Odynophagia natural history, complications and prognosis

If left untreated, patients with odynophagia may progress to develop weight loss, malnutrition, and food aversion. Prognosis is generally excellent, and the mortality/survival rate of patients with odynophagia depend on the primary cause.

• If left untreated, patients with odynophagia may progress to develop weight loss, malnutrition, and food aversion.
• However the causes of odynophagia have their own independent course of progression and complication. 

• Common complications of odynophagia depend on the treatment and progress of primary disease, which may include:
  • URTI: LRTI, toxemia, meningitis, pneumonia, otitis, orbital infections, systemic infections, encephalitis.
  • GERD: Stricture,weight loss, Barrett’s esophagus, erosive esophagitis, esophageal ulcer, esophageal adenocarcinoma.
  • Tumor: Metastasis, narrowing of food passage, weight loss, DVT.
  • Foreign body: local inflammation, non invasive and invasive infections.
  • Esophagitis: Weight loss, superimposed bacterial infections, stricture.

• Prognosis is generally excellent, and the mortality/survival rate of patients with odynophagia depend on the primary cause.
  • Tumors: Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. Adenocarcinoma has better prognosis compared to squamous cell cancers.
  • URTI: Prognosis is generally excellent. Viral URTI’s have better outcomes compared to bacterial URTI’s.
  • GERD: Prognosis is generally good. If untreated 20% may develop esophageal strictures.^[1]
  • Foreign body: Prognosis is generally excellent, if foreign body is removed in a timely manner.
  • Esophagitis: Prognosis is generally good. It depends mostly on the cause of esophageal inflammation. Viral infections recover earlier with less complications compared to autoimmune, bacterial and chemical causes.

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