Pseudodysphagia

Pseudodysphagia is the irrational fear of swallowing or choking. The symptoms are psychosomatic in nature. The act of swallowing becomes mentally linked with choking, or with undercapacity of the esophageal opening. This can induce panic reactions prior to or during the act of swallowing. The sensation of difficult swallowing feels authentic to the affected individual, although it is based on nothing in reality. It is important that dysphagia (difficult or painful swallowing) be ruled out before a diagnosis of pseudodysphagia is made. Fear of choking is associated with anxiety, depression, panic attacks, hypochondriasis, and weight loss. The condition can occur in both children and adults, and is equally common among males and females. Quality of life can be severely affected. Avoidance of restaurants or social settings is also common, since sometimes food can only be taken in small bites or with liquid.

Characterization of idiopathic dysphagia as psychosomatic has recently been challenged by published case reports documenting instances of "pseudodysphagia" patients suffering from the little-known entity Omohyoid Muscle Syndrome. Should this syndrome be found to have a spectrum of severity (particularly if mild cases of OMS do not demonstrate the typical transient soft neck mass), the medical community may now need to consider ruling out this subtle but truly somatic etiology prior to arriving at true pseudodysphagia, the latter being essentially a diagnosis of exclusion.

See also

• Phagophobia

References

• Dysphagia Volume 24, Number 3, 357-361, doi:10.1007/s00455-008-9206-8
• Case Report Pseudodysphagia Due to Omohyoid Muscle Syndrome Lina Kim, Heekyu Kwon and Sung-Bom Pyun
• Adrienne Perlman (1997). Deglutition and Its Disorders: Anatomy, Physiology, Clinical Diagnosis. Thomson Delmar Learning. ISBN 1-56593-621-3.