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Pain swallowing Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Pain swallowing. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you had pain with swallowing?

    Why: to determine if acute or chronic.

  2. Is the painful swallowing constant or intermittent?

    Why: If intermittent, must consider a Schatzki ring (lower esophageal ring) or achalasia.

  3. Is the person with painful swallowing male or female?

    Why: If male, suggests esophageal cancer. If female, suggests esophageal web, as in Plummer-Vinson syndrome.

  4. Risk factors for esophageal cancer?

    Why: e.g. Chinese, African or the Caspian regions of Iran ethnicity; male sex; heavy alcohol use; heavy cigarette smoking; Plummer-Vinson syndrome; achalasia; celiac disease.

  5. Risk factors for oral cancer?

    Why: e.g. cigarette smoking, poor dental hygiene, spirits, recurrent mouth infections or syphilis.

  6. Risk factors for oral and esophageal Candida infection (thrush)?

    Why: e.g. May be associated with poor oral hygiene, alcoholism, AIDS, leukemia, lymphoma, diabetes mellitus, iron deficiency, steroids, tumor chemotherapy, broad spectrum antibiotics, achalasia and scleroderma.

  7. Past medical history?

    Why: e.g. a history of syphilis would suggest an aortic aneurysm or other chest masses that may cause pain with swallowing; gastro-esophageal reflux may be associated with scleroderma, pregnancy or obesity; esophageal cancer may be associated with Plummer-Vinson syndrome, achalasia, celiac disease.

  8. Medications?

    Why: e.g. some medications increase the risk of oral and esophageal Candida infection including steroids, broad spectrum antibiotics and tumor chemotherapy; some medications such emepronium and slow release potassium tablets may lodge in the gullet when swallowed lying down or without water and cause ulceration of the esophagus.

  9. Alcohol history?

    Why: alcohol increases the risk of gastro-esophageal reflux, esophageal cancer, Candida infection of the oesophagus.

  10. Cigarette smoking?

    Why: increases the risk of gastro-esophageal reflux and esophageal cancer.

  11. Sexual history?

    Why: may indicate risk of syphilis or HIV which may be associated with painful swallowing.

  12. Difficulty in swallowing?

    Why: Most causes of painful swallowing will also cause difficulty with swallowing. If painful swallowing is present without any real difficulty with swallowing must consider Candida infection, herpes simplex infection or medication induced ulceration of the esophagus (e.g. from emepronium or slow release potassium tablets that may lodge in the gullet when swallowed lying down or without water).

  13. Difficulty with swallowing both solids and liquids?

    Why: consider achalasia, scleroderma or diffuse esophageal spasm.

  14. Difficulty with swallowing solids only (nil difficulty with swallowing liquids)?

    Why: suggests esophageal cancer until proven otherwise.

  15. Heartburn?

    Why: If there is heartburn as well as pain with swallowing, should consider a diagnosis of reflux oesophagitis with or without a hiatus hernia, achalasia, diffuse esophageal spasm or advanced esophageal cancer.

  16. Significant weight loss?

    Why: very often associated with advanced esophageal cancer or achalasia.

  17. Hand swelling and/or thickening and tightening of the skin of the fingers?

    Why: may suggest scleroderma.

  18. Symptoms of gastro-esophageal reflux?

    Why: e.g. heartburn, aggravated by bending, stooping or lying down, relieved by antacids. May have pain with drinking hot liquids or alcohol. Regurgitation of food and acid into the mouth may occur, particularly when the person is bending or lying flat. May be associated with pregnancy, obesity, cigarette smoking, scleroderma, eating chocolate or fat, drinking coffee or alcohol.

  19. Symptoms of esophageal cancer?

    Why: e.g. progressive difficulty with swallowing; initially there is difficulty with swallowing solids, but eventually difficulty with swallowing liquids also occurs. Pain occurs if food gets stuck due to narrowing of the esophageal lumen. Weight loss occurs due to difficulty with swallowing and also due to reduced appetite.

  20. Symptoms of achalasia?

    Why: e.g. intermittent difficulty with swallowing both solids and liquids; regurgitation of food into mouth from the esophagus may occur, particularly at night; occasionally food may get stuck; drinking large quantities of fluids help force the food through if food gets stuck; severe pain behind the breastbone due to dysfunctional contraction of the esophagus; weight loss may occur but is usually not marked.

  21. Symptoms of scleroderma?

    Why: e.g. difficulty with swallowing, heartburn, hand swelling and/or thickening and tightening of the skin of the fingers, Raynaud's phenomenon.

  22. Symptoms of diffuse esophageal spasm?

    Why: e.g. pain behind the breastbone, difficulty with swallowing both solids and liquids. Liquids that are either very hot or cold may aggravate the pain. Pain may occur without difficulty with swallowing and may be difficult to distinguish from angina.

  23. Symptoms of glossitis (inflammation of the tongue)?

    Why: e.g. smooth appearance of the tongue, tongue may be red. In later stages there may be shallow ulceration. May be due to nutritional deficiency in iron, folate or Vitamin B12.

  24. Symptoms of oral candidiasis?

    Why: e.g. creamy white curd-like patches in the mouth which are removed only with difficulty and leave a bleeding surface. If the infection spreads to the esophagus it may cause pain with swallowing.

  25. Symptoms of Plummer-Vinson syndrome?

    Why: e.g. difficulty swallowing, glossitis (inflammation of the tongue), angular stomatitis (inflammation of the corners of the mouth) and symptoms of iron deficiency anemia ( tiredness, pallor of the skin and eyes). This syndrome is rare and affects mainly women. Cause is unknown.

  26. Symptoms of tonsillitis?

    Why: e.g. very sore throat, fever, swollen neck lymph nodes, malaise.

Conditions listing medical symptoms: Pain swallowing:

The following list of conditions have 'Pain swallowing' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Pain swallowing or choose View All.

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