Pain when swallowing can originate from the mouth, throat or esophagus. Sometimes pain when swallowing can also be related to pathology in the larynx. Swallowing is a complex mechanism involving many muscles, including the lips, tongue, jaw, cheeks and throat. Although pain when swallowing can be felt in the mouth or throat, causes related to the esophagus can present as chest pain. Usually a sore throat and pain when swallowing are caused by a cold virus. You can remedy this discomfort through the right self-care measures. If your symptoms persist or worsen, contact your doctor. This can investigate the cause of pain when swallowing and initiate treatment.
- Pain when swallowing due to infections
- Tonsillitis
- Epiglottitis
- Strep throat
- Candidosis of the oral mucosa
- Pfeiffer’s disease
- Herpes simplex virus (HSV)
- Infectious causes of acute or chronic sore throat
- Foreign objects
- Other causes of pain when swallowing
- Larynx inflammation or laryngeal cancer
- Esophageal ulcers (ulcers in the esophagus)
- Oral gonorrhea
- Throat cancer and esophageal cancer
- Allergies
- Additional symptoms
- When to consult a doctor?
- Examination and diagnosis
- Treatment of painful swallowing
- Pain when swallowing due to a cold virus
- Allergies
- Fungal infection
- Prognosis of swallowing pain
Common tonsils and tonsillitis / Source: Solar22/Shutterstock.com
Pain when swallowing due to infections
Pain when swallowing can be caused by stomatitis (damage to the oral mucosa), tonsillitis (tonsillitis), epiglottitis (an inflammation of the epiglottis) and esophagitis (esophagitis). It is more pronounced in severe infections and in some cases dysphagia (difficulty swallowing) may be present. Some infectious causes of pain when swallowing are as follows.
Tonsillitis
Tonsillitis or tonsillitis is an inflammation of the tonsils. The tonsils are in the mouth, nose and throat. Tonsillitis is a common cause of painful swallowing. Tonsillitis is a contagious condition. Viruses or bacterial infections, including strep throat, can cause tonsillitis. If the pain when swallowing is due to tonsillitis, you may also experience the following symptoms:
- swollen tonsils
- white or yellow spots on the tonsils
- bad breath
- sensitive jaw or neck
- fever
Epiglottitis
Epiglottitis is an inflammation of the epiglottis, a thin, lid-like cartilage valve, covered with a mucous membrane, located at the base of the tongue. In addition to pain when swallowing, typical symptoms of epiglottitis include:
- difficulty swallowing
- a sore throat
- high fever
- drool
White dots in the throat due to streptococcal throat infection / Source: En:RescueFF, Wikimedia Commons (Public domain)
Strep throat
Throat infections are one of the most common causes of pain when swallowing. This may involve throat infection with, for example, Streptococcal bacteria. Symptoms include:
- swollen, tender lymph nodes on one or both sides of the neck
- pain in the soft palate
- red spots on the soft palate
- fever
- white spots on the tonsils
Candidosis of the oral mucosa
The yeast Candida albicans occurs naturally in and on the human body and feels most comfortable in a warm and moist environment. Candida can occur on the skin, in skin folds and on the mucous membranes (of the mouth, esophagus, vagina and intestines). In healthy people this does not cause any complaints, but the yeast can spread if the conditions are favorable and then cause complaints. If the fungus grows and causes mucosal abnormalities, it is called ‘candidosis’ (of the oral mucosa). This is not contagious, but it is very annoying. There are local and general factors that promote the (over)growth of the fungus. Local factors include:
- long-term irritation due to, for example, poorly fitting dentures;
- poor oral hygiene;
- smoking;
- local use of corticosteroids (use of inhaled corticosteroids in asthma;
- dry mouth;
- irradiation of the oral cavity area.
General factors are:
- immune disorders;
- hormonal disorders such as diabetes;
- use of medicines, such as antibiotics and corticosteroids;
- a serious vitamin B deficiency or iron deficiency.
Candidosis can be recognized by white or red and sometimes only as smooth mucosal changes in the mouth, which are sometimes accompanied by a painful, burning sensation. Some people also experience pain when swallowing, which is often a sign that the infection has spread to your esophagus.
