Odynophagia differential diagnosis

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


Odynophagia should be differentiated from dysphagia (difficulty in swallowing). There are many causes of odynophagia. They can also be differentiated with help of appropriate H & E and diagnostic procedures.[1][2][3][4][5]

Differentiating odynopaghia from dysphagia:

Factor Odynopagia Dysphagia
Defination Pain in swallowing Inability to start or continue to swallow
Pathophysiology Irritation of sensory nerves Motor nerves paralysis or mechanical obstruction
Involved areas Pharynx and esophagus Motor nerves or esophagus

Odynophagia differentials:

Causes Pain History finding Examination finding Diagnostic test
URTI Acute pain Change in voice, fever, runny nose inflamed oral mucosa, enlarged lymph nodes or tonsils Oral swab culture
Tumors Dull Pain Loss of weight and appetite, risk factors, may have dysphagia swelling may be seen, tumor may spread to lymph nodes Endoscopy
Foreign body Acute pain History of foreign body intake Foreign body may be seen, surrounding area may be inflamed Laryngoscopy
GERD Burning pain Pain worse at night, decrease food intake but normal appetite Oral mucosa normal, mild tender epigastrium Manomatary
Esophagitis Burning pain Retrosternal pain on swallowing, food aversion Oral mucosa normal Endoscopy


  1. Sopeña B, Limeres J, García-Caballero L, Diniz-Freitas M, Seoane J, Diz P (2018). "A Dramatic Case of Odynophagia". Dysphagia. 33 (1): 133–135. doi:10.1007/s00455-017-9861-8. PMID 29128948.
  2. Fukuda S, Watanabe N, Domen T, Ishioka M, Sawaguchi M, Ohba R; et al. (2018). "A case of esophageal actinomycosis with a unique morphology presenting as a refractory ulcer". Clin J Gastroenterol. 11 (1): 38–41. doi:10.1007/s12328-017-0797-1. PMID 29124648.
  3. Chi TH, Hung CC, Chen RF, Yuan CH, Chen JC (2017). "Spontaneous retropharyngeal emphysema: A case report". Niger J Clin Pract. 20 (9): 1213–1215. doi:10.4103/njcp.njcp_3_16. PMID 29072250.
  4. Jovov B, Reed CC, Shaheen NJ, Pruitt A, Ferrell K, Orlando GS; et al. (2017). "Fragments of e-Cadherin as Biomarkers of Non-erosive Reflux Disease". Dig Dis Sci. doi:10.1007/s10620-017-4815-4. PMID 29071486.
  5. Althuwaini S, Bamehriz F, Aldohayan A, Alshammari W, Alhaidar S, Alotaibi M; et al. (2017). "Prevalence and Predictors of Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy". Obes Surg. doi:10.1007/s11695-017-2971-4. PMID 29043549.

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