Many acute illnesses, particularly infections, involve the throat. We all know the ‘classic’ sore throat that may even occur several times a year, often with a cold or the flu. The discomfort or pain in a sore throat can vary in nature. Sometimes it feels like a burning sensation or burning pain. However, there are many other non-infectious causes of a burning throat such as digestive conditions, allergies and even trauma to the throat although the cause may not always be obvious. It is important to understand what a burning throat may mean, how it is caused and what other symptoms to look out for in order to identify a possible cause.
Meaning of Burning in the Throat
The throat (pharynx) is part of both the respiratory tract and digestive tract. Air moves in an out of the lungs via the throat. Similarly food and fluids also transits through th e throat. A small flap of tissue known as the epiglottis closes the passage to the lungs when food or fluids enter the throat and are swallowed. This prevents food and fluids from entering the lungs. Problems in the throat can therefore be due to respiratory and digestive issues. Due to the close proximity to the oral cavity (mouth), throat symptoms may also be due to dental problems at times.
There are a number of different sensations that may be experienced when the throat is irritated or injured. Pain is a broad term to describe significant discomfort and is often used with other terms like soreness or aches. However, the nature of pain may vary. Sometimes it feels like a burning pain or just a burning sensation although not pain as such. It is usually a sign of inflammation which may be due to a host of possibilities, such as mechanical or chemical trauma or infections.
Inflammation is the body’s mechanism to protect itself against injury. It presents as pain, swelling, heat and redness. The inflammatory process is triggered by an insult or perceived threat. For example, if a corrosive chemical makes contact with delicate living tissue then inflammation is triggered. Sometimes inflammation is triggered by the immune system in response to harmful bacteria (infections) or harmless substances (allergies). There are also instances where inflammation is initiated for no clearly identifiable reason.
A burning throat usually means that the throat is inflamed for some reason.
Causes of Burning Throat
Both mechanical and chemical injury to the throat can lead to burning. Mechanical causes can include placing objects in the throat to initiate vomiting (purging in eating disorders), deep vigorous brushing with a toothbrush, swallowing non-edible items or hard foods without chewing and during medical procedures (iatrogenic) among other causes. Chemical trauma may be due to consuming corrosive substances, tobacco chewing and a very common cause is from stomach acid due to vomiting or acid reflux. Smoke inhalation can also cause throat injury which may be due to both heat and the noxious substances in the smoke. Repeated coughing can also injure the throat.
Viral and bacterial infections are among the more common infectious causes that may lead to a burning throat. Possible causes have been discussed further under sore throat. The tonsils are located in the throat (pharynx) and collectively inflammation of these areas is known as tonsillopharyngitis. It commonly occurs as a part of viral upper respiratory tract infections (URTIs) with the flu and common cold. Strep throat is another common throat infection caused by streptococci bacteria. Fungal throat infections are rare although it may occur together with oral candidiasis (mouth thrush) especially in people with a weakened immune system. Dental infections may also involve the throat.
A number of allergic conditions may involve the throat as well. With the throat being connected to the nose (nasopharynx) and the middle ear (via the eustachian tube), allergic conditions in these areas could also affect the throat. The inflammation is a result of the immune system reacting to otherwise harmless substances. In allergic rhinitis, the inflammation and excessive mucus can also drain into the throat over long periods and irritate it. This is part of post nasal drip. People with allergies involving the respiratory tract are also more prone to infections which may present as repeated sore throat.
Reflux and Vomiting
Although acid reflux and vomiting have been briefly mentioned under chemical trauma, these two conditions are such a common cause of a chronic sore throat that it requires further discussion. Acid reflux, also known as gastroesophageal reflux disease (GERD) is a very common digestive condition. It typically causes heartburn and related symptoms but in silent acid reflux these symptoms may not always be present. Instead vague symptoms like a morning sore throat may be present since reflux tends to worsen at night while sleeping.
Everybody experiences vomiting now and then with a stomach bug (gastroenteritis) or food poisoning. The contents of the stomach, which includes acid and strong digestive enzymes, can injure the throat. Repeated vomiting may occur with pregnancy and a persistent sore throat may be present. With eating disorders like bulimia, the repeated vomiting coupled with purging methods like sticking a finger down the throat can cause both chemical and mechanical injury to the throat.
Burning Throat and Other Symptoms
A burning sensation or pain in the throat is a symptom and not a condition. Many other symptoms may also occur simultaneously. These other symptoms can vary depending on the underlying cause. Other throat symptoms that may occur with a burning throat include:
- Difficulty swallowing
- Painful swallowing
- Hoarse voice or a whispery tone
- Pain when talking
- Itchy throat
- Redness of the throat
- Swollen tonsils
With upper respiratory tract infections there may also be other symptoms such as:
- Swollen neck lymph nodes
- Runny nose and sneezing
- Coughing (dry or productive)
- Watery eyes
With digestive-related conditions that may cause a burning throat there may also be:
- Nausea with or without vomiting
- Changes in appetite
- Worsening of symptoms after eating
- Weight loss (if severe or prolonged)
- Abdominal pain
- Diarrhea (sometimes)
- Excessive belching