Choking phobia (1756)

Key points below

What is choking phobia?

Choking phobia is a fear of eating, drinking or taking pills. It is also called Pseudodysphagia.  There is nothing wrong with the child’s throat.  They fear that swallowing will cause pain or discomfort. Choking phobia is diagnosed after testing to be sure there is no problem with swallowing.  Swallowing problems are called dysphagia.

What causes choking phobia?

This fear often starts after something painful or scary happens in or around the mouth.  This might happen after choking on food or having dental work.  It can also happen after an illness like strep throat, hand foot and mouth infection, or flu. 

What are the symptoms?

Your child may:
be afraid, cry or not want to eat or drink, even their favorite things.
spit out foods and their own spit.
have trouble swallowing.
only want liquids or smooth foods.

How can I help my child at home?

Offer your child small amounts of:
preferred liquids.
popsicles or ice cubes to suck on.
tastes of smooth broth or soups.
dips, sauces or smooth foods.
Then try to work up in amounts that they swallow.  Do this over time when they feel comfortable.

When should I get help for my child?

Call your child’s doctor if you are worried your child is not eating well or has choking phobia.
The doctor will review your concerns and help decide next steps. Call your child’s doctor right away if your child: 
is very tired, weak, or can not wake up easily.
has dry lips and tongue or not peeing as often as normal.
will not eat or drink for more than 2 days.
is losing weight. 
can not swallow their own spit.

What tests might need to be done?

The doctor will check your child and may order blood tests. Your child may need an endoscopy to look down their throat.  Video may be used to see how your child swallows.  This is called a video swallow study.  These may be done in the hospital or as an outpatient. 

How is choking phobia treated?

The best care for choking phobia is with a therapist at a feeding therapy clinic. In this therapy, the feeding therapists give the child different foods and teach them how to cope with their fear. This therapy helps the child begin to feel safe to eat foods.  They will do this until they can eat a normal diet.  This can take time.
For children who are 8 years or older, the therapist may also use cognitive therapy.  This therapy teaches the child how to cope with the fear. 
Some children may also need medicine. It may be to increase hunger or decrease their anxiety.  Your child’s provider will talk to you if this is needed. 

What happens after therapy?

Choking phobia is often short term. After therapy, children are able to eat normally.  Other therapies may be needed if there are more mental health issues or picky eating problems. 

Other teaching sheets that may be helpful
#1670 Anxiety Disorders in Children 
#1671 Anxiety Disorders in Adolescents 


Call your child’s doctor, nurse, or clinic if you have any concerns or if your child:
becomes light headed, dizzy, sick to their stomach or faints. 
can not stop throwing up. 
gets dehydrated. Watch for dry lips and tongue, less tears or spit and not peeing as often as they used to.
is losing weight quickly.
shows an increase in feelings of hopelessness and helplessness, talks about wanting to hurt themselves or death, or shows increasingly reckless behavior. 
has special health care needs not covered by this information.