Understanding the Difference Between Odynophagia and Dysphagia

senior man with throat or neck irritation

When swallowing becomes a pain or a challenge, it’s more than just a mere inconvenience—it could be a sign of a more serious condition that warrants medical attention. Dysphagia and odynophagia are two terms that often emerge in conversations about throat discomfort, but they are not synonymous. Dysphagia, the term for difficulty swallowing, can turn eating into a frustrating and sometimes risky task, while odynophagia, or painful swallowing, can transform each bite into an agonizing ordeal. Both conditions may arise from a variety of causes, ranging from infections to neurological disorders, and understanding these can help in seeking timely and appropriate care. In this blog, we delve into the differences between odynophagia and dysphagia, explore the possible causes of each, and discuss why consulting an Ear, Nose, and Throat (ENT) specialist can be an essential step towards diagnosis and treatment.

What is Dysphagia?

Dysphagia is the medical term for difficulty in swallowing. Individuals with dysphagia have trouble passing food or liquid from the mouth to the stomach. This condition can occur at any age, but it is more prevalent in the elderly. It often signifies an issue with the throat or the esophagus, the tube that moves food from the mouth to the stomach.

Dysphagia can manifest in various ways, including:

  • Difficulty starting a swallow
  • The feeling of food being stuck in the throat or chest
  • Coughing or choking when eating or drinking, leading to a risk of food entering the airway, which can cause pneumonia
  • The need to cut food into smaller pieces or avoid certain foods
  • Unexpected weight loss due to an inability to eat properly

The condition is categorized into two types:

  1. Esophageal dysphagia: This type is the sensation that food is stuck in the base of your throat or in your chest after you have started to swallow. It may be due to a narrowing of the esophagus, muscle weakness, or issues with relaxation of the esophageal sphincters.
  2. Oropharyngeal dysphagia: This form of dysphagia is due to conditions that affect the muscles and nerves that help move food through the throat and into the esophagus. People with neurological or muscular conditions, such as Parkinson’s disease or stroke, may experience this type of swallowing difficulty.

Treatment for dysphagia depends on the underlying cause. It can range from dietary changes and swallowing therapy to medication and surgery. It’s important to address dysphagia not only to alleviate the discomfort associated with eating but also to prevent potential complications such as malnutrition, dehydration, and respiratory problems.

Possible Causes of Dysphagia:

  • Neurological Disorders: Conditions such as Parkinson’s disease, multiple sclerosis, or stroke can affect the nervous system and lead to dysphagia.
  • Esophageal Conditions: Esophagitis, esophageal strictures, or cancer can cause the esophagus to narrow, creating swallowing difficulties.
  • Muscular Disorders: Myasthenia gravis or scleroderma can affect the muscles involved in swallowing.

What is Odynophagia?

Odynophagia is the medical term used to describe painful swallowing. When experiencing odynophagia, a person may feel pain when swallowing food, liquid, or even saliva. This pain can be felt in the throat, esophagus, or behind the sternum (chest bone). Unlike dysphagia, which refers to the physical difficulty in swallowing, odynophagia is specifically characterized by the pain that occurs during the act of swallowing.

The causes of odynophagia are various and can include:

  • Infections: Such as those caused by viruses (like the common cold or flu), bacteria (including streptococcal pharyngitis), or fungal infections (like esophageal candidiasis).
  • Mucosal Injuries: Caused by acid reflux disease (GERD), where stomach acid irritates the esophagus, or by eating very hot or acidic foods that can cause burns or irritations.
  • Ulcers or Inflammations: In the throat or esophagus, which can be due to infections, medications, or diseases like Crohn’s disease.
  • Cancers: Malignancies in the throat, esophagus, or surrounding areas can lead to pain while swallowing.

Odynophagia can be a serious symptom because it may be related to a significant underlying condition that requires prompt medical evaluation and treatment. If someone is experiencing pain when swallowing, especially if it persists or is accompanied by other symptoms like weight loss, regurgitation, or choking, they should seek medical attention. An Ear, Nose, and Throat (ENT) specialist can perform a thorough examination and recommend appropriate diagnostic tests, such as endoscopy or imaging studies, to determine the cause of the pain and provide targeted treatment.

When to See an ENT Specialist:

  • Persistent Symptoms: If you experience dysphagia or odynophagia for more than a few weeks, it’s important to seek medical advice.
  • Associated Symptoms: Difficulty breathing, weight loss, or regurgitation of food are signs that you should visit an ENT specialist.
  • Obstructive Symptoms: If you suspect that a blockage in the throat or esophagus is causing swallowing difficulties, prompt evaluation is necessary.


While dysphagia and odynophagia may present with similar discomfort related to swallowing, their causes and implications can be different. An ENT specialist can provide comprehensive evaluation and treatment, ensuring that any underlying conditions are appropriately managed. If you are experiencing any of these symptoms, don’t hesitate to contact an ENT clinic for further assessment and care. Remember, early diagnosis and treatment are key to managing any health condition. If you’re experiencing any signs of dysphagia or odynophagia, schedule an appointment with your local Anne Arundel ENT specialist today.

Lee A. Kleiman a doctor at Anne Arundel ENT

Dr. Lee A. Kleiman is a double board certified ENT & plastic surgeon at Anne Arundel ENT in Annapolis, Maryland known for his superior clinical outcomes in all Surgical and Non-Surgical ENT, specializing in Sinus Care, Voice and Swallowing, Rhinoplasty and Revision Rhinoplasty, and Facelifts and Non-surgical Aesthetic. He also continues to attend conferences internationally and nationally to keep abreast of the latest treatments and technology.