Paracetamol has an analgesic and fever-reducing effect / Source: Martin Sulman
Pfeiffer’s disease
Mononucleosis is an infectious disease that is mainly found in adolescents. The disease is caused by the Epstein Barr virus and often starts with a throat infection and significant swelling of the lymph nodes in the neck and neck (swollen lymph nodes). The recovery from glandular fever often takes longer than with a normal throat infection. There is no cure for glandular fever. You can alleviate the complaints with a gargle, some lozenges and possibly paracetamol for the pain.
Herpes simplex virus (HSV)
Infection of the oral mucosa can be caused by the herpes simplex virus type 1. In immunocompromised people, recurrent outbreaks of oral herpes can lead to progressive, gradually enlarging sores. The infection can move to the esophagus and ulcers in the esophagus can cause pain when swallowing.
Sinusitis / Source: Istock.com/KatarzynaBialasiewicz
Infectious causes of acute or chronic sore throat
Pain when swallowing (and sore throat) is often caused by irritation of the mucous membrane as a result of a cold (often caused by a rhino or adenovirus), a sinus infection or the flu. The mucous membrane can become so irritated that local resistance decreases. Ultimately, certain bacteria can see their chance and cause a throat infection or tonsillitis.
Foreign objects
Foreign objects can sometimes be swallowed by children and even adults. Small indigestible objects (e.g. a coin) often pass through the digestive system until they are excreted in the feces. In that case there is nothing to worry about. Larger or sharp objects, such as fish bones, can cause complaints if, for example, they get stuck in the esophagus, stomach or elsewhere in the digestive tract. A small sharp object that gets stuck in the esophagus can cause pain (when swallowing). A doctor can expertly remove some objects stuck in the esophagus.
Sometimes medicines (e.g. NSAIDs) that have been swallowed with insufficient water can get stuck in the esophagus and act on the esophageal wall during the night. This can result in a lot of damage, such as perforation or ulceration. This problem is more common than many people think. The advice to rinse medicines with plenty of water is therefore not superfluous.
Other causes of pain when swallowing
There are a number of non-infectious causes of inflammation, ulceration and other complaints in the digestive tract that can result in pain when swallowing.
Larynx inflammation or laryngeal cancer
Inflammation of the voice box (laryngitis) or cancer of the larynx can cause pain when swallowing. Supraglottic tumors in particular (i.e. tumors in the upper part of the larynx, above the vocal cords) can cause pain when swallowing or a dry or raw throat. You may feel as if there is a lump in your throat and you may also choke frequently.
Esophageal ulcers (ulcers in the esophagus)
Gastroesophageal reflux (GERD) is a condition that occurs when stomach acid flows back into the esophagus. GERD is the most common cause of esophageal ulcers, which can manifest as pain or difficulty swallowing, among other symptoms.
Oral gonorrhea
Gonorrhea is a venereal disease caused by the bacterium Neisseria gonorrhoeae. Gonorrhea is very contagious. If the throat is infected with the bacteria, this does not necessarily cause any complaints. But it can also lead to a sore throat. In addition to a sore throat, oral gonorrhea can cause complaints such as pain when swallowing and fever.
Alcohol and esophageal cancer / Source: Istock.com/karelnoppe
Throat cancer and esophageal cancer
Esophageal cancer occurs in approximately 1,900 people in the Netherlands every year. Esophageal cancer mainly occurs in the elderly and factors such as smoking, alcohol and eating a lot of meat increase the risk of esophageal cancer. You can suffer from all kinds of complaints, such as food getting stuck in the esophagus, but also pain in the upper abdomen that lasts for a long time and ultimately does not disappear with medication. You may also experience persistent pain behind the breastbone, sometimes especially when swallowing.
Throat cancer can cause a range of symptoms, such as coughing, incessant sore throat, pain or difficulty swallowing, earache, voice changes such as hoarseness and weight loss.
