Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Diagnosis and successful visual biofeedback therapy using fiberoptic endoscopic evaluation of swallowing in a young adult patient with psychogenic dysphagia: a case report

  • Youngmo Kim (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Sang Hun Han (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Yong Beom Shin (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Jin A Yoon (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Sang Hun Kim (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital)
  • Received : 2021.10.11
  • Accepted : 2021.12.04
  • Published : 2023.01.31
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Abstract

Psychogenic dysphagia is a deglutition disorder characterized by a fear of swallowing, with no structural or functional causes. This report presents the case of a young male patient who had severe malnutrition due to psychogenic dysphagia and was provided visual biofeedback using fiberoptic endoscopic evaluation of swallowing (FEES). A healthy 25-year-old man presented to our clinic with a complaint of throat discomfort when swallowing that had started 6 months prior. As the symptoms worsened, he became fearful of food spreading to his lungs after swallowing and the development of respiratory difficulties. His food intake gradually decreased, resulting in a weight loss of 20 kg within 2 months. Evaluation of organic and other functional causes of dysphagia was performed, but no abnormalities were detected. The sensation of a lump in his throat, fear of swallowing, and anxiety were transformed into somatic symptoms. The patient was diagnosed with psychogenic dysphagia. After visual biofeedback by a physician who performed FEES, the patient resumed eating normally and increased his food intake. If routine tests do not reveal structural or functional causes of dysphagia, assessment of a psychogenic swallowing disorder should be considered. FEES can help in the diagnosis and management of psychogenic dysphagia.

Keywords

Acknowledgement

This work was supported by a clinical research grant from Pusan National University Hospital in 2021.

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