Overcoming Swallowing Anxiety: Your Throat Discomfort

When swallowing, there is always a concern about choking, which leads to swallowing forcefully?

Hello doctor, I am currently 20 years old and have never had any swallowing issues before.
However, last month I choked on some noodles, and since then, I have been worried about choking while eating, which has made swallowing feel very effortful.
Three days ago, after eating dumplings, I felt a sensation of something stuck at the left side of my tongue root near the throat, but there was no pain.
After a few days, that sensation disappeared, but sometimes when I swallow saliva or drink water, I still feel that sensation in that area, while at other times I do not.
As a result, I currently feel like I have to exert a lot of effort to swallow, which has decreased my appetite and significantly reduced my food intake.
I would like to ask the doctor, based on the swallowing issues described above, what could be the possible problem?

Chun-Jia, 20~29 year old female. Ask Date: 2021/12/13

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you are concerned, you may visit an otolaryngologist or a gastroenterologist for an examination.
If no significant abnormalities are found, it is recommended to maintain a normal diet and avoid excessive straining while swallowing to prevent discomfort in the throat muscles.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/12/13

More Info

Swallowing anxiety, often referred to as "dysphagia," can be a distressing experience, especially when it arises suddenly after an incident like choking. Your situation, where you previously had no swallowing issues but developed anxiety after choking on noodles, is not uncommon. This phenomenon can lead to a cycle of fear and discomfort that exacerbates the problem.

When you choke, your body can develop a heightened sensitivity to the act of swallowing. This is a protective mechanism; however, it can also lead to increased anxiety about eating and drinking. The sensation of an "object" or discomfort in the throat, particularly on the left side near the base of the tongue, can be attributed to several factors:
1. Muscle Tension: Anxiety can cause muscle tension in the throat, making swallowing feel more laborious. This tension can create a sensation of tightness or discomfort, which may feel like an obstruction.

2. Psychological Factors: The fear of choking again can lead to hyper-awareness of bodily sensations. This heightened state of alertness can make normal swallowing feel abnormal, as you may be overly focused on the act itself.

3. Post-Choking Sensitivity: After a choking incident, it’s common for individuals to experience a temporary change in their swallowing reflex. This can manifest as a feeling of something stuck in the throat, even when there is nothing physically obstructing it.

4. Gastroesophageal Reflux Disease (GERD): Sometimes, anxiety can exacerbate conditions like GERD, which can lead to sensations of discomfort in the throat. If you experience heartburn or acid reflux, it might be worth discussing with a healthcare provider.

5. Physical Examination: It’s essential to rule out any physical issues. A healthcare provider may perform a physical examination or recommend a swallowing study to assess your swallowing function and ensure there are no underlying issues.

To address your swallowing anxiety, consider the following strategies:
- Mindfulness and Relaxation Techniques: Practicing mindfulness can help reduce anxiety. Techniques such as deep breathing, progressive muscle relaxation, or meditation can help calm your mind and body, making swallowing feel less daunting.

- Gradual Exposure: Gradually reintroducing foods that you enjoy can help desensitize your anxiety. Start with softer foods that are easier to swallow and gradually progress to more challenging textures as you become more comfortable.

- Cognitive Behavioral Therapy (CBT): If your anxiety persists, seeking help from a mental health professional trained in CBT can be beneficial. This therapy can help you reframe negative thoughts about swallowing and develop coping strategies.

- Hydration and Nutrition: Ensure you stay hydrated and maintain a balanced diet. If you find it challenging to eat solid foods, consider smoothies or soups that are easier to swallow.

- Consult a Specialist: If the sensation of discomfort continues or worsens, it may be wise to consult an otolaryngologist (ear, nose, and throat specialist) or a gastroenterologist. They can provide a thorough evaluation and determine if any medical intervention is necessary.

In conclusion, swallowing anxiety can significantly impact your quality of life, but with the right strategies and support, you can overcome it. Remember that you are not alone in this experience, and seeking help is a positive step toward recovery.

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