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{{Search infobox}}
__NOTOC__
{{CMG}}; {{AE}} {{ADI}}


{{SK}} painful swallowing, pain during swallowing
'''For patient information on this topic, click [[odynophagia (patient information)|here]].'''
{{Odynophagia}}
{{CMG}}; {{AE}} {{SKA}}


==Overview==
{{SK}} Painful swallowing, Pain during swallowing, Odenophagia, Odinophagia, Odenophagia.
'''Odynophagia''' is defined as painful swallowing.


== Causes==
==[[Odynophagia overview|Overview]]==
===Common Causes===
==[[Odynophagia historical perspective|Historical Perspective]]==
* [[Upper respiratory tract infections]]
==[[Odynophagia pathophysiology|Pathophysiology]]==
* [[Achalasia cardia]]
==[[Odynophagia causes|Causes]]==
* [[Scleroderma]]
==[[Odynophagia differential diagnosis|Differentiating Odynophagia from other Conditions]]==
* [[Zenkers diverticulum]]
==[[Odynophagia epidemiology and demographics|Epidemiology and Demographics]]==
* [[Esophageal cancer]]
==[[Odynophagia risk factors|Risk Factors]]==
* [[Myasthenia gravis]]
==[[Odynophagia natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
* [[Tonsillitis]]
==Diagnosis==
===Causes by Organ System===
[[Odynophagia history and symptoms|History and Symptoms]] | [[Odynophagia physical examination|Physical Examination]] | [[Odynophagia laboratory findings|Laboratory Findings]] | [[Odynophagia electrocardiogram|Electrocardiogram]] | [[Odynophagia chest x ray|Chest X Ray]] | [[Odynophagia CT|CT]] | [[Odynophagia MRI|MRI]] | [[Odynophagia echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Odynophagia other imaging findings|Other Imaging Findings]] | [[Odynophagia other diagnostic studies|Other Diagnostic Studies]]
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Aortic aneurysm]], [[Double aortic arch]], [[Enlarged left atrium]], [[Mediastinitis]], [[Mitral valve stenosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| [[Botulism]], [[Chemical burns]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Stevens-Johnson Syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[Cricopharyngeal spasm]], [[Epiglottitis]], [[Esophagotracheal fistula]], [[Glossitis]], [[Goiter]], [[Gum disease]], [[Laryngitis]], [[Oral submucous fibrosis]], [[Oral ulcers]], [[Palatoplegia]], [[Stomatitis]], [[Zenker's Diverticulum]], [[Herpangina]], [[Retropharyngeal abscess ]], [[Palate cancer]], [[Supraglottic laryngeal cancer ]], [[Xerostomia]]
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Diabetic neuropathy]], [[Hyperthyroidism]], [[Hypothyroidism]], [[Riedel thyroiditis]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Achalasia]], [[Barrett's oesophagus]], [[Diverticulum]], [[Esophageal achalasia]], [[Esophageal atresia]], [[Esophageal spasm]], [[Esophageal stricture ]], [[Esophagitis ]], [[Fibrosis]], [[Gastritis]], [[Gastroesophageal reflux]], [[Intramural pseudodiverticulosis]], [[Peptic stenosis]], [[Schatzki ring]], [[Myoneurogastrointestinal encephalopathy syndrome]], [[Crohn's disease]], [[Eosinophilic esophagitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Opitz-Frias syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Agranulocytosis]], [[Lymphadenopathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Radiation esophagitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Abscesses]], [[Acute pharyngitis ]], [[Adenoiditis]], [[Angina tonsillaris]], [[Candidiasis]], [[Chagas Disease]], [[Cytomegalovirus ]], [[Diphtheria]], [[Esophageal moniliasis]], [[Flu]], [[Herpangina]], [[Herpes simplex virus (HSV)]], [[Herpes stomatitis ]], [[HIV/AIDS]], [[Mononucleosis]], [[Mumps]], [[Oral candidiasis]], [[Paracoccidioidomycosis]], [[Pharyngitis]], [[Poliomyelitis]], [[Rabies]], [[Reflux esophagitis]], [[Respiratory tract infections ]], [[Retropharyngeal abscess ]], [[Scarlet Fever]], [[Tetanus]], [[Tonsillar abscess]], [[Tooth infection]], [[Typhoid fever]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Elongated styloid process]], [[Extreme spinal curvature]], [[Global hystericus]], [[Schatzki ring]], [[Leiomyoma]], [[Dermatomyositis]], [[Myasthenia Gravis]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Amyotrophic Lateral Sclerosis (ALS)]], [[Brainstem stroke]], [[Bulbar palsy]], [[Central hypoglossal nerve paralysis]], [[Central vagal nucleus lesion]], [[Cerebrovascular accident]], [[Guillain-Barre syndrome]], [[Huntington's chorea]], [[Multiple Sclerosis]], [[Myoneurogastrointestinal encephalopathy syndrome]], [[Neuroferritinopathy]], [[Peripheral neuropathy]], [[Polyradiculitis]], [[Syringobulbia]], [[Vagal disorder]], [[Diabetic neuropathy]], [[Poliomyelitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Gaucher's disease]], [[Plummer-Vinson Syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Bronchial carcinoma]], [[Carcinoma of the vocal tract ]], [[Carotid body tumor]], [[Esophageal cancer]], [[Gastric tumors]], [[Hypopharyngeal cancer ]], [[Laryngeal cancer]], [[Leiomyoma]], [[Oral cancer ]], [[Palate cancer]], [[Paraneoplastic syndrome]], [[Supraglottic laryngeal cancer ]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Anxiety disorders]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Bronchial carcinoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Allergic swelling]], [[Amyloidosis]], [[Behcet's Syndrome]], [[CREST syndrome ]], [[Crohn's disease]], [[Dermatomyositis]], [[Eosinophilic esophagitis]], [[Esophageal sarcoidosis]], [[Graft versus host reaction]], [[Inclusion body myositis]], [[Myasthenia Gravis]], [[Parkinson's Disease]], [[Riedel thyroiditis]], [[Rheumatoid Arthritis]], [[Scleroderma]], [[Systemic Lupus Erythematosus]], [[Systemic sclerosis]], [[Xerostomia]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Esophageal trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Alcoholism]], [[Aspiration of foreign body]]
|-
|}


