Odynophagia

What is Odynophagia ?

Origin of the word ‘Odynophagia’ is from Greek ⁽¹⁾.

• Odyno- Pain ⁽¹⁾
• Phagia- (phagein)- to eat. ⁽¹⁾

So the word meaning can be considered as ‘Pain to eat’ or pain while eating.

Definition of Odynophagia

Painful swallowing is called as odynophagia ⁽²⁾. The pain may be related to particular food item or temperature of food or simply may not be related to any other factors. It may or may not be associated with difficulty in swallowing ⁽³⁾.

Pain felt while swallowing can be from the mouth, oesophagus or throat ⁽⁴⁾. The person suffering from odynophagia may describe the pain as burning pain, aching pain or stabbing pain ⁽⁵⁾.

Image 1: Odynophagia

Difference between Dysphagia and Odynophagia

These are two terms often confused between or used interchangeably. In fact they are different in their meanings and in definition, though both may occur simultaneously in various disease conditions.

When someone feels difficulty in swallowing, then it is dysphagia. Whereas, someone feels pain while swallowing is odynophagia ⁽⁶⁾.

How is Odynophagia pronounced?

According to Merriam-Webster Medical Dictionary, Odynophagia pronunciation is ‘ō-din-ə-ˈfā-j(ē-)ə’ ⁽⁷⁾. It sounds similar to O-din-e-fajea.

Odynophagia ICD

• Odynophagia ICD-9 : CM- R13 ⁽⁸⁾
• Odynophagia ICD-10 : 787.20 ⁽⁸⁾

Causes of Odynophagia

Pain while swallowing can happen if infections, inflammations, foreign body or tumours occur in mouth, throat or oesophagus ⁽⁴⁾.

General Causes	Specific causes
Drinks and food that are too hot or cold (8)	Infections- Oral candidiasis, HIV infection, Cytomegalovirus infection, Herpes infection etc (4)
Medications (8)	Inflammations- Tonsillitis, pharyngitis, epiglottitis, esophagitis (8)
Drugs, Alcohol, Tobacco (3)	Ulcers (8)
Injury in mouth, tongue, throat (9)	Abscesses (8)
Foreign body in throat Eg: Impacted Fish bone (4)	Tumours of oesophagus or throat. (8)
	GERD- Gastro esophageal reflux disease (4)

Table 1: Causes of Odynophagia can also be considered as differential diagnosis of Odynophagia.

Odynophagia Symptoms

Odynophagia by itself is a symptom of an underlying disease, condition or abnormality. Other symptoms may accompany odynophagia, depending on the underlying condition. For instance, tonsillitis can be accompanied by throat pain, fever and headache along with odynophagia.

In case of tumours of the oesophagus, there can be associated obstruction resulting in pain and loss of weight. In general, loss of weight is seen commonly in patients with odynophagia ⁽⁴⁾.

Diagnosis of Odynophagia

A proper examination of oral cavity and throat followed by endoscopic evaluation of oesophagus generally helps in diagnosing the cause of Odynophagia ⁽¹⁰⁾.

Oesophageal manometry can help in finding if the oesophageal muscles are functioning normally ⁽⁴⁾. If there is abscess in the throat, surgical drainage may be required.

Image 2: An endoscopic image of oesophagus showing cancerous growth leading to odynophagia.

Image 3: Endoscopic image of oesophagus showing herpes simplex infection. The patient presented in the outpatient department with odynophagia.

Odynophagia Treatment

When the cause of odynophagia is diagnosed, the treatment depends on removing this cause. Foreign bodies in the mouth or throat can be removed by simple procedures or by endoscopy. Ulcers, infections and inflammations may require antibiotics for cure^{(4, 10)}.

Surgery might be inevitable in oesophageal cancers. Chemotherapy and radiotherapy may also be needed.

Summary

Odynophagia is the term used for painful swallowing. This can be due to infections, tumours, inflammations, or injury to mouth, throat or oesophagus. Appropriate investigations can help in easy diagnosis and treatment of the difficulty.

In most cases, odynophagia can be treated successfully by treating the underlying cause.

References:

1. www.medicinenet.com/script/main/art.asp?articlekey=25604
2. “odynophagia”. The American Heritage Science Dictionary. Houghton Mifflin Company
3. Schiff, Bradley A. (January 2016). Merck Manuals Professional Edition. Merck Sharp & Dohme Corp.
4. www.epainassist.com/face-mouth-throat/what-is-odynophagia
5. Allan B. Wolfson, ed. (2005). Harwood-Nuss’ Clinical Practice of Emergency Medicine (4th ed.). pp. 307–8
6. www.uptodate.com/contents/approach-to-the-evaluation-of-dysphagia-in-adults?
7. www.merriam-webster.com/medical/odynophagia
8. en.wikipedia.org/wiki/Odynophagia
9. Scully, Crispian (2008). Edinburgh: Churchill Livingstone. pp. 131–139
10. www.healthline.com/health/odynophagia#diagnosis