Pain when swallowing: causes, examination and treatment

Other names: Боль при глотании, больно глотать, боль в горле при глотании, одинофагия, больно глотать с одной стороны, ком и боль в горле, больно глотать без температуры

Pain when swallowing is a common complaint, which in most cases is caused by a common viral inflammation of the pharynx and tonsils. Such pain increases over a day or two, is accompanied by a runny nose, hoarseness and cough, and goes away on its own within a week. Other options are alarming: pain on only one side, the inability to open the mouth and swallow even saliva, a nasal voice, high fever without a runny nose, and pain that lasts more than two weeks. They may hide streptococcal tonsillitis, peritonsillar abscess, epiglottic lesions, foreign body, reflux and, less commonly, tumors. Examination of the pharynx helps to figure it out, and if streptococcus is suspected, a swab from the throat.

🧾 МКБ-10: R13 🏥 Where it is treated: 7 Most often a virusOne-sided pain - alarmingExamination of the pharynx decides

👨‍⚕️ Which doctor

Otolaryngologist, therapist

🔬 Diagnostics

Examination of the pharynx, throat smear and culture, general blood test, endoscopy if indicated

💊 Treatment

Pain relief and rinsing, antibiotics only for bacterial sore throat, treatment of the cause

📈 Prognosis

Favorable for viral nature

⚠️ At risk

Hypothermia, contact with the sick, smoking, reflux, reduced immunity

⏱ When to see a doctor

Planned; if there is difficulty breathing - emergency

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Затруднённое дыхание, шумный вдох, невозможность лечь — вызвать 103
Невозможно проглотить слюну, слюнотечение изо рта
Рот открывается с трудом, голос стал гнусавым
Отёк и болезненная припухлость на шее
Температура выше 38 °C без насморка и кашля
Боль сохраняется дольше двух недель или есть похудение

How to evaluate a sore throat

Not only the intensity of the pain is important, but also its nature and accompanying symptoms. Bilateral pain with runny nose, hoarseness and cough is almost always viral. Sharp unilateral pain radiating to the ear, difficulty opening the mouth and a nasal voice is typical of a peritonsillar abscess. Pain with high fever, plaque on the tonsils and enlarged cervical nodes without a cough makes you think about streptococcal sore throat. Burning and pain in the morning with a sour taste indicate reflux. The persistence of complaints for more than two weeks in a smoker requires mandatory examination by a specialist.

Bilateral pain with runny nose and cough - virus
Unilateral increasing pain - risk of abscess
Plaques and fever without cough - possible streptococcus
Morning burning and sour taste - reflux
Pain longer than two weeks - mandatory examination

Common reasons

The vast majority of episodes are caused by respiratory viruses - they infect the mucous membrane of the pharynx, causing redness, soreness and pain. Group A beta-hemolytic streptococcus is responsible for a minority of cases, but it is the one that requires antibiotics to prevent heart and kidney complications. In adolescents and young adults, prolonged pain with severe weakness and enlarged lymph nodes may be a manifestation of infectious mononucleosis. In addition to infections, the pharynx is irritated by dry air, smoking, vocal strain, acid reflux from the stomach and allergies. Less common are candidiasis, fishbone injury, and dental causes.

Viral pharyngitis and tonsillitis
Streptococcal sore throat
Infectious mononucleosis
Peritonsillar abscess
Gastroesophageal reflux
Dry air, smoking, voice strain
Foreign body, mucosal injury
Candidiasis of the pharynx

Dangerous Causes You Shouldn't Miss

There is a small group of conditions in which the clock counts. Acute inflammation of the epiglottis causes severe pain when swallowing, drooling, noisy breathing and a forced sitting position - this threatens to block the airways. Peritonsillar and retropharyngeal abscesses are accompanied by increasing unilateral pain, spasm of the masticatory muscles and swelling of the neck and require surgical opening. It is also worth remembering about neoplasms of the pharynx and larynx: they are more often manifested by prolonged one-sided pain, hoarseness, difficulty swallowing and weight loss, especially in smokers over 45 years of age.

Acute epiglottitis
Peritonsillar and retropharyngeal abscess
Cellulitis of the neck
Foreign body with wall damage
Tumors of the pharynx and larynx
Diphtheria in unvaccinated people

Survey

In typical cases, an examination is sufficient: the doctor evaluates the mucous membrane of the pharynx, tonsils, the presence of plaque, asymmetry, the condition of the lymph nodes and the mobility of the lower jaw. To confirm streptococcal sore throat, a swab is taken from the throat for a rapid test or culture - this allows you to avoid prescribing antibiotics without reason. A general blood test helps in cases of suspected mononucleosis. For prolonged or one-sided pain, an endoscopic examination of the pharynx and larynx is performed, and if an abscess or spread of the process to the neck is suspected, an ultrasound or computed tomography is performed.

Examination by an otolaryngologist
Throat swab and culture with antibiotic sensitivity
General blood test
Endoscopy of the pharynx and larynx for prolonged pain
Ultrasound or CT scan of the neck if an abscess is suspected

What to do and how to treat it

With a viral sore throat, simple measures help: warm drinks, humidification of the air, soft foods, local painkillers and rinses. Painkillers from the group of non-steroidal anti-inflammatory drugs are taken according to instructions and for a short course. Antibiotics are needed only for confirmed bacterial sore throat and are prescribed by a doctor for a full course, otherwise they are useless and harmful. An abscess is treated by opening and drainage; for epiglottitis, care is provided in a hospital. If the cause is reflux, they work on nutrition, regimen and drugs that reduce acidity, as prescribed by the gastroenterologist.

Warm drinks, soft foods, humidification
Local anesthetics and rinses
Short course painkillers
Antibiotics only as prescribed for bacterial sore throat
Opening an abscess with paratonsillitis
Quitting smoking and irritating foods
Treatment of reflux with morning pain and burning

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Первичный осмотр отоларинголога Посев на микрофлору с определением чувствительности к антибиотикам

💊 Treatment

Промывание лакун нёбных миндалин Вскрытие абсцессов ЛОР-органов

Frequently asked questions: Pain when swallowing

When do you need antibiotics for a sore throat?+

Only with confirmed bacterial, usually streptococcal, sore throat. Signs that increase the likelihood: temperature above 38 ° C, plaque on the tonsils, enlarged cervical lymph nodes and absence of cough. The decision is made by the doctor, if possible - after a throat swab.

It hurts to swallow, but there is no fever - what is it?+

Most often, mild viral pharyngitis, irritation from dry air or vocal stress, as well as reflux, in which the pain is worse in the morning. If the pain is one-sided or lasts longer than two weeks, you need to be examined by an otolaryngologist.

What to do if it hurts to even swallow saliva?+

This is a worrying sign. When combined with difficulty opening the mouth, drooling, a nasal voice, or noisy breathing, it may indicate an abscess or inflammation of the epiglottis. You should immediately consult a doctor, and if you have difficulty breathing, call 103.

Do rinses help?+

Rinsing with a warm saline solution alleviates the condition and moisturizes the mucous membrane, although it does not shorten the duration of the disease. They are safe and complementary to pain relief. You should not gargle with aggressive solutions and alcohol tinctures.

Why does pain radiate to the ear?+

The pharynx and ear have a common innervation, so inflammation of the tonsils is often reflected by pain in the ear. But unilateral pain radiating to the ear can also be a sign of a peritonsillar abscess or tumor, so if it persists, an examination is necessary.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.