===Causes in Alphabetical Order <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===
==Treatment==
{{MultiCol}}
* [[Abscesses]]
* [[Achalasia]]
* [[Acute pharyngitis ]]
* [[Adenoiditis]]
* [[Agranulocytosis]]
* [[Alcoholism]]
* [[Allergic swelling]]
* [[Amyloidosis]]
* [[Amyotrophic Lateral Sclerosis (ALS)]]
* [[Angina tonsillaris]]
* [[Anxiety disorders]]
* [[Aortic aneurysm]]
* [[Aspiration of foreign body]]
* [[Barrett's oesophagus]]
* [[Behcet's Syndrome]]
* [[Botulism]]
* [[Brainstem stroke]]
* [[Bronchial carcinoma]]
* [[Bulbar palsy]]
* [[Candidiasis]]
* [[Carcinoma of the vocal tract ]]
* [[Carotid body tumor]]
* [[Central hypoglossal nerve paralysis]]
* [[Central vagal nucleus lesion]]
* [[Cerebrovascular accident]]
* [[Chagas Disease]]<ref>http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002348/</ref>
* [[Chemical burns]]
* [[CREST syndrome ]]
* [[Cricopharyngeal spasm]]
* [[Crohn's disease]]
* [[Cytomegalovirus ]]
* [[Dermatomyositis]]
* [[Diabetic neuropathy]]
* [[Diphtheria]]
* [[Diverticulum]]
* [[Double aortic arch]]
* [[Elongated styloid process]]
* [[Enlarged left atrium]]
* [[Eosinophilic esophagitis]]
* [[Epiglottitis]]
* [[Esophageal achalasia]]
* [[Esophageal atresia]]
* [[Esophageal cancer]]
* [[Esophageal moniliasis]]
* [[Esophageal spasm]]
* [[Esophageal stricture ]]
* [[Esophagus|Esophageal]] [[Trauma|trauma]]
* [[Esophageal sarcoidosis]]
* [[Esophagitis ]]
* [[Esophagotracheal fistula]]
* [[Extreme spinal curvature]]
* [[Fibrosis]]
* [[Flu]]
* [[Gastric tumors]]
* [[Gastritis]]
* [[Gastroesophageal reflux]]
* [[Gaucher's disease]]<ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018671/</ref>
* [[Global hystericus]]<ref>http://www.ncbi.nlm.nih.gov/pubmed/6875362</ref>
* [[Glossitis]]
* [[Goiter]]
* [[Graft versus host reaction]]
* [[Guillain-Barre syndrome]]
* [[Gum disease]]
* [[Herpangina]]
* [[Herpes simplex virus (HSV)]]
* [[Herpes stomatitis ]]
* [[HIV/AIDS]]
* [[Huntington's chorea]]
* [[Hyperthyroidism]]
* [[Hypopharyngeal cancer ]]
* [[Hypothyroidism]]


