odynofagi

Odynophagia, also known as odynofagi, is the medical term for painful swallowing. It is a symptom, not a disease, and can affect swallowing of liquids, solids, or both. It is distinct from dysphagia, which mainly refers to difficulty swallowing or the sensation of food sticking.

Common Causes

Odynophagia most often arises from inflammation or injury to the oropharynx or esophagus. Infectious esophagitis is a frequent cause, especially in immunocompromised individuals, and can be due to Candida species, herpes simplex virus, or cytomegalovirus. Pill-induced esophagitis from medications such as doxycycline, nonsteroidal anti-inflammatory drugs, or bisphosphonates is another important and preventable cause. Gastroesophageal reflux disease with esophagitis, peptic ulcers, and other forms of esophageal irritation are also common. Less frequently, odynophagia may be caused by esophageal cancer, chemical or caustic injury, radiation-induced esophagitis, or eosinophilic esophagitis.

Diagnosis

Evaluation starts with a focused history and physical examination. Endoscopy with biopsy is the standard test to identify mucosal inflammation, ulcers, or malignancy. Cultures or PCR from esophageal or throat swabs may help detect infectious etiologies. Imaging (such as a barium swallow) is used in selected cases. Additional tests may include HIV testing or laboratory workup to assess dehydration, anemia, or systemic illness.

Treatment

Treatments target the underlying cause. Antifungals (e.g., fluconazole) for Candida esophagitis, antivirals (e.g., acyclovir or ganciclovir) for HSV or CMV, or discontinuation of offending medications are common approaches. Acid suppression, analgesia, and hydration support symptom relief. Severe cases or complications may require hospitalization and IV therapy.

When to seek care

Seek urgent care for severe chest or back pain, fever, vomiting, dehydration, or an inability to swallow liquids, as these may indicate serious infection or esophageal perforation. Persistent odynophagia warrants medical evaluation to exclude serious pathology.