphthous ulcer
It is a condition affecting the mouth. It is a misnomer as most commonly this condition presents as a bleb in mouth.
It is painful to touch so may cause odynophagia. Sometimes this bleb ruptures and forms an ulcer which is superficial on oral mucosa.
It usually resolves in a few days.
Toothache
Toothache is a pain in the tooth. It is caused by a variety of conditions like injury and infections of gum.
It generally presents as pain while chewing. Sometimes it may present as pain while swallowing and fever.
Candidiasis
This is a condition causes by infection of candida fungus in mouth and throat.
It generally occurs in infants and people with low immunity. It presents as pain while swallowing and seen as refusal to feed in infants.
It occurs in patients with diabetes mellitus and HIV. It may also occur in people with poor oral hygiene.
Gastroesophageal reflux disease
It’s also called GERD. In this disease there is an acid reflux from stomach to esophagus and throat, mouth.
This acid reflux can injure the parts of the esophagus and throat. It can cause an ulcer in these areas.
This ulcer can cause pain while swallowing or odynophagia.
It may also present with loss of appetite and weight loss in affected children and people.
HIV
HIV infection causes AIDS. It is a syndrome caused by low immunity because of HIV infection. HIV is the most common cause of secondary or acquired immunodeficiency.
AIDS itself can cause various infections in the throat and esophagus. It presents as pain while swallowing or odynophagia.
Cancer of oral cavity and esophagus
Cancers of the oral cavity and esophagus may present with pain while swallowing food.
These cancers are caused by cigarette smoking, tobacco abuse and alcohol abuse. It can also be because of genetic causes. GERD too can cause cancer of esophagus.
Tests needed for odynophagia
Your doctor will ask you the history of illness and associated symptoms. He/ she will examine you.
Odynophagia is a symptoms so it is important to find the cause of this symptom.
For obvious causes no tests are needed for the diagnosis of the conditions.
Endoscopy is an investigation in which your gastroenterologist will pass a small camera into the esophagus and stomach through the mouth.
This test detects abnormal areas in the upper gastrointestinal tract.
The biopsy sample can be taken with a test. The pathological findings in the lab on this biopsy sample may identify the cause of odynophagia.
Treatment of odynophagia
Treatment of pain while swallowing depends upon the underlying cause. Some causes will resolve on their own even without treatment.
Medical treatment
Conditions like GERD need treatment with acid reducing agents like proton pump inhibitors pantoprazole or omeprazole.
Local anaesthetic containing oral syrups like Mucain gel may provide pain relief.
Surgical treatment
For cancer conditions surgical treatment may be needed to remove the cancerous cells. Surgery aims to remove the part involving cancer so that it does not spread to other normal body parts.
Radiotherapy
Some cancerous condition may require radiotherapy alone or with surgery.