Odynophagia (Pain on Swallowing) - What it is
Odynophagia refers to pain on swallowing.
Odynophagia (Pain on Swallowing) - Symptoms
Odynophagia (Pain on Swallowing) - How to prevent?
Odynophagia (Pain on Swallowing) - Causes and Risk Factors
Some of the common causes of odynophagia include:
1. Infections
Infections involving the tonsils, throat, epiglottis and oesophagus may cause pain on swallowing.
Some of these infections include:
- Acute viral/bacterial pharyngitis
- Acute tonsillitis
- Oral and oesophageal candidiasis
- HIV infections
- Herpes simplex infections
2. Tumours
Cancers of the mouth, throat, voice box (larynx), tongue and oesophagus can also sometimes cause pain when swallowing.
3. Inflammation
Inflammation of the mouth, pharynx and oesophagus can sometimes occur when they are exposed to caustic substances.
These can sometimes be ingested substances (e.g. hot fluids, acidic substances). Medical conditions such as gastro-oesophageal reflux disease (GERD) can also cause inflammation when these organs are are constantly exposed to acid reflux from the stomach.
4. Foreign Body
Foreign bodies (e.g. fish-bones) sometimes can get stuck when they are swallowed. They can lodge in the tonsils, throat or oesophagus and cause pain on swallowing.
5. Oesophageal Disorders
Sometimes, pain on swallowing can be due to a disorder in the motility of the oesophagus. These include:
- Oesophageal spasm
- Achalasia
- Nutcracker Oesophagus
Odynophagia (Pain on Swallowing) - Diagnosis
What tests can be done to investigate odynophagia?
Depending on your doctor’s findings, he or she may ask you to undergo one or more of the following investigations:
1. Nasoendoscopy
A flexible camera with light is passed through one of your nostrils to look at the back of your nose, larynx and throat. This test can be done in the clinic and is useful to look for conditions affecting the throat, larynx and back of the tongue (e.g. ulcers and tumours).
2. Oesophago-gastroduodenoscopy (OGD)
In an OGD, the doctor will pass a flexible tube with a camera and light through your mouth into your oesophagus, stomach and the duodenum (first part of the small intestine). An OGD is useful for looking for mechanical causes of dysphagia (e.g. tumours, strictures). It is usually a day procedure.
3. Manometry
A tube with pressure sensors is passed down your oesophagus to measure the strength and co-ordination of the contractions of your oesophagus. This test is useful to investigate motility disorders affecting swallowing.
4. Imaging Studies
Your doctor may order some X-rays or scans. One of these X-rays is a barium swallow. In a barium swallow, an X-ray of your oesophagus and stomach is taken after swallowing some dilute barium to outline the stomach. This test is good for looking for tumours and strictures.
Odynophagia (Pain on Swallowing) - Treatments
The type of treatment you will need to undergo will depend on the underlying cause of the odynophagia. Your doctor will usually discuss this with you.
Odynophagia (Pain on Swallowing) - Preparing for surgery
Odynophagia (Pain on Swallowing) - Post-surgery care
Odynophagia (Pain on Swallowing) - Other Information
Sore throats are not usually serious and often pass in three to seven days. There are some treatments you can use at home to relieve your symptoms.
Painkillers
For treating sore throats, over-the-counter painkillers, such as paracetamol, are usually recommended. These may also help reduce a high temperature (fever).
You should not take aspirin or ibuprofen if you have:
- asthma
- current or past stomach problems, such as a stomach ulcer
- current or past liver or kidney problems
Children under the age of 16 should never be given aspirin.
Take painkillers as necessary to relieve your pain. Always read the manufacturer’s instructions so you do not exceed the recommended or prescribed dose.
Self-care tips
If you or someone in your family has a sore throat, the tips below may help relieve the symptoms:
- avoid food or drink that is too hot, as this could irritate the throat
- eat cool, soft food and drink cool or warm liquids
- adults and older children can suck lozenges, hard sweets, ice cubes or ice lollies
- avoid smoking and smoky environments
- regularly gargling with a mouthwash of warm, salty water may help reduce swelling or pain
- drink enough fluids, especially if you have a fever
Steam inhalation is not recommended, as it's unlikely to help a sore throat and there is a risk of scalding.
Antibiotics
The use of antibiotics is not usually recommended for treating sore throats. This is because most sore throats are not caused by bacteria.
Even if your sore throat is caused by bacteria, antibiotics have very little effect on the severity of the symptoms and how long they last, and may cause unpleasant side effects.
Overusing antibiotics to treat minor ailments can also make them less effective in the treatment of life-threatening conditions. This is known as antibiotic resistance.
Antibiotics are usually only prescribed if:
- your sore throat is particularly severe
- you are at increased risk of a severe infection – for example because you have a weakened immune system due to HIV or diabetes(a long-term condition caused by too much glucose in the blood)
- you are at risk of having a weakened immune system – there are some medications that can cause this, such as carbimazole (to treat an overactive thyroid gland)
- you have a history of rheumatic fever (a condition that can cause widespread inflammation throughout the body)
- you have valvular heart disease (a disease affecting the valves in your heart, which control blood flow)
- you experience repeated infections caused by the group A streptococcus bacteria
Delayed antibiotics prescription
If your pharmacist thinks you might need antibiotics, they may recommend you see your GP who might issue a prescription but ask you to wait up to three days for symptoms to improve.
If your sore throat gets worse, or has not improved after three days, you should have instructions to either:
- take your prescription slip to a pharmacy
- return to the GP surgery after three days to collect your medication
Recent studies show that complications of a sore throat are uncommon and usually not serious. A delayed antibiotic prescription seems to be as effective as an immediate prescription in reducing complications.
Using a delayed prescription provides similar benefits to an immediate prescription. Most importantly, this helps you to avoid taking antibiotics when they're not needed and helps prevent antibiotic resistance.
Tonsillectomy
A tonsillectomy is a surgical procedure to remove the tonsils (the two lumps of tissue on either side of your throat). If your child has repeated infections of the tonsils (tonsillitis), a tonsillectomy may be considered.
Read more about treating tonsillitis.
Glandular fever
If you are 15-25 years of age with a persistent sore throat, you may have glandular fever(also known as infectious mononucleosis, or mono). This is a type of viral infection with symptoms that can last up to six weeks.
Cancer
A persistent sore throat can also be a symptom of some types of cancer, such as throat cancer. This type of cancer is rare and mainly affects people over the age of 50. In the UK every year, 5,300 people are diagnosed with cancer of the oropharynx (the area at the back of your throat) or mouth.
Read more about mouth cancer
Non-infectious causes
In some cases, a sore throat may be caused by substances that irritate the throat. Sources can include:
- alcohol
- cigarette smoke
- an allergy– such as hay fever
- gastro-oesophageal reflux disease (GORD)– when stomach acid leaks out of the stomach and into the gullet
You may find that avoiding these substances, or seeking treatment for an allergy or GORD, can help to reduce symptoms of a sore throat.
Giving up smoking
If you smoke, giving up will reduce irritation to your throat and strengthen your defences against infection.
The Quit Your Way Scotland service can offer you advice and encouragement to help you quit smoking. Phone Quit Your Way Scotland free on 0800 84 84 84 (8.00am to 10.00pm, every day).
Your GP or pharmacist will also be able to give you help and advice about giving up smoking, or you can read more about quitting smoking.
Preventing a sore throat
As sore throats are caused by bacterial or viral infections, they can be difficult to prevent.
If you have a sore throat caused by an infection, you can help prevent the infection spreading by practising good hygiene, such as washing your hands regularly and keeping surfaces clean and free of germs.