Pain when swallowing occurs mainly in the context of inflammation of the oral cavity, throat and neck. These inflammations are mostly of viral origin, but can also be triggered by a bacterial infection if the symptoms are pronounced. This means that swallowing pain usually occurs as a symptom of a cold and is then accompanied by other complaints such as sore throat, hoarseness and fever. However, since pain when swallowing can also be an expression of a serious illness, urgent medical clarification is required depending on the other symptoms and the duration of the pain.
Causes
Pain when swallowing can have many different causes. For example, swallowing pain can occur due to inflammation, injuries, tumor diseases and nerve pain in the area supplied by the tongue-pharyngeal nerve (9th cranial nerve), a so-called glossopharyngeal neuralgia. It should be noted, however, that pain when swallowing usually occurs in the context of colds, i.e. inflammation.
The various causes of pain when swallowing are briefly described below. This list contains the most important triggers for swallowing pain. The following inflammations in the area of the mouth, throat and esophagus can cause unpleasant pain when swallowing.
Glossitis is an inflammation of the tongue, which can have a variety of causes. Causes of glossitis can be changes in the area of the teeth (sharp edges of the teeth, tartar, metal alloys during tooth restoration), a vitamin deficiency (A, B and C), a so-called Hunter glossitis in the context of a vitamin B12 deficiency, the Plummer-Vinson syndrome in the case of iron deficiency or a fungal infection (oral thrush). Glossitis can also occur in the case of a sugar disease (diabetes mellitus), in the menopause (climacteric) or larval depression, i.e. a depression with physical symptoms.
Stomatitis is an inflammation of the oral mucosa, which can also have various causes. For example, inflammation of the oral mucosa can be caused by previous gingivitis, by pathogenic microorganisms (viruses, bacteria), by inadequate dental and/or oral hygiene, by vitamin deficiency (A, B and C) and also by nicotine and alcohol abuse. Tonsillitis is an inflammation of the palatal tonsils.
Mostly streptococci of (bacteria) are responsible for this inflammation. More rarely, pneumococci or Haemophilus influenzae can also be made responsible for tonsillitis. In children, tonsillitis can also be caused by a viral infection.
Tonsillitis occurs mainly in older children and young adults. Do you have signs of tonsillitis? Simply carry out our tonsillitis self-test!
In addition to tonsillitis, there are other causes of pain when swallowing in the area of the palatine tonsils: Angina-Plaut-Vincent (Angina ulceromembranacea), Angina agranulocytotica, diphtheria, a specific angina in the venereal disease syphilis (Lues) and also in the bacterial infectious disease tuberculosis. In addition, herpangina caused by the Coxsackie A virus and Pfeiffer glandular fever caused by the Epstein-Barr virus can also cause swallowing pain. A peritonsillar abscess, which can be recognized by a bulging of the palatal arch, is a complication of tonsillitis.
The cause of such a peritonsillar abscess is the spread of the inflammation into the connective tissue between the tonsil and a pharyngeal muscle (Musculus constrictor pharyngis), where an encapsulated accumulation of pus (abscess) can then form. Such an encapsulated accumulation of pus can also occur in the area of the floor of the mouth. The cause of an oral floor abscess can be injuries and infections of the tongue due to the impaling of foreign bodies such as bones or bone splinters.
Oral floor abscesses can also originate from the dental system or the mandibular salivary glands (glandula sublingualis or glandula submandibularis). An inflammation of the pharyngeal mucosa is called pharyngitis. An acute inflammation of the pharyngeal mucosa usually occurs when there is a viral infection of the upper airways.
Bacterial colonization may occur in the further course of the disease; this is called secondary bacterial colonization.If the inflammation of the throat persists for more than three months, this condition is called chronic pharyngitis. There are various triggers for a chronic inflammation of the pharyngeal mucosa. For example, chemical stimuli at the workplace, exposure to dust, dry room air, constant mouth breathing in the case of obstructed nasal breathing, nicotine or alcohol dependence play a role.
Radiation therapy in the head and neck area can also be a trigger for a longer lasting inflammation of the pharyngeal mucosa. Candidiasis is an infection of mucous membranes with the fungus Candida albicans, i.e. a fungal disease. It is mainly observed in weakened, very emaciated (cachectic) patients during the treatment of a cancerous disease (during radiotherapy and/or chemotherapy) or also after a longer therapy with an antibiotic.
