Pseudodysphagia: The Fear of Choking
Pseudodysphagia is the fear of choking. Those with this phobia are often afraid of swallowing, but not because of the process of swallowing. Instead, they are afraid that swallowing will lead to choking. The fear of swallowing, phagophobia, is different. Pseudodysphagia can become so severe that it causes malnutrition and malnourishment, interfering with your health. It can cause the constant feeling that there is a lump in your throat, called globus hystericus.
Pseudodysphagia is a psychosomatic illness. It can create the feeling of having a lump in your throat. If you have this fear, you are afraid of choking and may avoid eating solid foods. Some people resort to eating pureed foods, such as baby food, or a liquid diet. This can cause malnourishment. While some people develop this phobia after a choking scare, others can not pinpoint an incident that caused the fear. It frequently develops progressively; as you become more obsessed with the fear, you start to avoid more foods until your health is impacted.
Ruling Out Other Medical Conditions
Before a diagnosis of pseudodysphagia is made, certain medical conditions should be ruled out. Dysphagia causes difficulty swallowing. People with this condition can sometimes experience pain when swallowing. It can be caused by weak muscles in the tongue, cheek or throat. Medical conditions, such as a stroke, can result in dysphagia. It can become serious if you are not able to eat enough food to remain healthy.
Another medical condition, omophydroid muscle syndrome occurs when the muscle in the front of the neck is chronically sore or swollen, making swallowing painful. While this condition is considered rare, it is possible that those diagnosed with pseudodysphagia actually have this condition.
Some medications can also cause throat muscles to constrict. Your doctor should complete a thorough evaluation to determine if there is an underlying medical condition causing your symptoms.
The first step in treatment is to determine if the condition is caused by a medical condition and, if so, to treat that condition. Your doctor might also request blood tests and analyze your nutritional intake and work with you if you are suffering from malnourishment.
There is no specific treatment for pseudodysphagia. Because it often coincides with other mental health issues, such as generalized anxiety disorder or other phobias, your doctor might refer you to a mental health professional for a complete evaluation. Once you have an accurate diagnosis, the mental health professional will work with you on creating a treatment plan, which may include cognitive behavioral therapy or talk therapy.
Your therapist might create a desensitization program, where you are gradually reintroduced to swallowing foods. In the beginning, you might be asked to put a piece of food in your mouth, without swallowing, and, as you get used to swallowing soft foods, foods with more solidity will be slowly introduced. This process is slow and can take weeks or months for you to feel comfortable swallowing foods again.
"Dysphagia," Date Unknown, Staff Writer, National Institute on Deafness and Other Communication Disorders
"Overcoming Eating Phobias," Date Unknown, Staff Writer, Anxiety Care UK