Pain when swallowing
introduction
Pain when swallowing occurs mainly in the context of inflammation of the oral cavity, throat and throat. These inflammations are mostly of viral origin, but if the symptoms are pronounced, they can also be triggered by an infection with a bacterium. This means that swallowing pain usually occurs as a symptom of a cold and is then accompanied by other symptoms such as sore throat, hoarseness and fever. However, since pain when swallowing can also be an expression of a serious illness, an urgent medical clarification is required depending on the further symptoms and the duration of the pain.
Read more on this topic: Sore throat when swallowing
causes
Pain when swallowing can have a variety of causes. Swallowing pain in inflammation, injuries, tumor diseases and nerve pain in the supply area of the tongue and throat nerve (9th cranial nerve), a so-called glossopharyngeal neuralgia, can occur. It should be noted, however, that pain when swallowing occurs in most cases in the context of colds, i.e. inflammation. In the following, the various causes of pain when swallowing are briefly discussed. This list contains the most important triggers for swallowing pain. The following inflammations in the area of the mouth, throat and esophagus (esophagus) can cause unpleasant pain when swallowing.
Read more on the topic:
- Causes of difficulty swallowing
- Symptoms of laryngitis
- S.swelling on the side of the neck
- Symptoms of vocal cord inflammation
Glossitis
At a Glossitis it is an inflammation of the tonguethat can have a variety of causes. Changes in the area of the teeth (sharp tooth edges, Tartar, Metal alloys in dental restoration) Vitamin deficiency (A., B. and C.), a so-called Hunter glossitis in the context of a Vitamin B12 deficiency, Plummer-Vinson Syndrome Iron deficiency or a fungal infection (oral thrush). Even with a sugar disorder (Diabetes mellitus), in the Menopause (Climacteric) or a larvae depression, that is, depression with physical symptoms, glossitis can occur.
Stomatitis
Stomatitis is inflammation of the Oral mucosawhich can also have various causes. So there can be an inflammation of the oral mucosa caused by a previous one Inflammation of the gums (Gingivitis), through pathogenic microorganisms (viruses, bacteria), through insufficient dental and / or oral care, through a vitamin deficiency (A, B and C) and also with Nicotine and alcohol abuse occur.
Tonsillitis (angina tonsillaris)
At a Tonsillitis it is an inflammation of the Palatine tonsils. Usually streptococci (bacteria) are responsible for this inflammation. Less often can too Pneumococci or Haemophilus influenzae be held responsible for tonsillitis. In children, tonsillitis can also be caused by a viral infections to be triggered. Tonsillitis is most common in older children and young adults.
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Angina
In addition to tonsillitis, there are other causes of pain when swallowing in the area of the tonsils: Angina-Plaut-Vincent (angina ulceromembranacea), angina agranulocytotica, diphtheria, a specific angina in the case of venereal disease syphilis (Lues) and also with the bacterial infectious disease tuberculosis. In addition, herpangina can also be caused by the Coxsackie A Virus and the Pfeiffer glandular fever by the Epstein-Barr Virus cause swallowing pain.
Peritonsillar abscess
A peritonsillar abscess, which can be recognized by a bulging of the palatal arch, is a complication of a Tonsillitis (Tonsillitis). The cause of such a peritonsillar abscess is the spread of the inflammation into the connective tissue between the tonsil and one Throat muscle (Musculus constrictor pharyngis), where an encapsulated collection of pus (abscess) can then form.
Floor abscess of the mouth
Such an encapsulated accumulation of pus can also occur in the area of the floor of the mouth. The cause of an abscess in the floor of the mouth can be injuries and infections of the tongue due to the impaling of foreign bodies such as bones or bone fragments. An abscess of the floor of the mouth can also originate from the dental system or the lower salivary glands (sublingual gland or submandibular gland).
Read more on the subject at: Pain under the tongue.
Pharyngitis
Inflammation of the Pharynx is called Pharyngitis designated. An acute inflammation of the pharynx usually occurs in one Viral infection the upper airways. In the further course a bacterial Settlement is added, one then speaks of one 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 chronic inflammation of the lining of the throat. So play for example chemical stimuli at work, Exposure to dust, dry room air, constant mouth breathing with impaired nasal breathing, nicotine or alcohol addiction play a role. Radiation therapy in the head and neck area can also trigger prolonged inflammation of the pharynx.
Thrush (candidiasis)
Candidiasis is an infection of the mucous membranes with the Candida albicans fungus, so one Fungal disease. This can be observed above all in weakened, very emaciated (cachectic) patients during the treatment of cancer (in the case of radiation and / or chemotherapy) or after prolonged therapy with one antibiotic.
Epiglottitis
A Epiglottitis is a life threatening one Epiglottitis. In children, the cause is usually an infection with the bacterium Haemophilus influenzae Type B. The following pathogens are more likely to be considered in adults: streptococci, staphylococci and pneumococci, i.e. bacterial infections.
