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SUMMARY: Çiyiltepe M, Türkbay T. Phagophobia: a case report. Turk J Pediatr 2006; 48: 80-84.
Phagophobia is a form of psychogenic dysphagia. Although it is characterized by a fear and avoidance of swallowing food, fluids, or pills, physical examination and laboratory findings are normal. Here, we present a case of phagophobia, who at 13 years of age was brought to our hospital by his family because of his fear and avoidance of swallowing food and loss of weight. After psychiatric interview, the patient underwent an oral peripheral examination, stroboscopic laryngeal evaluation, the Bedside Swallow Evaluation, and the Modified Barium Swallow Study. His physical examination and all laboratory findings were normal. The management of this case included the combination of behavior therapy and a dysphagia management program. After approximately one month of utilizing these techniques, the case showed considerable improvement.
Key words: phagophobia, organic dysphagia, assessment, behavior therapy, dysphagia management program.
Phagophobia, a fear of swallowing, is a form of psychogenic dysphagia. It is characterized by various significant swallowing complaints with normal physical examination and laboratory findings. In the past, many authors used the term "choking phobia" to describe these patients1. However, choking phobia is a confusing term because patients often do not distinguish difficulties with bolus propulsion versus aspiration; they may refer to either problem as choking, whereas clinicians define choking as a symptom of aspiration. Therefore, Shapiro et al.2 suggested the term "phagophobia", which is more suitable for such patients.
Phagophobic patients show fear and avoidance of swallowing food, fluids, or pills. It is recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a specific phobia in the residual category (i.e., "other"), along with phobias of vomiting or contracting an illness3. Effects of phagophobia can include weight loss, avoidance of eating, and malnutrition. The prevalence of phagophobia is as yet unknown1. case series are usually reported in the literature.
This article presents a child with phagophobia, including clinical features, diagnostic processing, and treatment techniques that proved helpful in symptom relief.
Case Report
The patient was a 13-year-old boy who reported a three-month history of phagophobia. His symptoms, which began whenever he started to eat, included a sensation of his throat tightening, a difficulty initiating swallow, a feeling that food...