Painful Swallowing: Causes

What causes painful swallowing?

Painful swallowing can have a number of causes, including infections, conditions specific to the esophagus (tube connecting your mouth to your stomach), and mechanical obstructions, such as food or something caught in your throat.

Infectious or inflammatory causes of painful swallowing

Painful swallowing may be caused by infections or inflammation including:

• Candida (type of fungal infection)
• Cytomegalovirus
• Gingivitis (inflammation of the gums)
• Herpesvirus
• Pharyngitis (throat infection)
• Syphilis
• Tooth abscess
• Ulcers in the mouth or throat
• Varicella-zoster virus

Esophageal causes of painful swallowing

Painful swallowing can also be caused by esophageal conditions including:

• Achalasia (disorder of the esophagus that impairs its ability to propel food down to the stomach)
• Erosive esophagitis (inflammation of the esophagus)
• Esophageal narrowing due to radiation, chemicals or medications
• Esophageal spasms
• Gastroesophageal reflux disease (GERD)
• Nutcracker esophagus (disorder characterized by abnormal contraction of muscles of the esophagus)
• Schatzki’s ring (abnormal ring of tissue in the lower esophagus)

Neurological and muscular causes of painful swallowing

Painful swallowing can also be caused by neurological and muscular conditions including:

• Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, a severe neuromuscular disease that causes muscle weakness and disability
• Muscular dystrophy (inherited disorder that causes a progressive muscle weakness and loss of muscle tissue)
• Multiple sclerosis (disease that affects the brain and spinal cord causing weakness, coordination and balance difficulties, and other problems)
• Myasthenia gravis (autoimmune neuromuscular disorder that causes muscle weakness)
• Parkinson’s disease (brain disorder that impairs movement and coordination)
• Polymyositis (widespread inflammation and weakness of the muscles)
• Scleroderma (connective tissue disorder characterized by thickening and stiffening of the skin)

Serious or life-threatening causes of painful swallowing

In some cases, painful swallowing may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These conditions include:

• Food or object stuck in your throat
• Stroke
• Tumors of the mouth, throat or esophagus

Questions for diagnosing the cause of painful swallowing

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your painful swallowing including:

• How long have you felt painful swallowing? Has it gotten better over time or worse?
• Is the pain limited to swallowing certain foods?
• Does the pain occur when swallowing liquids, solids, or all substances?
• Is your throat sore, or does it feel like there is a lump?
• Have you been ill recently with symptoms such as coughing or chest irritation?
• Could you have inhaled or swallowed something that is irritating your throat?
• Do you have any other symptoms?
• Do you have any other medical problems?
• What medications do you take?

What are the potential complications of painful swallowing?

Because painful swallowing can be due to a serious disease, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

• Development of esophageal cancer
• Malnourishment
• Permanent damage to the throat or esophagus
• Weight loss

References:

Painful swallowing. MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003116.htm. Accessed May 5, 2011.

Swallowing difficulty. MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003115.htm. Accessed May 5, 2011.