Severe throat pain after cake at night could be from acid reflux, a scratch/irritation from dry food, or an unrelated throat infection. Reflux is more likely if you also have burning in the chest or throat, sour taste, burping, cough, or symptoms worse when lying down. Reflux can cause throat pain, especially after eating and reclining. [Harrison's Principles of Internal Medicine, 22e]

Go to emergency care now if you have any trouble breathing, cannot swallow liquids or saliva, are drooling, have noisy high-pitched breathing, swelling of the lips/tongue/throat, hives, or symptoms worsening rapidly. These can signal airway obstruction or an allergic reaction. The NHS emergency guidance recommends urgent assessment for these symptoms.

If you can breathe and swallow normally:

Get urgent medical advice today if pain is severe, you have fever, white patches on the tonsils, swollen neck glands, dehydration, persistent vomiting, chest pain, or the pain is not easing. If it continues more than a few days or keeps occurring after eating at night, arrange a clinician visit.

If it is only throat pain and you can breathe and swallow normally, it is usually temporary irritation or reflux.

It should start easing within a few hours to a day. Seek urgent care if you develop trouble swallowing, breathing difficulty, swelling, rash, fever, or if the pain becomes worse or does not improve within 1-2 days.

Yes, Betadine (povidone-iodine) gargle can be used short-term for throat irritation, but it may not be necessary if the pain is only from food irritation or reflux. Cool water and salt-water gargles are gentler options.

If you use it:

Avoid it or ask a pharmacist/doctor first if you have an iodine allergy, thyroid disease, are pregnant or breastfeeding, or take thyroid-related medication. The official Betadine label also says not to swallow it.

If it stings or makes the pain worse, stop and use warm salt-water gargles instead.