Phagophobia: A Pathological Fear of Swallowing

Phagophobia involves an intense and irrational fear of swallowing and choking. Find out what sufferers feel and what can be done about it.
Phagophobia: A Pathological Fear of Swallowing
Elena Sanz

Written and verified by the psychologist Elena Sanz.

Last update: 17 March, 2023

For most people, eating is one of life’s great pleasures. Indeed, not only do we enjoy food, but much of our interactions and social gatherings revolve around food and drink. However, for some people, these moments are a true ordeal and generate high levels of anxiety. That’s because they suffer from an intense fear of choking. It’s known as phagophobia.

This condition can affect people of all ages and interferes significantly with their daily lives.

Imagine not being able to eat certain solid foods, feeling really nervous when it comes to drinking water, or not even being able to swallow your own saliva. As you can imagine, such a situation causes great discomfort and requires professional intervention if the sufferer is to recover their quality of life.

man with nervous dysphagia
Professionals treat phagophobia with psychological therapy.


Difficulty or inability to swallow solid and liquid foods is called dysphagia. In these cases, swallowing becomes extremely difficult. Moreover, sufferers might aspirate food into the trachea, and may experience coughing, choking, or vomiting.

Dysphagia is a medical condition that usually has an organic origin. This means it’s related to physical injuries, diseases, or neurological disorders. However, in some cases, these difficulties have a psychological origin.

Phagophobia is, as the name suggests, a phobia. Sufferers experience an intense, persistent, and apparently irrational fear of swallowing. The sufferer fears choking and even senses their throat narrowing. This isn’t only a subjective perception. In fact, it may be that, due to their anxiety, the muscles in the area become tense. They also experience the sensation of having a dry throat.

This also generates an anticipatory fear. It leads to a concern regarding mealtimes and, in many cases, a refusal to eat or drink.

The causes of phagophobia

Phagophobia is a relatively rare disorder. It’s estimated to affect approximately one in 500 people. It’s more common in childhood. That said, it can also occur in adults with extreme difficulties in swallowing control. But, if there’s no physical cause that can account for this intense fear, why does it occur?

In most cases, it’s related to a previous episode in which the individual choked, inhaled food, vomited, or had some type of traumatic experience related to swallowing. It can also be caused by the sufferer witnessing another person experiencing it or hearing about an episode of this nature.

Therefore, the sufferer associates the moment of eating food or liquids with feelings of stress, tension, and fear. Moreover, they experience fear and great anxiety in the face of the possibility of it happening again.

In the case of children, the parents’ exaggerated fear of choking, and their consequent overprotection may also be related. However, in some cases, there’s no prior episode or clear trigger.

The consequences of phagophobia

Suffering from phagophobia has consequences at the physical, psychological, and social levels. They’ll depend on the severity of the fear, but, as a rule, they’re as follows:

  • Due to the sufferer’s rejection of eating or drinking, they can suffer malnutrition and dehydration to different degrees.
  • There may be significant weight loss.
  • Anxiety can produce physical and physiological symptoms. For example, dry mouth and throat, muscle tension, sweating, or tachycardia. These symptoms tend to appear early on.
  • The sufferer experiences significant worries and fears. They cause them anxiety and discomfort and reduce their self-esteem.
  • The sufferer’s social and relational plane is also affected. For instance, sufferers of phagophobia might avoid eating in the presence of others or do so only with highly trusted people.
Children with eating problems
The most common trigger for dysphagia in children is a choking episode.

Treatment and intervention

The life of the phagophobia sufferer is affected in different ways. In addition, their feelings of well-being are diminished by the disorder. Fortunately, the collaboration of various professionals (doctors, speech therapists, psychologists, etc) can aid recovery.

As a rule, interventions are aimed at proposing vocal exercises or stretching to improve muscle control. Professionals might also recommend an adapted diet at the early stages, to help the sufferer gradually progress.

Psychology seeks to work with irrational thoughts and offer appropriate relaxation techniques. They also use strategies to control attention. This allows the sufferer to divert their focus from the act of swallowing, thus reducing their anxiety.

In the case of children, the collaboration of parents is crucial. Indeed, they must try to remain calm and not overemphasize the child’s problem, so as not to aggravate the association between mealtimes and psychological discomfort.

While every case of phagophobia is different, it’s always essential to seek professional support to overcome it.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Begotka, A. M., Silverman, A. H., & Goday, P. (2021). A multidisciplinary approach to the management of phagophobia. Children’s Health Care50(2), 192-206.
  • Shan, A., Escribano, E., Goretti, M., Camarneiro, R., Villaseñor, A., & Jiménez, R. (2020). Fagofobia en la infancia y adolescencia: serie de casos en un hospital pediátrico de tercer nivel. En I Congreso Digital Asociación Española de Pediatría.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.