Sore throat and difficulty swallowing: what to know

Painful swallowing can occur with a viral illness, strep throat or inflammation around the throat. Common cold, influenza and COVID-19 may cause throat pain alongside cough, congestion, aches or tiredness. Glandular fever can produce a particularly painful, persistent throat and swollen neck glands. Acid reflux, allergies, dry air and smoke can irritate the lining. Difficulty swallowing is different from simply having pain: inability to swallow liquids or saliva is a warning sign. Symptoms cannot determine the cause without an examination.

If you can swallow, take small frequent sips and try cool or warm fluids, whichever feels better. Choose soft foods and avoid alcohol, smoking, spicy foods and very hot drinks. Rest and use a pharmacist-approved pain reliever according to its label. Do not force solid food if it feels stuck. Keep track of urine, fluid intake and whether symptoms are improving. Avoid sharing utensils while an infection is possible.

Call emergency services now for difficulty breathing, drooling because you cannot swallow, a rapidly worsening voice, blue lips, severe neck swelling or inability to swallow fluids. Seek same-day assessment if swallowing is becoming harder, pain is strongly one-sided, your mouth will not open normally, or you are becoming dehydrated. Arrange a review if symptoms are not improving or keep returning.

Is my swallowing difficulty caused by inflammation, infection or reflux? Do I need a throat swab or respiratory test? What signs should make me return urgently, and how can I maintain fluids safely?