Why does it feel like you have been choked? (+3 reasons)

In this article, we will discuss different factors which may cause a feeling of being choked. We will also discuss how your lifestyle and psychological well-being may play a role in such feelings. 

Why does it feel like you have been choked?

Obstruction of the airways sometimes gives the feeling of being choked. The obstruction might be caused by psychological factors, underlying disease conditions, and lifestyle factors.

Psychological factors are one of the most common reasons for having a feeling of being choked. Patients who get frequent panic attacks, are under stressful conditions or had previous bad experiences of being choked might trigger these sensations.

Sometimes heartburn, acid reflux, angina, and oesophagal spasms may cause choking sensations. Diseases of the throat involving thyroid glands, vocal cords, larynx, and pharynx may also induce such feelings.

Your posture, obesity, and smoking habits may trigger sensations of being choked. These sensations prevail even when you are not choking. Therefore, consult your psychiatrist for proper guidance and maintenance of such symptoms.

What factors cause a feeling of being choked?

Some psychological conditions, underlying diseases and lifestyle activities may cause a feeling of being choked.

Psychological factors

Due to a manic episode, you may have a choking sensation in your neck and throat. You may experience dizziness, lightheadedness, or a fear of death. Similarly, people with anxiety and depression may have throat tightness or the sensation that something is stuck in their throat.

The underlying condition is known as Globus sensation and has nothing to do with eating. The patient often gets the feeling of getting choked. Choking sensation may also prevail due to phobia. Pseudodysphagia is an irrational and psychological fear of swallowing or, in its milder version, of choking. 

Due to post-traumatic stress disorder (PTSD), you may get a phobia of choking on food due to a previous mishap. In one of the case reports, five children developed PTSD after getting choked with food previously. Their choking anxiety appeared to symbolize a dread of death and separation from their parents (1).

Underlying disease condition

The feeling of being choked is sometimes caused by the underlying disease. Gastrointestinal reflux disease (GERD) may cause swallowing difficulties and throat tightening, which gives the sensation of being choked.

Allergic reactions may cause blockage or oedema in the throat. This gives a feeling of being choked. The body’s response to allergies might result in enough mucus to clog or restrict the oesophagus. This produces inflammation, pain and choking.

Vocal cord paralysis and dysfunction prevent the airway from fully opening or closing. This may cause aspiration (inhalation of food and liquid), or feeling of being choked. Hiatal hernia is also known to place unnecessary strain and twisting of the stomach.

Oesophagal spasms are painful contractions of the oesophagus that may restrict the movement of food down the stomach. In some cases, the thyroid gland may become enlarged due to various thyroid disorders such as goitre. You may feel that something is stuck in your throat.

You may experience choking if you have a heart problem. Angina causes tightness or pain which can occasionally be felt in the throat. Because of the pressure, the stomach may hold acid, which may flow up into the oesophagus. The patient may experience GERD, heartburn, the feeling of being choked, and difficulty in breathing.

Lifestyle factors

Sometimes the lifestyle conditions and factors illicit a feeling of being choked. Chronic cigarette smoking may impair the contractile reflex of the pharynx-upper oesophagal sphincter. Choking feelings are also common in patients who are obese. Extra fat around the neck, chest, or belly might make it harder to breathe deeply.

You may also get strangling feelings due to exercise-induced laryngeal obstruction (EILO) and exercise-induced bronchoconstriction (EIB). EILO is described as an abnormal constriction of the upper airways around the glottis and above the vocal cords.

Head flexion and extension have been proven to reduce airway and oesophagal airways. In addition, cervical spine disorders such as hyperlordosis, scoliosis, and lordosis can obstruct the airways, leading to the feeling of being choked.

If you have obstructive sleep apnea (OSA), it may cause the blockage of airways, resulting in breathing pauses. When the airways become obstructed, the oxygen levels drop, causing a feeling of being choked, coughing, and gasping for air.

How to prevent and manage the feeling of being choked?

Although the feeling of being choked is a psychological factor, treating or managing the underlying cause may prevent such sensations. A healthy lifestyle modification like quitting smoking, improving posture, and avoiding stressful conditions may reduce choking sensations.

Getting enough sleep and adopting sleep hygiene may eliminate the chances of choking feelings. It is important to lose weight and improve your diet. Some clinical intervention may be recommended by the doctor to reduce the occurrence of choking, including:

  • Antacid: Treating GERD and acid reflux with antacids may help. Examples include Gaviscon and Peopto Bismol.
  • Antihistamines: These can be used to reduce breathing difficulties and the feeling of choking. Examples include cetirizine and fexofenadine.
  • Benzodiazepines: They are commonly prescribed for panic attacks, phobias, and anxiety. Examples include lorazepam and alprazolam.
  • Antidepressants: Certain antidepressants may reduce panic attacks and anxiety disorder. Examples include Prozac (fluoxetine), and Effexor (venlafaxine).

However, they may cause drug-induced insomnia. Therefore, the side effects should be monitored to reduce the occurance of choking feeling.

During GERD, I often woke yp with bitter acid feeling, heartburn, and feeling of getting choked. However, the symptoms begin to improve once I started taking antacids. You should never ignore such symptoms if they occur frequently. 

Often these symptoms may reflect serious pscyological trauma. Cognitive behavioral therapy, and expoure therapy may decrease these feelings.

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Chatoor I, Conley C, Dickson L. Food refusal after an incident of choking: A posttraumatic eating disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 1988 Jan 1;27(1):105-10. https://www.sciencedirect.com/science/article/abs/pii/S0890856709653624