What Might Cause Painful Swallowing? (2024)

Painful swallowing can feel like discomfort or pain or may feel like a burning or squeezing sensation. It may be felt anywhere from the neck to the breastbone. Pain in the throat or chest during swallowing is called odynophagia.

Painful swallowing can be caused by several things, including infection, acid reflux, or damage to the esophagus (food tube). This article will discuss what can cause painful swallowing, when to be concerned, and what to do about it.

Symptoms of Painful Swallowing

In addition to pain or discomfort while swallowing, a person with odynophagia may also experience:

• Soreness or ulcers in the mouth
• Pain and a burning sensation after swallowing
• Feeling as though food is "stuck"
• Reflux (stomach acid flows back into the food tube) or indigestion

Painful swallowing often feels like a sensation of squeezing or burning. It may be felt high in the neck or down lower behind the breastbone.

Causes of Painful Swallowing

Painful swallowing can be caused by many different things, including:

Infections, such as:

• Sore throat from a virus such as a cold or flu
• A bacterial infection such as strep throat
• Herpes simplex virus
• A gum or tooth infection or abscess
• Cytomegalovirus (closely related to the viruses that cause chickenpox and mononucleosis)
• Candida albicans (fungal infection commonly called thrush usually affecting the mouth but can affect the esophagus, particularly in people with a compromised immune system)
• Tonsillitis (infection of the tonsils)
• Peritonsillar abscess (an area of pus-filled tissue at the back of the mouth beside one of the tonsils)
• Middle ear infection (otitis media)

Conditions affecting the mouth, throat, or esophagus, such as:

• Gastroesophageal reflux disease (GERD) (when acidic stomach contents flow back up into the esophagus)
• Esophagitis (inflammation and irritation of the lining of the esophagus)
• Esophageal spasms
• Nutcracker esophagus (powerful swallowing contractions, often caused by gastroesophageal reflux)
• Gingivitis (gum disease)
• Ulcers (sores) in the mouth, esophagus, or throat
• Laryngitis (inflammation of the larynx/voice box causing swollen vocal cords)

Damage to the mouth, esophagus, or throat, such as:

• An object or food stuck in the throat
• Scratches, tears, cuts, or irritation in the mouth, throat, or esophagus
• Burns

What Medications Can Cause Painful Swallowing

Some medications may cause ulcers in the esophagus, including:

• Tetracyclines (antibiotic)
• Aspirin
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil/Motrin (ibuprofen) and Aleve (naproxen)

How to Treat Painful Swallowing

Painful swallowing is treated by addressing what is causing the underlying problem (such as antibiotics for strep throat) and with symptom relief.

Ways to help relieve painful swallowing symptoms include:

• Changing eating habits, such as eating soft foods and avoiding foods that are very hot or very cold
• Not smoking, which can irritate the throat
• Using over-the-counter (OTC) lozenges or throat sprays
• Using a local anesthetic containing lidocaine (spray or oral solution) to numb the throat
• Pain management with Tylenol (acetaminophen) or NSAIDs

Complications Associated With Painful Swallowing

In addition to complications from the cause of the painful swallowing, ongoing pain while swallowing can lead to:

• Lack of adequate food and fluid intake
• Unintentional weight loss
• Reduced physical wellness and quality of life

Are There Tests to Diagnose the Cause of Painful Swallowing?

If you are experiencing painful swallowing, a healthcare provider will first do a physical examination and ask some questions about your symptoms and medical history. They may ask about the following:

• The nature of the pain (is it constant, does it come and go, is it getting worse, etc.)
• How the pain feels (sore throat, feeling like there is a lump in your throat, etc.)
• How it affects swallowing (pain when swallowing liquids, solids, or both)
• The circ*mstances surrounding the pain (such as have you swallowed or inhaled any irritating substances)
• Any other symptoms you may have
• Other health problems you have
• Any medications you take

If your healthcare provider feels it's necessary, they may run tests such as:

• Tests for strep throat: A rapid antigen test is common, or a throat culture may be performed.
• HIV testing: This tests for the human immunodeficiency virus.
• Endoscopy: A flexible tube with a light and camera is used to look inside the body and sometimes remove tissue (biopsy) to analyze in the lab.
• Barium swallowand upper gastrointestinal (GI) series: A drink containing barium is swallowed then X-rays are performed.
• Chest or neck X-ray
• Esophageal pH monitoring: This test measures acid in the esophagus.
• Esophageal manometry: This test measures pressure in the esophagus.
• Esophagogastroduodenoscopy(EGD): An endoscope is used to examine the lining of the esophagus, stomach, and first part of the small intestine.
  

When to See a Healthcare Provider Painful Swallowing

Contact a healthcare provider if your painful swallowing is prolonged, is bothering you, or is accompanied by:

• Blood in your stools (or your stools appear black or tarry)
• Shortness of breath
• Wheezing
• Light-headedness
• Weight loss
• Fever
• Chills
• Abdominal pain
  
• Cough
• Nausea or vomiting
  
• Heartburn
  
• Sour taste in the mouth
  

Summary

Painful swallowing is a symptom that can have many different causes, including infection, medical conditions such as GERD (gastroesophageal reflux disease), and damage from objects stuck in the throat.

Painful swallowing can be felt anywhere from the neck to the breastbone. It may feel like pain, discomfort, burning, or a squeezing sensation.

Painful swallowing is a common symptom of many different conditions. See a healthcare provider if you are experiencing unexplained painful swallowing or if the pain while swallowing isn't going away or is accompanied by other symptoms.

Treating the underlying cause is the most important way to treat painful swallowing. Symptoms can be relieved by changing eating habits, using lozenges or numbing sprays/oral solutions, or taking pain medication such as NSAIDs.