Allergies
Allergies to pet dander, mold, dust and pollen can lead to pain when swallowing, a sore throat and a range of other complaints.
Additional symptoms
Depending on the cause, pain when swallowing may be accompanied by other symptoms, such as:
- a metallic taste in the mouth
- a bitter taste in the mouth
- a bad taste in the mouth
- swollen lymph nodes in the neck or neck
- hoarseness
- lump feeling in the throat
- cough
Headache / Source: Andresr/Shutterstock.com
- headache
- a sore throat
- fever
- cold shivers
- shortness of breath
- shortness of breath
- difficulty swallowing
- stiff neck
- earache
- pain in the oral cavity that worsens when swallowing
- chestpain
- red, inflamed tonsils
- muscle pain (in the upper back or limbs)
- pain in the tongue
- wheezing (wheezing sound when exhaling)
When to call a doctor if you have swallowing pain?l / Source: Staras/Istock.com
When to consult a doctor?
Pain when swallowing often disappears after a few days, especially if it is due to a cold. In some cases, medical attention is required to determine the cause and receive adequate treatment. It is best to consult a doctor if the following conditions apply:
- the cause of pain when swallowing is unknown
- the pain lasts longer than a week or becomes worse
- there are white spots at the back of the throat
It is also important to recognize when painful swallowing may be a sign of a medical emergency. Seek immediate medical attention if one or more of the following symptoms occur in addition to vomiting pain
- swelling of the throat
- difficulty breathing
- problems opening the mouth
- unusual drooling
Blood collection / Source: Istock.com/anna1311
Examination and diagnosis
An accurate diagnosis is essential for the treatment of pain on swallowing. Your doctor may recommend several tests to make a diagnosis. After reviewing your medical history, the doctor will ask all kinds of questions about your complaints and then conduct a physical examination. Additional research may include:
- Throat swab. During a throat culture, the doctor removes a sample of mucus from the throat with a cotton swab. A throat culture examines the growth of bacteria in the throat.
- Blood tests. To determine if an infection is present.
- Barium swallow test. A barium swallow test is a special type of X-ray of the esophagus. Before the X-ray is taken, you will drink a barium-containing liquid. The barium reveals the path that food takes from the mouth to the stomach.
- CT-scan. Doctors use CT scans to create images of the throat. These help the doctor identify any abnormalities and abnormalities, such as tumors that may cause pain when swallowing.
Ginger tea with honey / Source: Istock.com/ChamilleWhite
Treatment of painful swallowing
The treatment for painful swallowing depends on the type of swallowing problem you have. Sometimes a swallowing problem resolves spontaneously without treatment. In many other cases, swallowing problems can be easily treated. A number of causes require medical treatment by your doctor or a specialist.
Pain when swallowing due to a cold virus
You can tackle a sore throat with difficulty swallowing or speaking due to a cold virus with self-care measures:
- Drinking something regularly, such as cold water, can soothe the sore throat.
- Sucking on a licorice or throat lozenge can ease the pain.
- In case of severe pain, take enough paracetamol at fixed times.
- Gargle with a mixture of warm water and ½ to 1 teaspoon of salt.
- Drink warm liquids that soothe the throat, such as hot tea with honey and ginger, broth, or warm water with lemon. Herbal teas are especially soothing for a sore throat.
- Cool your throat by eating a cold treat such as an ice cream cone.
- Turn on a cool humidifier to add moisture to the air.
- Rest your voice until your throat feels better.
Allergies
You can treat allergy symptoms with over-the-counter and prescription medications. Lifestyle changes such as using air purifiers and avoiding triggers are also important.
Fungal infection
A fungal infection in the mouth is easy to treat in healthy children and adults. But symptoms can be worse and more difficult to treat in people with weak immune systems. The doctor will probably prescribe antifungal medications that you should take for about 10 to 14 days. These are available in tablets, lozenges or liquids and are generally easy to take. Because the infection can be a symptom of other medical problems, your doctor may also want to perform other tests to rule it out.
Prognosis of swallowing pain
If the cause of pain when swallowing is quickly identified and treated, the symptoms often improve significantly.
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