Painful swallowing is any pain or discomfort while swallowing. You may feel it high in the neck or lower down behind the breastbone. Most often, the pain feels like a strong sensation of squeezing or burning. Painful swallowing may be a symptom of a serious disorder.
Swallowing - pain or burning; Odynophagia; Burning feeling when swallowing
Swallowing involves many nerves and muscles in the mouth, throat area, and food pipe (esophagus). Part of swallowing is voluntary. This means you are aware of controlling the action. However, much of swallowing is involuntary.
The structures involved with the process of swallowing include the tongue, teeth, epiglottis, and esophagus. The teeth are used to grind and chop up food into tiny pieces, while the glands in the mouth moisten the food with saliva. In the first stage of swallowing, the tongue pushes the food into the throat. In the second stage of swallowing, an important small flap of tissue called the epiglottis, folds over the voice box (larynx) at the entrance to the windpipe (trachea), preventing food from going down the wrong way. In the final stage, the esophagus contracts and moves food toward the stomach.
Problems at any point in the swallowing process (including chewing, moving food to the back of the mouth, or moving it to the stomach) can result in painful swallowing.
Swallowing problems can cause symptoms such as:
- Chest pain
- Feeling of food stuck in the throat
- Heaviness or pressure in the neck or upper chest while eating
Swallowing problems may be due to infections, such as:
- Gum disease (gingivitis)
- Herpes simplex virus
- Human immunodeficiency virus (HIV)
- Pharyngitis (sore throat)
Swallowing problems may be due to a problem with the esophagus, such as:
- Esophageal spasms
- Gastroesophageal reflux disease
- Inflammation of the esophagus
- Nutcracker esophagus
- Ulcer in the esophagus, especially due to the antibiotic doxycycline, aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxyn
Other causes of swallowing problems include:
- Mouth or throat ulcers
- Something stuck in the throat (for example, fish or chicken bones)
- Tooth infection or abscess
Some tips that may help you to ease swallowing pain at home include:
- Eat slowly and chew your food well.
- Eat pureed foods or liquids if solid foods are hard to swallow.
- Avoid very cold or very hot foods if they make your symptoms worse.
If someone is choking, immediately perform the Heimlich maneuver.
When to Contact a Medical Professional
Call your health care provider if you have painful swallowing and:
- Blood in your stools or your stools appear black or tarry
- Shortness of breath or lightheadedness
- Weight loss
Tell your provider about any other symptoms that occur with the painful swallowing, including:
- Abdominal pain
- Nausea or vomiting
- Sour taste in the mouth
What to Expect at Your Office Visit
Your provider will examine you and ask about your medical history and symptoms, including:
- Do you have pain when swallowing solids, liquids, or both?
- Is the pain constant or does it come and go?
- Is the pain getting worse?
- Do you have difficulty swallowing?
- Do you have a sore throat?
- Does it feel like there is a lump in your throat?
- Have you inhaled or swallowed any irritating substances?
- What other symptoms do you have?
- What other health problems do you have?
- What medicines do you take?
The following tests may be done:
- Endoscopy with biopsy
- Barium swallow and upper GI series
- Chest x-ray
- Esophageal pH monitoring (measures acid in the esophagus)
- Esophageal manometry (measures pressure in the esophagus)
- Esophagogastroduodenoscopy (EGD)
- HIV testing
- Neck x-ray
- Throat culture
Devault KR. Symptoms of esophageal disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 13.
Nussenbaum B, Bradford CR. Pharyngitis in adults. In: Flint PW, Haughey BH, Lund V, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 9.
Pandolfino JE, Kahrilas PJ. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 43.
Wilcox CM. Gastrointestinal consequences of infection with human immunodeficiency virus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 34.
- Last reviewed on 7/11/2017
- Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.