Define dysphagia and odynophagia, and what does each suggest?

Dysphagia is difficulty swallowing; odynophagia is pain on swallowing (worse with hot, citrus, or alcoholic drinks). Dysphagia points to obstruction or a motility disorder; odynophagia suggests mucosal inflammation or ulceration.

Clinical relevance. Separating these symptoms guides whether to look for obstruction, dysmotility, or mucosal disease.

More Detail

Dysphagia and odynophagia

These two swallowing symptoms point to different processes and are assessed together.

Definitions

• Dysphagia: difficulty in swallowing - the sensation that food sticks or will not pass.
• Odynophagia: burning pain during or after swallowing, lasting a few seconds, classically worse with hot beverages, citrus drinks, and alcohol.

What each suggests

• Dysphagia implies mechanical obstruction or a motility (neuromuscular) disorder.
• Odynophagia implies mucosal injury - oesophagitis, candidal or herpetic infection, ulceration.

Other accompanying symptoms to elicit

• Regurgitation, weight loss, anaemia, cachexia, change of voice, cough or dyspnoea, and angina-like chest pain.
• It is important to distinguish regurgitation (effortless return of food) from true vomiting.

Missing a malignant cause is the chief danger, so progressive dysphagia in an older patient always warrants prompt endoscopy.