It Hurts When I Swallow — What Could Be Wrong?

It Hurts When I Swallow — What Could Be Wrong?

Painful swallowing (odynophagia) is different from trouble swallowing. Here is what it typically means.

Pain when swallowing most often comes from inflammation or infection in the throat or esophagus.

• Common causes include:
• Pharyngitis / tonsillitis — a sore throat from a virus or strep infection
• Laryngitis — inflammation of the voice box, often from a cold or voice overuse
• GERD (acid reflux) — stomach acid irritating the lower throat and esophagus
• Esophagitis — inflammation of the esophagus from reflux, medication, or infection
• Tonsil abscess (peritonsillar abscess) — a pocket of pus near the tonsil that causes severe pain
• Mouth or throat ulcer — can make swallowing painful
• Dental infection — can radiate pain to the throat

Cancer of the throat or esophagus typically causes difficulty swallowing without pain in the early stages. Pain is more likely a sign of inflammation.

What to Look For

• Usually not serious:
• Pain that came with a cold, sore throat, or fever
• Improved by drinking warm liquids or taking pain relievers
• Visible redness or swelling in the throat
• Goes away within 1–2 weeks
• Pain is worse on one side (likely tonsillitis)

• Worth having checked:
• Severe pain that prevents you from swallowing saliva
• Pain lasting more than 2–3 weeks
• Pain accompanied by difficulty swallowing
• Pain accompanied by hoarseness that lasts
• Unexplained weight loss

When to See a Doctor

• See a doctor if:
• Pain is severe enough that you cannot swallow your saliva
• Pain lasts more than 2 weeks
• You have a high fever
• You have trouble breathing
• You cannot open your mouth fully
• You have a muffled voice or "hot potato" voice

Clinical Guidance