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How To Overcome Swallowing Anxiety

how to overcome swallowing anxiety

Do you have a fear of swallowing sometimes or you’re looking to overcome the fear of swallowing? You are likely suffering from swallowing anxiety.

Swallowing anxiety or fear of swallowing, also known as phagophobia, is a rare type of disease and anxiety disorder that affects children, young adults and older adults, especially females.

Mostly confused with pseudodysphagia (the fear of choking), phagophobia has a high prevalence rate of co-occurring with panic disorder, obsessive conditions, separation anxiety, life events, and eating traumatic antecedents.

They are a psychological form of dysphagia, a medical condition or difficulty swallowing.

Phagophobia is the avoidance of swallowing food, pills, fluids usually based on fear of choking. It may occur with phobias of vomiting or phobias of contracting an illness.

Pseudodysphagia is the fear of swallowing leading to choking.

People with phagophobia avoid swallowing while those suffering from pseudodysphagia are scared that swallowing will lead to choking.

These conditions can become debilitating to an extent that it causes great distress, social anxiety and fear of fear which can be severe enough to be life-threatening.

Phagophobia happens in a variety of ways in adults, such as feelings of having a lump in the throat and fear of choking, vomiting, fear of eating in public, fear of swallowing leading to choking.

In children, manifestations could vary from crying, spitting out food, gagging, vomiting. These conditions can cause effects such as weight loss, avoidance of eating, malnutrition, social phobia.

What Are The Causes Of Swallowing Anxiety

Fear of eating in public

Phagophobia can spring from the fear of being judged negatively or over-anxiousness on fitting in.

This can create fear of actions such as spilling food, drooling, choking and regurgitating food, appearing in a messy way or being judged a messy eater.

Previous swallowing anxiety

Phagophobia anxiety may occur from previous swallowing anxiety, individuals with preceding experience of choking develop a certain fear of repeated situations.

Globus hystericus

Globus hystericus or Globus pharyngeus is the sensation of having something stuck in your throat with symptoms including frequent throat clearing, lumpy feeling around the throat region and/or mucus in the throat. Stress, anxiety and sometimes underlying medical conditions may cause Globus hystericus.

Precipitated choking episodes

Sudden choking events can also cause phagophobia. Unexpected blockage and / constriction of the lungs airways can induce strangulation and fear of dying therefore resulting in fear and avoidance of swallowing.

How Is Swallowing Anxiety Associated With Choking Anxiety

Swallowing is a complex action achieved with a series of nerves, oesophagus and over 25 muscles. Anxiety causes muscle tensions that stimulate choking and swallowing difficulty.

Swallowing and choking are inseparable because of a need to block off passaging air from the trachea or windpipe to the lungs, therefore inducing difficulty in breathing and choking.

Phagophobia closely relates to choking and mostly used as a synonym of pseudodysphagia.

While phagophobia and pseudodysphagia are closely related, the difference is the nature of fear.

The former, swallowing anxiety originates from deflection in passing through food down the oesophagus and the latter, pseudodysphagia arises from fear of choking from swallowing food.

It is safe to note that although these two conditions are common to eating; they are quite distinct from eating disorders.

Choking anxiety is a constant fear of swallowing solid, semi-solid foods, pills, or liquid with abnormal sensations, as though food will stick to the throat.

Negative thoughts of choking to death, panic attacks, sweating, restlessness, difficulty breathing usually follow it.

Signs You’re Experiencing Swallowing Or Choking Anxiety

You shouldn’t overlook choking sensation in the throat, constant choking feelings either before eating, when you are eating, or just as you are about to swallow because it can be signs of severe swallowing or choking anxiety.

Difficulty swallowing

Do you find it hard to swallow your saliva, food, and fluids?. Difficulty swallowing can be a symptom of phagophobia and underlying medical conditions.

Apprehension before eating and/or medications

People experiencing phagophobia and pseudodysphagia are more likely to be prone to feelings of dread and intense fear before eating or using medications.

Panic attacks

Increased heart rate, sweating, restlessness and difficulty breathing sometimes take place with panic attacks. Attacks are usually subject to certain things.

Weight loss

Abnormal weight loss caused by starvation, loss of appetite, fear and avoidance of swallowing is common symptoms accompanied by choking and swallowing anxiety.

