Painful Swallowing (Odynophagia)

What is painful swallowing?

Painful swallowing or, medically, odynophagia, is any pain felt in the throat or chest during swallowing.

Causes

Causes of painful swallowing can be divided into:

1. Conditions with THROAT PAIN
2. Conditions with CHEST PAIN

Can be chest pain during swallowing a sign of heart disease?

Chest pain during swallowing more likely results from an esophageal problem (food impaction, acid reflux, infection, spasm) than from coronary heart disease. Note, that in both esophageal spasms and heart disease (angina pectoris) chest pain can be triggered by large meals, anxiety and exercise ^[23].

Diagnosis and Treatment

If you suffer from painful swallowing that does not seem to arise from a simple condition, such as mild throat infection, visit a doctor. You might need a referral to a specialist, such as a dentist, an ENT doctor, gastroenterologist or neurologist. More details about investigations and treatment of swallowing problems are in the article about difficulty swallowing (dysphagia).

Home Remedies

To prevent or limit painful swallowing:

• Have small meals, eat slowly and chew food well.
• Avoid dry, rough, spicy and very hot or cold foods.

When you experience severe chest pain during swallowing due to esophageal spasm, try the following to release the food that has stuck in your esophagus ^[3]:

• Pinch the nose with the fingers and blow air through it (Valsalva maneuver) ^[2].
• In diffuse esophageal spasm or achalasia, drinking some carbonated ^[5] or warm/hot water ^[11,22] can relieve pain.
• In one small study, adding peppermint oil extract in water helped relieve pain in diffuse esophageal spasm ^[24].

• References

  1. Pharyngeal cancer symptoms  Cancer Treatment Centers of America
  2. Spieker MR et al, 2000, Evaluating dysphagia  American Family Physician
  3. Richter JE, Dysphagia, odynophagia, heartburn and other esophageal symptoms  University of Alberta
  4. Janssens C et al, 1991, Odynophagia is less of a problem, as there is a clear relation between pain and swallowing  HON.ch
  5. Mohammed SH et al, 1986, Dislodgement of impacted oesophageal foreign bodies with carbonated beverages  PubMed
  6. Comacchio F et al 2012, Carotidynia: new aspects of a controversial entity  PubMed Central
  7. Alafaci C et al, 2015, Glossopharyngeal neuralgia caused by a complex neurovascular conflict: Case report and review of the literature  PubMed Central
  8. Spieker MR et al, 2000, Evaluating dysphagia  American Family Physician
  9. Richmon JD et al, Odynophagia  Ento Key
  10. Eosinophilic esophagitis  American Academy of Allergy, Asthma & Immunology
  11. Esophageal spasms and strictures  Cleveland Clinic
  12. Lechien JR et al, 2016, Impact of laryngopharyngeal reflux on subjective and objective voice assessments: a prospective study  PubMed Central
  13. Medications and dysphagia/swallowing risks  CT.gov
  14. ES Information: Common Symptoms And Possible Explanations For Them  Livingwitheagle
  15. Singh PM et al, 2013, An uncommonly common: Glossopharyngeal neuralgia PubMed Central
  16. Fishman S et al, 2012, Pain Conditions, Bonica’s Management of Pain, p. 1058
  17. Very strange back pain when I swallow  Steady Health
  18. Mallory-Weiss tear  BMJ Best Practice
  19. Esophageal spasms risk factors  Mayo Clinic
  20. Esophageal spasms, clinical presentation  Emedicine
  21. Esophageal spasms, treatment & management  Emedicine
  22. Moo in Park, 2011, Hot Water Swallows May Improve Symptoms in Patients With Achalasia  PubMed Central
  23. Lynch KL, Symptomatic Diffuse Esophageal Spasm  Merck Manual
  24. Pimentel M et al, 2001, Peppermint oil improves the manometric findings in diffuse esophageal spasm
      PubMed