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When swallowing causes panic

Fear of swallowing - Phagophobia

Phagophobia or swallowing anxiety is the fear of swallowing. This is usually accompanied by the fear of suffocation (choking phobia).  It should not be confused with globus hystericus or anorexia nervosa. Besides the fear of swallowing food, there may also be the fear of swallowing saliva.

Phagophobia is counted among the specific phobias (ICD: F40.2) and is distinguished from agoraphobia, panic disorder and generalized anxiety disorders. The disorder is also mentioned in DSM-5.

(Kopie 8)

[Translate to Englisch:] Kurze Einführung (Video)

About swallowing fear (phagophobia)

Frequency

The disorder is considered very rare, there is hardly any data and no standardized therapy. In the literature there are mostly single case descriptions or case series with a small number of cases. A somewhat larger number of cases includes a study that collected 41 patients over a period of 27 years. A 2:1 dominance of women and a high association with anxiety and panic disorders as well as compulsions were found. Stressful life events were also frequent.

In our own experience, we have some doubts about these figures, as we have often been involved with the disease pattern in recent years.

Triggering and complaint development

Triggering and complaint development

In practically all cases, the original triggering food is avoided. If there is a fear of solid food, the food is liquefied, i.e. solid food is drunk. Somewhat less frequent is the fear of swallowing liquid food (water, juices, milk, coffee, etc.). Here, too, a threatening experience with drinks is at the beginning. Avoiding drinks is usually more difficult and can be solved by thickening (gelatine), for example. Water is then "eaten".
Both of these methods usually lead to weight loss, are associated with great fears and can be life-threatening.


Causes and background

Phagophobia, breath and panic

We could observe large breathing abnormalities in all patients treated by us. There was more or less pronounced chronic hyperventilation, which explains a substantial part of the accompanying symptoms (panic, tension, dizziness, light-headedness, palpitations, fatigue, exhaustion, pressure on the chest, tightness of the neck, etc.).

The corresponding measured values (especially CO2) were highly conspicuous.

Research

[Translate to Englisch:] Zur Phagophobie-Forschung

Phagophobia or swallowing anxiety is the fear of swallowing. This is usually accompanied by the fear of suffocation (choking phobia).  It should not be confused with globus hystericus or anorexia nervosa. Besides the fear of swallowing food, there may also be the fear of swallowing saliva.

We were able to gain new insights into the fear of swallowing, which lead to better therapy results. Since there is hardly any research in this field, we ask you to fill in an online questionnaire ( if you suffer from fear of swallowing. You will then find the results on youtube or on our pages (www.weiss.de/schluckangst or you can write us an email: schluckangst@weiss.de, if you would like to be informed.

Video: Swallowing for beginners

Therapy

[Translate to Englisch:] Videos: Fallgeschichten

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