Epiglottitis is a life-threatening inflammation of the epiglottis. In children, the cause is usually an infection with the bacterium Haemophilus influenzae type B. In adults, the following pathogens are more likely to be considered: streptococci, staphylococci and pneumococci, i.e. bacterial infections.
Oesophagitis is an inflammation of the oesophagus, which can also be caused by a fungal infection, for example. During endoscopy, white coatings can be seen in the esophagus. In addition, an inflammation of the esophagus can also be triggered by ascending acidic gastric juice; in this case it is called reflux esophagitis.
The following injuries in the area of the mouth, throat and esophagus can cause unpleasant pain when swallowing. The most common cause of a tongue bite is a seizure (epileptic seizure), where the affected person unintentionally bites his tongue. A tongue bite can range from minor mucous membrane injuries to partial rupture of the tongue or complete loss of the tongue.
An impalement injury is characterized by the penetration or penetration of the body with a stake-like object. If it comes thereby to injuries within the range of the palate so the concerning deplore naturally also palate pain when swallowing. An example of an impalement injury in the soft palate area is when children fall with a pencil or a stick in their mouth.
Of course, scalds or burns in the area of the mouth, throat or esophagus can cause excruciating pain when swallowing. Scaldings and burns can occur when children drink unobserved from the spout of coffee or tea pots or household cleaners, by mixing up the contents of bottles (when acids or alkalis are filled into ordinary drinking bottles), by clumsy pipetting or with suicidal intent. Foreign bodies in the area of the mouth, throat or esophagus can impede the act of swallowing and thus cause swallowing pain.
Especially with small children, swallowing foreign bodies should always be considered. The following tumors in the area of the mouth, throat and esophagus (esophagus) can cause unpleasant pain when swallowing: cancer of the tongue, mouth floor cancer, mouth dragon cancer (oropharyngeal carcinoma), throat dragon cancer (hypopharyngeal carcinoma), esophageal cancer (esophageal carcinoma) Since pain when swallowing has many causes, there are also various specialists and therapists who can be involved in the diagnosis and planning of treatment. In any case, a suitable contact point is a general practitioner or an ear, nose and throat (ENT) doctor.
A dermatologist can also be consulted for diseases of the oral mucosa. An internist or gastroenterologist is primarily responsible for diseases affecting the esophagus. At the beginning of the approach to a possible diagnosis, there is always a detailed medical history by interviewing the patient (anamnesis).
It is also important to pay attention to other complaints of the patient. With regard to a possible cancer disease, the questioning of the so-called B-symptoms (fever, night sweats, weight loss) also plays a role. This should be followed by a physical examination of the affected person, whereby the examiner should primarily inspect the oral cavity, throat and larynx.
During this examination it can be determined whether there is redness, swelling, blisters or pus as a sign of inflammation. In addition, any palpable lymph nodes and the thyroid gland in the neck can be examined by simply palpating.In addition, a throat swab can be taken to search for the causative pathogens. A blood test with determination of the inflammation parameters C-reactive protein (CRP) and white blood cells (leukocytes) can also verify the presence of inflammation.
If, for example, it is suspected that the oesophagus is the actual trigger for the pain when swallowing, it can be examined more closely by means of a mirror image (endoscopy), otherwise it is not accessible in the clinical examination. If reflux disease is suspected, an acid reflux measurement (24-hour pH measurement) can also be performed, in which the acid load in the esophagus and/or stomach is measured over a period of 24 hours using a probe. If the nasopharyngeal cavity is to be examined in more detail, the ear, nose and throat (ENT) physician is the best person to contact, as he or she has the best overview of these areas with the help of appropriate equipment.
Of course, imaging procedures such as ultrasound (sonography), computer tomography (CT) and magnetic resonance imaging (MRT) can also be used to record disease processes. Endosonography, i.e. the ultrasound examination of the inside of the body using a tube-shaped ultrasound device, may also be necessary. Depending on the issue at hand, special imaging and nuclear medicine procedures or the examination of tissue samples (biopsies), for example to rule out cancer, are also indicated.
