Differential Diagnosis for Odynophagia
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is often the most common cause of odynophagia due to the frequent exposure of the esophageal mucosa to acidic gastric contents, leading to inflammation and pain.
Other Likely Diagnoses
- Esophagitis: Inflammation of the esophagus, which can be caused by infection (e.g., candida, herpes), drugs, or chemicals, leading to painful swallowing.
- Esophageal Stricture: Narrowing of the esophagus, often due to chronic GERD or esophagitis, which can cause difficulty and pain when swallowing.
- Mallory-Weiss Syndrome: Tears in the mucous membrane or lining of the lower end of the esophagus, often associated with intense or prolonged vomiting, retching, or coughing.
Do Not Miss Diagnoses
- Esophageal Perforation: A hole in the esophagus, which can lead to severe infection and is life-threatening if not promptly treated. Symptoms can include severe chest pain and odynophagia.
- Cancer of the Esophagus: Although less common, esophageal cancer can cause odynophagia, especially if the tumor obstructs the esophagus or invades surrounding structures.
- Infectious Esophagitis in Immunocompromised Patients: Conditions like HIV/AIDS can predispose individuals to opportunistic infections (e.g., CMV, HSV) that cause esophagitis and odynophagia.
Rare Diagnoses
- Eosinophilic Esophagitis: A chronic immune system disease in which a type of white blood cell, the eosinophil, builds up in the esophagus in response to an allergen or irritant, leading to inflammation and difficulty swallowing.
- Pill Esophagitis: Injury to the esophagus caused by taking certain medications without enough water, leading to the pill getting stuck in the esophagus and causing irritation and pain.
- Caustic Esophageal Injury: Damage to the esophagus from ingesting corrosive substances, which can lead to chronic pain and difficulty swallowing if not properly managed.