Differential Diagnosis for Odynophagia
Odynophagia refers to painful swallowing, a symptom that can be caused by various conditions. Here's a categorized differential diagnosis:
Single Most Likely Diagnosis
- Gastroesophageal reflux disease (GERD): This is often the most common cause of odynophagia due to the reflux of stomach acid into the esophagus, leading to inflammation and pain.
Other Likely Diagnoses
- Esophagitis: Inflammation of the esophagus, which can be caused by infection, acid reflux, or other irritants.
- Esophageal spasm: Abnormal muscle contractions of the esophagus can cause pain during swallowing.
- Pill esophagitis: Certain medications can cause direct injury to the esophageal mucosa, leading to pain.
- Viral esophagitis: Viral infections, such as herpes simplex or cytomegalovirus, can cause esophageal inflammation and pain.
Do Not Miss Diagnoses
- Esophageal perforation: A hole in the esophagus, which can be life-threatening if not promptly treated.
- Caustic esophageal injury: Ingestion of corrosive substances can cause severe esophageal damage and pain.
- Esophageal cancer: Although less common, cancer of the esophagus can cause painful swallowing and should not be missed.
- Infectious esophagitis in immunocompromised patients: Certain infections, such as candidiasis or cytomegalovirus, can be severe and life-threatening in patients with weakened immune systems.
Rare Diagnoses
- Eosinophilic esophagitis: A chronic inflammatory condition of the esophagus characterized by eosinophilic infiltration.
- Scleroderma: A systemic disease that can cause esophageal dysmotility and pain.
- Radiation esophagitis: Inflammation of the esophagus caused by radiation therapy, typically for cancer treatment.
- Foreign body obstruction: An object lodged in the esophagus can cause pain and difficulty swallowing.