Pain - swallowing (burning)

Alternative names
Swallowing pain or burning; Odynophagia; Burning feeling when swallowing

A strong feeling of burning, squeezing pain while swallowing (felt high in the neck or lower down, behind the breastbone) may be a symptom of a serious disorder.


Swallowing is a complex act that involves the mouth, throat area, and esophagus (the tube that transports food to the stomach).

Problems at any point, from the mouth to the esophagus, can result in burning or intense pain with swallowing.

This may be accompanied by chest pain, the feeling that food is stuck in the throat, or heaviness or pressure in the neck or upper chest.

Common Causes

  • Infection       o Tooth infection or abscess       o Gum disease       o Pharyngitis       o Thrush (a fungal infection caused by candida)       o Herpes simplex infection       o Cytomegalovirus infection       o Human immunodeficiency virus infection (HIV)  
  • Ulcers in the mouth or throat from infection, medications, or chemical ingestions  
  • Esophagitis (inflammation in the esophagus, often from gastroesophageal reflux disease)  
  • A foreign body (such as fish or poultry bones)  
  • Esophageal motor disorders, such as nutcracker esophagus, diffuse esophageal spasm, or achalasia (more commonly, these result in dysphagia, a difficulty swallowing, rather than pain)

Home Care

Eat slowly and chew food thoroughly. If a person suddenly shows signs of choking and difficulty breathing, the Heimlich maneuver should be performed immediately.

You may have an easier time swallowing liquids or pureed foods than solids. Avoid very cold or very hot foods if you notice that they worsen the problem.

Call your health care provider if

  • Call your provider if the problem continues, even if the symptoms are intermittent.  
  • Tell your doctor about any other symptoms, such as cough, wheezing, fever, chills, abdominal pain, pain with swallowing, nausea or vomiting, vomiting of blood, weight loss, heartburn, or sour taste in the mouth.

What to expect at your health care provider’s office
The clinician will perform a physical examination and ask questions about this symptom, such as:

  • Is there pain when swallowing solids, liquids, or both?  
  • Is the pain constant or does it come and go?  
  • Is the pain getting worse?  
  • Do you have difficulty swallowing?  
  • Do you have a sore throat?  
  • Does it feel like there is a lump in the throat?  
  • Have you inhaled or swallowed any irritating substance?  
  • What other symptoms do you have?  
  • What other medical problems do you have?  
  • What medications do you take?

The following diagnostic tests may be performed:

  • Barium swallow and upper GI series  
  • Throat culture  
  • Neck x-ray  
  • Chest x-ray  
  • Endoscopy (EGD)  
  • Esophageal acidity test, also called a pH probe (checks for acid that comes from the stomach and enters the esophagus, as in gastroesophageal reflux disease)  
  • Esophageal manometry (pressure measurements)  
  • HIV testing


Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.