Why Does It Hurt to Swallow?

There are many reasons why you might feel pain when swallowing. Most likely, it's something like an infection or a pill that went down the wrong way, though there can be more serious reasons.

You might feel the pain anywhere inside your mouth, your throat, along your esophagus (the tube that leads to your stomach), or even in the center of your chest. Here are some causes, but you'll need to see your doctor to find out exactly what's going on.

Cold, Flu, or Sinus Infection

A sore throat that causes painful swallowing often signals that you’re getting one of these common illnesses. It can start a day before other symptoms like a runny nose and cough.

If it's a cold, you'll need to wait it out by sipping fluids and getting plenty of rest. If it might be the flu, which feels much worse and is a lot more serious than a cold, you need to see a doctor.

With a sinus infection, constantly trying to clear your throat of drainage can cause irritation and painful swallowing until the infection clears.

Strep Throat

Often just called strep, this bacterial infection can be very painful. Other telltale signs of strep are not having the usual symptoms of a cold and not having a cough.

When a grown-up gets strep, the symptoms are usually a sudden sore throat, possibly with a fever, and swollen lymph nodes in your neck. Children ages 3 and older can have fever, nausea, and vomiting along with a sore throat. Kids younger than 2 usually don't get strep.

See your doctor for a rapid strep test or a throat culture, which can find infections that the fast test sometimes misses. Antibiotics are the usual treatment. While it will go away on its own, treatment is recommended to feel better, prevent it from spreading to other people, and prevent complications.

Mono

This infection caused by the Epstein-Barr virus is easy to get -- and to spread. In addition to pain when swallowing, you might also have these symptoms: fever, headache, swollen tonsils and lymph nodes, muscle aches, and fatigue.

You'll need to take a blood test to diagnose mono. Most people feel better over time without special treatment, and your doctor will keep an eye on your health to make sure you don't have any complications.

Continued

Herpes Simplex Virus

Type 1 of this virus can cause sores inside your mouth (as well as along the lips) and pain when swallowing. The sores go away in a few days, but call your doctor if this is your first outbreak or if you have HIV. While you're recovering, skip acidic foods like citrus, get enough rest, and try to avoid stress to feel better.

Thrush

This yeast infection is common in people with HIV, but you’re also at risk for it if you have diabetes or a disease of the esophagus, take certain steroids, or take antibiotics. If thrush is the cause, you might also have these symptoms: loss of taste, a cotton-like feeling in your mouth, and dry, cracked, red skin at the corners of your lips.

See your doctor for treatment, which will probably mean taking an antifungal drug.

CMV

Part of the same virus family that causes herpes and mono, cytomegalovirus can switch between active and quiet periods. If CMV is the cause, you might also have these symptoms: fatigue, muscle aches, fever, nausea, and vomiting. Eating well and getting plenty of rest will help your body fight the infection, but see your doctor if you’re pregnant or have HIV or a weakened immune system since CMV can be particularly serious for you.

Swallowing Pills or Food

You don't want anything to stick to and irritate your esophagus. Small, oval, and heavier pills pass through more easily than large, round, and lighter ones. The medications most likely to cause problems are antibiotics like doxycycline and tetracycline, potassium supplements, and NSAIDs. (It can happen if you swallow a jagged piece of food, too.)

To prevent this, have at least a half-cup of water when you take a pill, and sit up straight for at least 10 minutes afterward. If it’s a medicine known to irritate, drink a cup of water and don’t lie down for at least 30 minutes.

GERD

GERD is gastroesophageal reflux disease. If you have it, you might also have these symptoms: heartburn with pain in the chest and throat, an acid taste in your mouth, vomiting, trouble swallowing, and a hoarse voice. The painful swallowing can happen if the acid reflux eats away at the lining of your esophagus.

See your doctor if you have heartburn two or more times a week. Changes to your diet may help, along with GERD medication.

Continued

Crohn’s Disease

It's rare for Crohn's to affect your esophagus (it usually affects the colon), but it can happen anywhere along the digestive tract, starting in your mouth or esophagus. You may find it both hard and painful to swallow.

If you have Crohn’s, you might also have these symptoms: diarrhea and cramping, weight loss, and poor appetite. Tell your doctor what's going on. You may need to get a test called an endoscopy to look for ulcers in your esophagus.

Some Cancers and Cancer Treatments

Painful swallowing isn't likely to be cancer. But it can be a symptom of throat and esophageal cancers. You might feel pain when swallowing as a tumor grows and the passageway gets narrower.

If you've had this symptom for a while and you're starting to feel like you need to eat soft food in tiny bites, see your doctor. You may need to get an imaging test of the upper part of your digestive system.

Some treatments for various types of cancer can also make it hurt to swallow. Chemotherapy or radiation to the head, neck, or upper chest can inflame the lining of the mouth, throat, or esophagus. Other symptoms include dry mouth or swelling. If you're having these problems while you get your cancer treatment, try eating softer foods, blender drinks, soups, and purees. Also, cold foods can be soothing, while very spicy foods can hurt more. This pain should stop soon after you're done with your cancer treatment.

WebMD Medical Reference Reviewed by Sabrina Felson, MD on May 04, 2019

Sources

SOURCES:

Nicklaus Children’s Hospital: “Painful swallowing.”

Mayo Clinic: “Sore throat.”

Seattle Children’s Hospital: “Sore throat.”

CDC: “Candida infections of the mouth, throat and esophagus.”

UCLA: “Odynophagia.”

Bennett, J. et al., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), Saunders, 2015.

Volberding, P. et al., Global HIV/AIDS Medicine, Saunders, 2008.

Current Drug Safety: “Pinpoint Localized Odynophagia (PLO) as a Specific Symptom of Pill-induced Oesophagitis (PIO) in the Evaluation of Acute Retrosternal Chest Pain.”

BMJ: “A severe case of odynophagia.”

UpToDate: “Acid Reflux in Adults.”

Journal of Korean Medical Science: “Esophagogastric Crohn's Disease Manifested by Life-Threatening Odynophagia and Chest Pain: a Case Report.”

Crohn’s and Colitis Foundation: “Living with Crohn’s Disease.”

BMJ Case Reports: “Oesophageal presentation of Crohn's disease.”

Johns Hopkins Medicine: “Warning signs of esophageal cancer.”

Gut: “Odynophagia – a symptom worth asking about?”

Canadian Cancer Society: “Difficulty swallowing.”

Niederhuber, J. et al., Abeloff's Clinical Oncology (Fifth Edition), Saunders, 2014.

© 2019 WebMD, LLC. All rights reserved.

Pagination