Esophagitis
A Esophagitis is a Esophagitiswhich can also be triggered by a fungal infection, for example. White deposits can then be seen in the esophagus during an endoscopy. In addition, an inflammation of the esophagus can also be triggered by rising acidic gastric juice, in this case one speaks of a Reflux esophagitis.
The following injuries in the area of the mouth, throat and gullet (esophagus) can cause unpleasant pain when swallowing.
Tongue bite
The most common cause of a tongue bite is a seizure (epileptic fit), where the person inadvertently bites their tongue.
A tongue bite ranges from minor damage to the mucous membrane to partial tears of the tongue to complete loss of the tongue.
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Impalation Violation
An impaling injury is characterized by penetrating or piercing the body with a pole-like object. If this results in injuries to the palate, those affected naturally also complain Palate pain when swallowing. An example of an impaction injury in the soft palate area is when children fall with a pencil or chopstick in their mouth.
Scalds and chemical burns
Of course, scalds or chemical burns in the area of the mouth, throat or esophagus can cause excruciating pain when swallowing. Scalds and chemical burns can occur when children drink unobserved from the spout of coffee or teapots or household cleaners, by mixing up the contents of the bottle (when acids or alkalis are filled into normal drinking bottles), by clumsy pipetting or with suicidal intent.
foreign body
Foreign bodies in the mouth, throat or esophagus can hinder the act of swallowing and cause swallowing pain. Especially with small children, swallowing foreign bodies should always be considered.
Tumors
The following tumors in the area of the mouth, throat and esophagus can cause uncomfortable pain when swallowing: Tongue cancer, floor cancer, oropharyngeal cancer, pharyngeal cancer (hypopharyngeal cancer), esophageal cancer (esophageal cancer).
Read more on the subject: Bump on the roof of the mouth
diagnosis
Because swallowing pain has many causes, there are also various specialists and therapists who can be involved in diagnosing and planning treatment. A suitable point of contact is always a General practitioners or also a Ear, nose and throat (ENT) doctor. In diseases of the oral mucosa can also be a Dermatologist be consulted. For clinical pictures that affect the esophagus (esophagus) is primary one Internist respectively Gastroenterologist responsible.
At the beginning of the approach to the possible diagnosis there is always a detailed survey of the Medical history by interviewing the patient (anamnese). It is important to pay attention to other complaints of the person concerned. With regard to a possible cancer, querying the so-called B symptoms (Fever, night sweats, weight loss) play a role.
Then the physical examination of the affected person, whereby the examiner should inspect the oral cavity, the throat and the larynx in particular. This can be used to determine whether a Redness, one swelling, Vesicles or pus exist as a sign of inflammation. In addition, there may be some on the neck palpable lymph nodes and the thyroid can be examined by simply touching them. In addition, a throat swab can be carried out, in which the causative pathogens can be searched for.
A blood test with determination of the Inflammation parameters C-reactive protein (CRP) and the white blood cells (White blood cells) can also verify the presence of inflammation. If, for example, there is a suspicion that the esophagus is actually the trigger for the pain when swallowing, this can be examined more closely with the help of a reflection (endoscopy), as this is otherwise not accessible in the clinical examination. If a reflux disease is suspected, a Acid reflux measurement (24-hour pH-metry), in which the acid load in the esophagus and / or the stomach is measured over a period of 24 hours using a probe.
If the nasopharynx is to be examined in more detail, the ear, nose and throat (ENT) doctor is the best contact, as he or she has the best overview of these areas with the help of the appropriate equipment. Of course, imaging methods such as Ultrasonic (Sonography), Computed tomography (CT) and Magnetic resonance imaging (MRT) record disease processes. Endosonography, i.e. the ultrasound examination of the inside of the body using a tubular ultrasound device, may also be necessary. Depending on the question, special imaging and nuclear medicine procedures or the examination of tissue samples (biopsies), for example to rule out cancer, are indicated.
therapy
The therapeutic approach to painful swallowing depends on the diagnosis and ranges from simple conservative measures (i.e. non-surgical) to various operations. Since colds are a frequent cause of pain when swallowing, the treatment of a viral infection of the upper airways (acute pharyngitis) is examined in more detail below.
In an acute one Inflammation of the lining of the throat become common warm neck wrap or warm drinks with honey as pleasant felt. Mild oils that are applied through the nose, such as Coldastop® nasal oil (contains vitamins A and E) can also help. In addition, lozenges containing dexpanthenol (Bepanthen®) or cetylpyridine chloride (Dobendan®) are used.
Those containing antibiotics Lozenges should be a viral infection avoided as these have no effect on a viral infection and can also cause allergic reactions and promote the occurrence of fungal infections. Systemic antibiotic therapy with Penicillin-G However, this should be done if the symptoms are pronounced, as in these cases there may be a secondary bacterial colonization against which the antibiotic shows an effect. There are also a variety of home remedies that can help relieve pain when swallowing or a sore throat. These include, for example, clay wraps, where a cloth with healing earth is tied around the neck, or potato or quark wraps. Gargling with sage or chamomile tea and using onion juice with honey or garlic are also said to be effective against sore throats.