{{ColBreak}}
[[Odynophagia medical therapy|Medical Therapy]] | [[Odynophagia surgery|Surgery]] | [[Odynophagia primary prevention|Primary Prevention]] | [[Odynophagia secondary prevention|Secondary Prevention]] | [[Odynophagia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Odynophagia future or investigational therapies|Future or Investigational Therapies]]
* [[Inclusion body myositis]]
* [[Intramural pseudodiverticulosis]]
* [[Laryngeal cancer]]
* [[Laryngitis]]
* [[Leiomyoma]]
* [[Lymphadenopathy]]
* [[Mediastinitis]]
* [[Mitral valve stenosis]]
* [[Mononucleosis]]
* [[Multiple Sclerosis]]
* [[Mumps]]
* [[Myasthenia Gravis]]
* [[Myoneurogastrointestinal encephalopathy syndrome]]<ref>http://ghr.nlm.nih.gov/condition/mitochondrial-neurogastrointestinal-encephalopathy-disease</ref>
* [[Neuroferritinopathy]]<ref>http://www.ncbi.nlm.nih.gov/books/NBK1141/</ref>
* [[Opitz-Frias syndrome]]<ref>http://www.ncbi.nlm.nih.gov/books/NBK1523/</ref>
* [[Oral cancer ]]


* [[Oral submucous fibrosis]]
==Case Studies==
* [[Oral ulcers]]
[[Odynophagia case study one|Case #1]]
* [[Oral candidiasis]]
* [[Palate cancer]]
* [[Palatoplegia]]
* [[Paracoccidioidomycosis]]
* [[Paraneoplastic syndrome]]
* [[Parkinson's Disease]]
* [[Peptic stenosis]]
* [[Peripheral neuropathy]]
* [[Pharyngitis]]
* [[Plummer-Vinson Syndrome]]
* [[Poliomyelitis]]
* [[Polyradiculitis]]
* [[Rabies]]
* [[Radiation esophagitis]]
* [[Reflux esophagitis]]
* [[Respiratory tract infections ]]
* [[Retropharyngeal abscess ]]
* [[Rheumatoid Arthritis]]
* [[Riedel thyroiditis]]
* [[Scarlet Fever]]
* [[Schatzki ring]]
* [[Scleroderma]]
* [[Stevens-Johnson Syndrome]]
* [[Stomatitis]]
* [[Supraglottic laryngeal cancer ]]
* [[Syringobulbia]]
* [[Systemic Lupus Erythematosus]]
* [[Systemic sclerosis]]
* [[Tetanus]]
* [[Tonsillar abscess]]
* [[Tooth infection]]
* [[Typhoid fever]]
* [[Vagal disorder]]
* [[Xerostomia]]
* [[Zenker's Diverticulum]]
 
{{EndMultiCol}}
 
==Symptoms to Differentiate Odynophagia From==
* [[Dysphagia]] is defined as difficulty in swallowing
 
== Diagnosis ==
 
=== History ===
A directed history should be performed to characterize the following:
* Onset
* Severity
* Duration
* Dysphagia with liquids versus solids
* Psychiatric history
* Prior episodes
* Substance exposure
* History of neck and head problems
 
=== Laboratory Findings ===
 
==== Electrolyte and Biomarker Studies ====
* Creatinine phosphokinase (CPK) can be used to rule out cardiac ischemia as a cause.
 
=== Electrocardiogram ===
Can be used to assess for [[left atrial enlargement]].
 
=== Chest X Ray ===
Can used to rule out [[lung cancer]] and other mass lesions as well as [[left atrial enlargement]].
 
=== MRI and CT ===
* MRI of brain can be used to exclude CVA and mass lesions of the head and neck.
 
=== Echocardiography or Ultrasound ===
Can be used to rule out an aneurysm or left atrial enlargement as a cause.
 
=== Other Diagnostic Studies ===
* [[Esophagogastroduodenoscopy]] (OGD)
* [[Biopsy]]
* [[Barium swallow]]
* [[Electromyogram]] ([[EMG]])
* Nerve conduction tests
* Esophageal manometry
 
== Treatment ==
* Endoscopy (acute and chronic mechanical obstructions)
* Speech therapy (ALS and stroke patients)
 
== Pharmacotherapy ==
* Proton pump inhibitors or promotility agents, weight loss, avoidance of offending foods (gastroesophageal reflux disease)
* Anticholinergics (ALS, stroke, lower esophageal spasms)
* Muscarinic agents (myasthenia gravis)
* Glucocorticoids (myasthenia gravis and polymyositis)
* Antispasmodics, botulinum toxin injection (lower esophageal spasm)
 
== Surgery and Device Based Therapy ==
* Thoracic surgery, possible balloon dilation (chronic mechanical obstruction)
 
== References ==
{{Reflist|2}}


[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Musculoskeletal Disease]]
[[Category:Musculoskeletal Disease]]
[[Category:Symptoms]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]


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Latest revision as of 16:20, 27 February 2018


For patient information on this topic, click here.

Odynophagia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]

Synonyms and keywords: Painful swallowing, Pain during swallowing, Odenophagia, Odinophagia, Odenophagia.

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Odynophagia from other Conditions

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1


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