Considerations

Swallowing is a complex act that involves the mouth, throat area, and esophagus (the tube that moves food to the stomach). Many nerves and muscles control how these body parts work. Part of swallowing is voluntary, which means you are aware of controlling the action. However, much of swallowing is involuntary.

Problems at any point -- from chewing food and moving it into the back of the mouth to moving the food into the stomach -- can result in painful swallowing.

Chest pain, the feeling of food stuck in the throat, or heaviness or pressure in the neck or upper chest while eating are often the result of swallowing difficulties.

Causes

Swallowing problems may be due to infections, such as: 

• Cytomegalovirus
• Gum disease (gingivitis)
• Herpes simplex virus
• Human immunodeficiency virus (HIV)
• Pharyngitis (sore throat)
• Thrush

Swallowing problems may be due to a problem with the esophagus, such as:

• Achalasia
• Esophageal spasms
• Gastroesophageal reflux disease
• Inflammation of the esophagus
• Nutcracker esophagus
• Ulcer in the espophagus, especially due to the antibiotic doxycycline

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

Home Care

Eat slowly and chew food thoroughly.

If someone is choking, immediatley perform the Heimlich maneuver .

You may have an easier time swallowing liquids or pureed foods than solids.

Avoid very cold or very hot foods if you notice that they make your symptoms worse.

When to Contact a Medical Professional

Call your doctor or nurse 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 doctor about any other symptoms that occur with the painful swallowing, including:

• Abdominal pain
• Chills
• Cough
• Fever
• Heartburn
• Nausea or vomiting
• Sour taste in the mouth
• Weight loss
• Wheezing

What to Expect at Your Office Visit

The doctor or nurse will examine you and ask questions 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 medications do you take?

The following tests may be done:

• 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

Alternative Names

Swallowing - pain or burning; Odynophagia; Burning feeling when swallowing

References

Falk GW, Katzka DA. Diseases of the esophagus.In: Goldman L, Schafer AI, eds.Cecil Medicine. 24th ed.Philadelphia,PA: Saunders Elsevier; 2011:chap 140.

Kahrilas PJ, Pandolfino JE. Esophageal neuromuscular function and motility disorders. In: Feldman M, Friedman LS, Brandt LJ, eds.Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed.Philadelphia,Pa: Saunders Elsevier; 2010:chap 42.

Updated: 4/9/2012

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.