Odynophagia: What You Need to Know

You’ve most likely never heard of odynophagia, let alone even know what it means.

To be brief, odynophagia is a medical term that means it’s painful to swallow food. It’s often confused with dysphagia.

We’ll cover what that is later.

If you or someone you love is suffering from odynophagia, you know how difficult it can be for you or that person.

But for those not familiar with it, you’re not sure what to think. Here you’ll learn about what exactly odynophagia is, what causes it, symptoms associated with it, how it’s diagnosed, treatment options, and when to see a doctor.

You’ll also learn exactly what the difference is between odynophagia and dysphagia, and scientific studies conducted on odynphagia.

 

What is Odynophagia?

The medical definition of odynophagia is pain when swallowing food, fluids, medication, and the like, which is often due to disease of the esophagus.(1)

Sometimes it is confused with dysphagia, which is difficulty swallowing.

Odynophagia can include any pain that is associated with swallowing found in the mouth, throat, or esophagus, which connects your mouth to your stomach, according to Study.com. (2)

This causes food to take a long time to reach the stomach from the esophagus, which can cause you to feel a stabbing pain in the chest.

Even though it’s confused with dysphagia, they’re often diagnosed together.

 

Causes

Infections

Acute or chronic infections of the mouth (stomatitis), tonsils/throat (tonsillopharyngitis), epiglottis (epiglottitis), and the esophagus (esophagitis) can result in the development of odynophagia.

The more severe the infection the more likely you could also develop dysphagia.

These infections can cause inflammation, ulcers, sores, or abscesses.

Some infections that can cause odynophagia include:(2)

» Oral candidiasis

» HIV infection

» Cytomegalovirus (CMV)

» Epstein-Barr (EBV)

» Any infectious cause of an acute or a chronic sore throat

» Herpes Simplex Virus (HSV)

Foreign Bodies

Foreign bodies that are lodged in the lining of the throat or esophagus, as well as other objects that can be partially or completely obstructing the area, can lead to odynophagia.(3)

Any obstruction to the throat can also affect breathing. Small and sharp foreign bodies, such as fish bones, that can pierce the lining of the throat is usually the main cause.

Inflammation, Sores, and Ulcers

Inflammation of the larynx can also result in odynophagia because of the role the larynx plays in swallowing.

Causes could be related to trauma (hot food/drink), autoimmune diseases, radiation, gastroesophageal reflux disease (GERD), or the inhalation of toxic gases. An abscess or ulcer in the throat can also cause odynophagia.

Tumors

According to Health Hype, „cancer of the mouth, throat, larynx, thyroid, neck, or the esophagus can cause odynophagia“.(3) This should be considered a likely cause in patients that smoke cigarettes, especially if accompanied by dysphagia and unintentional weight loss.

Metastases should always be a consideration in a cancer patient reporting odynophagia and/or dysphagia.

 

Esophageal Disorders

Conditions that mainly affect the esophagus may also be present with odynophagia. Pain in the chest is usually present as the result of esophagus pain. According to Dr. Chris from Health Hype, patients will often, and incorrectly, report pain after swallowing as a symptom, even though it’s actually related to the involuntary esophageal stage of swallowing.(3)

 

Symptoms

Symptoms associated with odynophagia can include:

  • Shortness of breath
  • Pain when swallowing
  • General pain in the mouth
  • Pain swallowing most severe during the morning and subsides as day goes on
  • A persistent sore throat in the morning (morning odynophagia)
  • Can be present with dysphonia (hoarse/whispering voice)
  • Occasionally a stabbing pain that radiates to your back

 

Diagnosis

The diagnosis of odynophagia does not involve any specific tests. Instead what will happen is that the doctor will base the diagnosis on the symptoms mentioned during a physical examination.

When the examination and list of symptoms are not enough for a diagnosis, the doctor may make an appointment for an endoscopy.

An endoscopy exam involves a small camera being sent down the throat to see what’s going on with throat and esophagus.

From there, the doctor will determine the next course of action. This step is particularly important if the cause requires treatment immediately, like a tumor or ulcer. Once a diagnosis has been made, the next step is treatment.

Just as it’s difficult to diagnose painful swallowing, it’s also difficult to treat it. There could be numerous reasons as to why someone is having difficulty swallowing, so there are various treatments.

Tumors could require surgery, but if they are cancerous, chemotherapy and radiation may also be necessary. Ulcers could also require surgery. The doctor could also recommend that you avoid certain foods and drinks, like spicy foods and caffeinated beverages.