Tension and excess sweating

Abnormal sweating and tension can occur with eating anxiety in public gatherings. This rises from the belief and misconception that others will judge you negatively.

Reluctance eating in public

This can co-occur with other social phobia signs.

Eating in small portions

Fluctuating appetite, loss of appetite, along eating in considerable amounts when unrelated to illness can be your body’s way of signalling the onset of phagophobia or pseudodysphagia.

Other signs of swallowing and / choking anxiety include;

  • Sore throat
  • Neck and/or throat pressure
  • Nausea and regurgitating food
  • Coughing and spluttering when swallowing

How To Overcome Swallowing Or Choking Anxiety

There are specific ways to discard swallowing and choking anxiety following a list of exposure therapy, cognitive-behavioral therapy, and medications.

Cognitive-behavioral therapy

These are activities that focus on relaxation and mindfulness. These activities enlighten you on negative thoughts to alter them and adopt a positive outlook.


Some medications are available to help combat swallowing and choking anxiety as they ease phagophobia by reducing the effects of stress and anxiety.

They are often prescribed for severe disorders only. Seek your doctor’s approval for a prescription that suits your condition best.

Exposure therapy

Exposure therapy involves steadily exposing yourself in small stages to your fears and feared scenarios with the help of your therapist. It helps to manage succeeding anxiety episodes.

Practice relaxed eating

Eat foods that interest you and stick to easily swallowable foods or eat in a relaxed environment. Normalize eating without indulging in other activities at the same time.

Change negative thoughts

Alter negative thoughts or misconceptions of how others see you. Concentrate on positive ideas and mindset, even in challenging situations.

Muscle relaxation procedure

This is a series of techniques that help relax the nerves and throat muscles necessary for eating and swallowing. Speak to your therapist to find the most suitable technique for you.

Change eating and drinking routines

Conform to regular eating and drinking habits and foods that incorporate into your daily activities.

Reduce tension

Stress and anxiety lead to restlessness, apprehension, tensions that affect eating and swallowing habits. Stop worrying and overthinking to reduce tension and anxiety effects.

How Does Anxiety Cause Swallowing Problems

Anxiety disorder is a condition that affects your behavior, attitude, and response to situations. It characterizes nervousness, restlessness, being on edge, inability to relax, intrusive thoughts that may become obsessive.

While anxiety is common in every human, it may become a disorder that affects your body’s overall performance.

Anxiety does not cause phagophobia or pseudodysphagia, however, it can affect the muscles required to swallow.

When you overthink certain actions or experience, it causes these thoughts to become alive in your subconsciousness making you sensitive to similar events.

When this happens, anxiety clouds and overwhelms your mind, making it difficult to concentrate on the little things such as eating, thus making it harder to swallow.

Health conditions worsened by anxiety can also cause difficulty swallowing or leading to choking.

How Does Swallowing Anxiety Lead To Fear Of Choking

Problems during swallowing range from apprehension, tension, restlessness, coughing, choking, and inability to swallow anything. For some people, fear of choking arises just as they are about to swallow, there is an unexpected switch that leads to intense fear and feelings of strangulation while eating, for others, it occurs right before they eat and/or just as they are about to take a spoonful of foods.

Swallowing anxiety can cause problems and fear of choking because of a blockage in the throat, pharynx or oesophagus or underlying medical conditions. Obsessive thoughts and behaviors can also create fear of choking from swallowing.


Swallowing and choking anxiety are types of specific phobia, which is the fear of certain objects, situations, events, or conditions.

These conditions can lead to lifelong problems, including malnutrition and dehydration.

Sometimes people suffering from these conditions have misconceptions that sticking to fluids only will help keep energy, while others become so addicted to alcohol thinking it will help combat or reduce anxiety effects.

Although phagophobia and pseudodysphagia springs from eating, they are, however, not related to eating disorders and can affect anyone of any age, mostly prevalent in women than men.

They can affect your overall functionality, be very detrimental to your medical health, and mental health.

They also occur in children with symptoms such as tantrums, fussiness, picky eating, loss of appetite that are sometimes overlooked.

There is no known cure for phagophobia yet, they can be combated following a series of medications, exposure, acceptance and commitment therapy, and cognitive-behavioral therapy.

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