It is possible to develop open sores, known as ulcers, within the throat (pharynx) and the esophagus, the tube leading to the stomach. An ulcer is a lesion that forms on the mucous membrane lining these structures, representing a break in the protective tissue layer. This injury often causes significant localized pain and discomfort, making routine actions like swallowing food or even saliva intensely difficult.
Identifying Ulcers in the Throat
Throat ulcers manifest with symptoms distinct from the general scratchiness of a common viral sore throat. The most telling symptom is severe pain experienced during swallowing, medically termed odynophagia, which is disproportionate to a typical infection. This sensation can feel like a sharp or burning pain that persists even when not actively swallowing. Patients may also notice visible lesions in the back of the throat or on the tonsils, appearing as whitish or yellowish patches surrounded by a red, inflamed border. Ulceration can frequently be accompanied by systemic signs such as a fever or noticeable swelling of the lymph nodes in the neck.
Common Sources of Pharyngeal Ulceration
The formation of ulcers in the pharynx or esophagus stems from a variety of causes, which are broadly categorized as infectious or non-infectious. A frequent non-infectious source is Gastroesophageal Reflux Disease (GERD) or Laryngopharyngeal Reflux (LPR). In these conditions, stomach acid repeatedly flows backward and chemically erodes the delicate lining of the lower pharynx and esophagus, leading to ulceration.
Infectious agents are also a common culprit, particularly viruses. The Herpes Simplex Virus (HSV), often associated with cold sores, can cause multiple ulcers in the esophagus, a condition known as herpetic esophagitis, which is more common in individuals with weakened immune systems. Another viral cause is Coxsackievirus, which causes a childhood illness called Herpangina, characterized by blistering sores on the soft palate and pharynx.
Less commonly, bacterial or fungal infections can also lead to ulceration in the throat. Fungal infections, such as oral thrush caused by Candida species, can sometimes extend into the pharynx, causing painful lesions. Certain oral medications can directly injure the mucosal lining if they dissolve slowly in the throat or become lodged in the esophagus.
Medications such as certain non-steroidal anti-inflammatory drugs (NSAIDs) or specific antibiotics like doxycycline have been documented to cause localized chemical injury, resulting in a distinct medication-induced ulcer. Physical trauma provides another pathway for ulcer development, such as injury from aggressive coughing, vomiting, or the friction caused by medical procedures like endotracheal intubation. Finally, ulcers can arise as a side effect of cancer treatments, notably chemotherapy and radiation therapy, which damage rapidly dividing mucosal cells.
Medical Treatment and Recovery
Identifying the specific cause begins with a thorough physical examination and patient history review. Specialized tests, such as a throat swab for culture, may be necessary to confirm the diagnosis. If an ulcer is suspected in the esophagus, an upper endoscopy (EGD) may be performed. During an EGD, a flexible tube is used to visually inspect the lesion, and a biopsy may be taken for laboratory analysis, including viral cultures or PCR assays. The treatment plan is then tailored precisely to the underlying cause.
Reflux-related ulcers are typically managed with acid-suppressing medications, such as Proton Pump Inhibitors (PPIs) or H2 blockers. If a viral infection like HSV is the confirmed cause, a course of antiviral medication, such as acyclovir, will be prescribed to speed up healing. Bacterial or fungal ulcers require targeted antibiotics or antifungal agents to eliminate the pathogen.
Symptom management is a major focus of the recovery process. Pain can be controlled with over-the-counter pain relievers or a medicated mouth rinse containing a local anesthetic, like lidocaine, to temporarily numb the affected area before eating. Patients are advised to adhere to a bland, soft diet, avoiding anything spicy, highly acidic, very hot, or rough, as these can further irritate the open sore. Maintaining hydration by drinking cool, non-acidic liquids is strongly encouraged to promote healing.