 

Treatment

The best treatment for odynophagia is to treat both the symptoms and the underlying cause of the issue.

For example, if a patient was suffering from acute odynophagia due to having cancer, then treating both odynophagia and cancer should be a part of the treatment plan.

This could involve using chemotherapy and radiation to shrink the tumor and to stop the cancer cells from spreading, but this would depend on how severe it is and where the cancer is located.

The exact treatment needed would depend on the two points mentioned. Surgery could also be used to remove the tumor.

Other ways of treating underlying causes of odynophagia include:

» If it’s an ulcer, it can be surgically removed

» If it’s due to an upper respiratory infection, oral forms of nasal decongestants and antibiotics may be prescribed

» If it’s the result of acid reflux, over-the-counter medications like antacids can be taken. In the severe cases where OTC medicine does not work, a physician may recommend a prescription medication.

People with odynophagia should also avoid peppermint, alcohol, and caffeinated drinks because they can cause acid reflux.

Once the underlying cause is treated, symptoms of odynophagia will subside.

 

When Should You See a Doctor?

Someone who suspects they have odynophagia should see a doctor if they have difficulty swallowing on a regular basis, or if you experience unexplained weight loss, regurgitation or vomiting.

If there’s an obstruction that interferes with breathing, you should seek out emergency help as soon as possible. If you’re unable to swallow because it feels like food is stuck in your throat or chest, seek help immediately.

 

The Difference Between Odynophagia and Dysphagia

People often confuse odynophagia with dysphagia.

The two are similar medical conditions but they have a distinct difference. Odynophagia is the medical term for painful swallowing.(1)

Dysphagia is the medical term for having difficulty with swallowing.

This does not mean it’s painful to swallow, it just means that you have a hard time completing the act of swallowing.

What confuses people is that some of the foods or drink that can cause painful swallowing can also cause you to have difficulty swallowing.

 

Scientific Studies on Odynophagia

According to a scientific study published by Head and Face Medicine in 2009 says that surface electromyography could be used as a screening method for the evaluation of odynophagia and dysphagia.(4)

A patient that could possibly have a swallowing disorder would greatly benefit from a diagnostic screening before being referred to a specialist for an evaluation.

This article analyzed various methods on how to assess dysphagia, introduced surface electromyography to quickly assess such patients, and proposed protocols for SEMG screenings to identify abnormalities.

According to data published by the study, SEMG to determine if a patient is suffering from odynophagia or dysphagia due to various causes is a reliable and simple method of screening.

SEMG is noninvasive and is free of radiation, and the discomfort level associated with this method is extremely low. It’s simple to use, saves the patient and the doctor a lot of time, and it’s not an expensive method.

The only major weakness this method seems to have is that it cannot accurately diagnose neurologically induced dysphagia.(5)

Better known as neurogenic dysphagia, it’s a result of sensorimotor impairment of the oral and pharyngeal phases of swallowing due to a neurological disorder, according to article by Johns Hopkins University School of Medicine.(5)

Some symptoms include:

  • Drooling
  • Having difficulty initiating swallowing food, drink, or medication
  • Nasal regurgitation
  • Difficulty with managing secretions
  • Choking or coughing episodes while eating, drinking, or taking medication
  • Food sticking to the throat

According to Europe PMC journal article, if this goes unrecognized and untreated, it can lead to dehydration, malnutrition, and respiratory complications.(6)

Though there are a plethora of unpleasant symptoms that come with neurogenic dysphagia, it can be unapparent a person has it due to other issues that could be present and mimicking neurogenic dysphagia.

Being unable to swallow correctly, along with a diminishing laryngeal cough reflex due to various factors can often complicate the diagnosis of neurogenic dysphagia.

 

Conclusion

If you think you or someone you know is suffering from this health disorder or they’re not sure which one they have:

» Immediately consult a doctor

» Get a proper diagnosis

» Figure out a treatment plan

This is not an illness to be taken lightly. If left untreated, it could mean death! Take the proper precautions, and take care.


References

(1)”doctorshealthpress.com/health-articles/odynophagia-painful-swallowing
(2)”study.com/academy/lesson/odynophagia-definition-causes-symptoms-treatment.html
(3)”healthhype.com/swallowing-pain-causes-of-odynophagia-painful-swallowing.html
(4)”ncbi.nlm.nih.gov/pmc/articles/PMC2654879/
(5)”ncbi.nlm.nih.gov/pubmed/8209677
(6)”europepmc.org/abstract/med/8209677