Odynophagia refers to pain on swallowing.

Some of the common causes of odynophagia include:

1. Infections

Infections involving the tonsils, throat, epiglottis and oesophagus may cause pain on swallowing.

Some of these infections include:

1. Acute viral/bacterial pharyngitis
2. Acute tonsillitis
3. Oral and oesophageal candidiasis
4. HIV infections
5. Herpes simplex infections

2. Tumours

Cancers of the mouth, throat, voice box (larynx), tongue and oesophagus can also sometimes cause pain when swallowing.

3. Inflammation

Inflammation of the mouth, pharynx and oesophagus can sometimes occur when they are exposed to caustic substances.

These can sometimes be ingested substances (e.g. hot fluids, acidic substances). Medical conditions such as gastro-oesophageal reflux disease (GERD) can also cause inflammation when these organs are are constantly exposed to acid reflux from the stomach.

4. Foreign Body

Foreign bodies (e.g. fish-bones) sometimes can get stuck when they are swallowed. They can lodge in the tonsils, throat or oesophagus and cause pain on swallowing.

5. Oesophageal Disorders

Sometimes, pain on swallowing can be due to a disorder in the motility of the oesophagus. These include:

1. Oesophageal spasm
2. Achalasia
3. Nutcracker Oesophagus

What tests can be done to investigate odynophagia?

Depending on your doctor’s findings, he or she may ask you to undergo one or more of the following investigations:

1. Nasoendoscopy

A flexible camera with light is passed through one of your nostrils to look at the back of your nose, larynx and throat. This test can be done in the clinic and is useful to look for conditions affecting the throat, larynx and back of the tongue (e.g. ulcers and tumours).

2. Oesophago-gastroduodenoscopy (OGD)

In an OGD, the doctor will pass a flexible tube with a camera and light through your mouth into your oesophagus, stomach and the duodenum (first part of the small intestine). An OGD is useful for looking for mechanical causes of dysphagia (e.g. tumours, strictures). It is usually a day procedure.

3. Manometry

A tube with pressure sensors is passed down your oesophagus to measure the strength and co-ordination of the contractions of your oesophagus. This test is useful to investigate motility disorders affecting swallowing.

4. Imaging Studies

Your doctor may order some X-rays or scans. One of these X-rays is a barium swallow. In a barium swallow, an X-ray of your oesophagus and stomach is taken after swallowing some dilute barium to outline the stomach. This test is good for looking for tumours and strictures.

The type of treatment you will need to undergo will depend on the underlying cause of the odynophagia. Your doctor will usually discuss this with you.