Yes, you can develop lesions similar to ulcers in your throat, specifically in the pharynx and the esophagus, the tube connecting the throat to the stomach. An ulcer is an open sore that forms when the protective lining of a mucous membrane breaks down, exposing the underlying tissue. In the throat region, these sores result from damage to the delicate epithelial cells lining the upper digestive tract. While the public refers to these as “throat ulcers,” they often involve distinct conditions affecting the pharynx or the esophagus.
Confirming Ulcers in the Pharynx and Esophagus
The term “throat ulcer” generally describes an open sore occurring anywhere in the pharynx, larynx (voice box), or esophagus. Medically, these lesions are precisely known as pharyngeal or esophageal ulcers, the latter being a type of peptic ulcer. The esophagus is particularly susceptible to these painful erosions because they disrupt the mucosal barrier.
These lesions are distinct from common oral canker sores (aphthous ulcers), which occur on non-keratinized tissue inside the mouth and are not contagious. Ulcers in the pharynx or esophagus typically signal a deeper underlying issue, such as chronic acid exposure or systemic infection. Unlike canker sores, which usually heal on their own, pharyngeal or esophageal ulcers often require medical intervention to address the root cause.
Triggers: Common Causes and Risk Factors
The breakdown of the protective mucosal lining in the throat and esophagus results from several mechanisms. The most frequent cause of these sores is chronic chemical irritation, primarily from stomach acid.
Chemical Irritation
Gastroesophageal Reflux Disease (GERD) is a leading cause of esophageal ulcers, where stomach contents repeatedly flow back into the lower esophagus. The powerful hydrochloric acid and digestive enzymes cause a severe inflammatory reaction called reflux esophagitis. Persistent exposure erodes the esophageal lining, eventually leading to a deep, open sore. These acid-related ulcers often form near the junction where the esophagus meets the stomach.
Medication-Induced Injury
Certain oral medications can directly injure the esophageal lining, a condition known as pill esophagitis. This occurs when a pill lodges or slowly dissolves in the esophagus instead of passing quickly into the stomach. Caustic medications include some antibiotics (doxycycline and tetracycline) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Taking pills without enough water or lying down immediately after ingestion increases the risk of this chemical burn and subsequent localized ulceration.
Infections
Infectious agents can directly damage the throat and esophageal tissue, particularly in individuals with weakened immune systems. Viral infections, such as Herpes Simplex Virus (HSV) or Cytomegalovirus (CMV), can cause painful esophageal ulcers. Fungal infections, most commonly Candida albicans (thrush), can also create white patches and superficial ulcers, especially after prolonged antibiotic use or in people with conditions like HIV.
Physical Trauma
Less common triggers include acute physical injury or thermal damage. Swallowing extremely hot liquids or caustic household chemicals can cause immediate and severe tissue necrosis and ulceration. Injury from medical procedures, such as an endoscopy, or the prolonged presence of a nasogastric tube can also mechanically stress the mucosal layer, leading to traumatic ulcers.
Diagnosis, Treatment, and When to Seek Help
Diagnosis begins with evaluating symptoms like painful swallowing (odynophagia) or difficulty swallowing (dysphagia). A healthcare provider typically recommends an upper endoscopy, the most definitive diagnostic tool, where a thin, flexible tube with a camera inspects the lining of the esophagus and stomach.
The endoscopist determines the size and location of the sore and takes a biopsy for laboratory analysis. The biopsy confirms the ulcer’s presence and identifies the underlying cause, such as infection or cellular changes related to chronic acid damage.
Treatment depends on the identified cause. GERD-related ulcers are managed with acid-suppressing medications (PPIs), which reduce stomach acid and allow tissue to heal. If infection is the culprit, treatment involves targeted antivirals, antifungals, or antibiotics. Lifestyle modifications, including avoiding acidic foods, not eating close to bedtime, and elevating the head of the bed, support healing.
Seek immediate medical attention if you experience signs of a severe complication. Warning signs include:
- Vomiting blood.
- Passing dark, tarry stools.
- Experiencing severe chest pain.
- Persistent difficulty or pain with swallowing that prevents adequate food or liquid intake, or an ulcer that does not heal after two to three weeks.