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What causes pain on swallowing? 11 possible conditions

Painful Swallowing

Painful swallowing is relatively common and experienced by people of all ages from time to time. This symptom can be caused by anything from a throat infection to a toothache. Difficulty swallowing along with pain is generally the sign of an infection or an allergic reaction. See your doctor if the pain is severe or if it interferes with eating, drinking, or breathing.

What Causes Painful Swallowing?

There are many causes for painful swallowing. If you experience pain when swallowing, it can be a symptom of:

  • swollen lymph glands (tonsils, adenoids)
  • throat injury
  • swallowing large pills
  • esophageal scarring (normally the result of acid erosion caused by acid reflux)
  • ear infection

The most common causes for difficulty swallowing are:

  • cold
  • flu
  • chronic cough
  • acid reflux disease
  • throat infection
  • tonsillitis
  • swallowing jagged foods such as chips or crackers improperly

What Symptoms Might Be Present Along With Painful Swallowing?

If an infection is causing the pain when swallowing, you may experience other symptoms such as:

  • fever
  • chills
  • headache
  • cough may be dry or productive
  • sweating
  • red inflamed tonsils

Diagnosing the Cause of Pain When Swallowing

When visiting your doctor, be sure to mention every symptom you are experiencing. Also let him or her know if any of these symptoms are new or getting worse. The type of symptoms you experience will help your doctor determine the cause of your pain.

Since a physical examination usually is not enough to determine a diagnosis, your doctor may administer tests such as:

  • blood test (usually taken with a needle from the inside of your arm)
  • throat culture (using a swab to take a sample from the back of your throat)
  • sputum culture (taking a sample of your phlegm)

These tests can help identify any bacteria or viruses causing the condition.

What Are the Treatment Options for Painful Swallowing?

Treatment options for painful swallowing depend solely on the cause of the pain. Your doctor will likely prescribe antibiotics to treat throat infections, tonsil infections, infections within the mouth, or esophageal infections.

Your doctor may provide a numbing mouthwash to numb your throat before swallowing the antibiotic. This numbing agent helps to block the pain you may feel when swallowing the pill. A throat spray can also treat the infection and numb the pain. Your doctor may prescribe anti-inflammatory medications to reduce inflammation of the esophagus, throat, or tonsils.

Over-the-counter antacids may relieve esophageal swelling due to acid reflux. However, if you have chronic acid reflux or gastroesophageal reflux disease (GERD), your doctor will prescribe medications specifically used to provide relief for chronic acid reflux. Over-the-counter antacids are for temporary use and not to treat chronic acid reflux.

If you frequently experience painful swallowing due to recurring tonsillitis, or if your tonsillitis does not respond to medication treatment, your doctor may suggest removing the tonsils surgically.

What Complications Can Arise From Pain When Swallowing?

Some complications that can occur with painful swallowing are:

  • tonsillectomy (tonsil removal)
  • worsening infection
  • chest infection
  • loss of taste may be temporary or permanent
  • swollen lymph nodes

Swollen lymph node glands on either side of your neck may make it difficult to turn your head fully to the side or to lean your head backward. This discomfort normally subsides as the infection leaves the body and lymph node glands reduced in size.

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See a list of possible causes in order from the most common to the least.


Strep Throat

Strep throat is a bacterial infection that causes inflammation and pain in the throat. It's especially common in children. Look out for sudden fever, a red throat with white patches, headache, and chills.

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Tonsillitis occurs when the tonsils (the lymph tissue in your throat) become infected. Symptoms include sore throat, fever, and swollen tonsils. Fortunately, it's normally easily diagnosed and treated.

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Types of Acid Reflux

Acid reflux symptoms are caused when stomach contents flow up from the stomach back into the esophagus, causing symptoms like heartburn, stomach pain, and burping.

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Esophagitis is inflammation of the esophagus that can be caused by acid reflux or certain medications. You may develop a sore throat or heartburn.

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Oral Thrush

Oral thrush occurs when a yeast infection develops inside your mouth. It's marked by white lesions on your tongue, inner cheeks, gums, palate, and/or tonsils.

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Sore Throat

A sore throat refers to pain, itchiness, or irritation of the throat. It may cause difficulty and pain when swallowing. Throat pain is the primary symptom of a sore throat. Other symptoms include dry throat, swolle...

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Esophageal Cancer

Esophageal cancer occurs when a malignant (cancerous) tumor forms in the lining of the esophagus, which is the muscular tube responsible for moving food from the throat to the stomach. As the cancer grows, it can affec...

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CMV Esophagitis

Cytomegalovirus esophagitis, or CMV esophagitis, is a serious infection of the esophagus triggered by the cytomegalovirus (CMV). Cytomegalovirus esophagitis is really two conditions; the cytomegalovirus itself, and th...

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Herpes Esophagitis

Herpes esophagitis is caused by the herpes simplex virus type 1 (HSV-1). The infection can cause some chest pain and difficulty swallowing.

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Diphtheria is a sometimes fatal bacterial infection that affects the nose and throat's membranes. Diptheria of the skin may show up as a red rash.

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Temporal Arteritis

Temporal arteritis is a condition in which the temporal arteries, which supply blood to the head and scalp, become inflamed or damaged. Scalp sensitivity or tenderness is a symptom.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.