Coping With Pseudodysphagia

Man clapping choking woman on the back
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Pseudodysphagia, or the fear of choking, is sometimes confused with phagophobia, or the fear of swallowing. Although both conditions involve the act of swallowing, the difference is in the precise nature of the fear. Those with phagophobia are afraid of the swallowing process, while those with pseudodysphagia worry that swallowing might lead to choking.

Some medical conditions also cause difficulty with swallowing and eating, so before self-diagnosing with a fear of choking, it is important to rule out physiological causes like certain neurological issues and conditions of the esophagus.

Pseudodysphagia and Eating

People with pseudodysphagia often have difficulty eating solid foods. Anxiety and tension cause throat muscles to constrict, which (somewhat ironically) further increases the chance of choking.

Many people find that excessive chewing and swallowing each bite with a large sip of liquid can help to ease their symptoms. Those with a more severe fear, however, may need to resort to shakes, baby food, and purees, or even subsist on a liquid diet.

In the era of food processors and high powered blenders, it's not impossible to maintain optimal health on a liquid diet, but over time, those who are less knowledgeable about the various facets of nutrition may experience malnutrition. For this and many other reasons, it's very important to treat pseudodysphagia as soon as possible.

Pseudodysphagia and the Dentist

Many people who do not otherwise suffer from pseudodysphagia are afraid of choking during or after a dental procedure. Those who have a more generalized fear of choking may find it difficult or impossible to visit the dentist at all. These fears often contribute to a more generalized fear of dentists.

Common dental choking fears include choking on saliva, choking on dental instruments, and choking on gauze. Some people are afraid that they will be unable to breathe or swallow while their mouths are numb. Many people find that their fears worsen when the chair is tipped all the way back.

If you are concerned about choking at the dentist's office, discuss your concerns with the dentist in advance. Dentists are used to dealing with people with all sorts of fears, and most have action plans ready to go.

In addition, set up a system for communicating your needs to the dentist during your procedure, such as raising your left hand to request suction. While dental procedures are never fun, honesty and open communication make the experience a bit easier for everyone.


If simply avoiding some foods is all that's needed to keep your pseudodysphagia at bay, then there's probably no need for therapy. But if your phobia is significantly interfering with your day-to-day life, relationships, and profession, or causing distress, make plans to see a mental health professional. With a bit of hard work, there is no reason for the fear of choking to take over your life.

3 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Philpott H, Garg M, Tomic D, Balasubramanian S, Sweis R. Dysphagia: thinking outside the boxWorld J Gastroenterol. 2017;23(38):6942–6951. doi:10.3748/wjg.v23.i38.6942

  2. Sahoo S, Hazari N, Padhy SK. Choking phobia: an uncommon phobic disorder, treated with behavior therapy: a case report and review of the literatureShanghai Arch Psychiatry. 2016;28(6):349–352. doi:10.11919/j.issn.1002-0829.216055

  3. Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature reviewClin Cosmet Investig Dent. 2016;8:35–50. doi:10.2147/CCIDE.S63626

Additional Reading
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). Arlington, VA: American Psychiatric Publishing, Inc.

By Lisa Fritscher
Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics.