Mold Exposure Does Not Cause Oropharyngeal Dysphagia with Throat Closure Sensation
Mold toxicity is not a recognized cause of oropharyngeal dysphagia characterized by a sensation that the throat closes with each bite. The symptoms you describe—throat closure sensation with swallowing—are consistent with functional dysphagia or globus pharyngeus, which are well-defined functional disorders unrelated to mold exposure 1.
Established Health Effects of Mold Exposure
The documented health effects of mold are limited to specific immune-mediated and infectious conditions:
Mold exposure causes asthma exacerbations, allergic rhinitis, allergic bronchopulmonary aspergillosis, allergic fungal sinusitis, and hypersensitivity pneumonitis through IgE-mediated and other immune mechanisms 1.
The most common symptoms in mold-exposed patients include rhinitis (62%), cough (52%), headache (34%), respiratory symptoms (34%), and fatigue (23%)—but not dysphagia 2.
Mold metabolites may act as irritants and contribute to "sick building syndrome," but the cause-and-effect relationship between inhalational mold exposure and systemic health complaints beyond respiratory and allergic conditions requires additional investigation 1.
Your Symptoms Match Functional Dysphagia, Not Mold Toxicity
The sensation of throat closure with each bite is a hallmark of functional oropharyngeal dysphagia:
Functional dysphagia presents with symptoms of "globus" (a feeling that it is "hard" to swallow) and patients often describe the throat closing or tightening, particularly during eating 1.
Positive diagnostic features include inability to swallow in the absence of drooling or excessive oral secretions, and inability to control anything in the mouth but ability to spit saliva into a cup 1.
Fear of choking is common, and patients adopt avoidance behaviors such as reducing food intake, changing head postures, eating slowly with raised bodily tension, and social avoidance 1.
Functional dysphagia is more often oropharyngeal rather than esophageal because oropharyngeal musculature is under voluntary rather than autonomic control 1.
What Actually Causes Oropharyngeal Dysphagia
The recognized causes of oropharyngeal dysphagia with throat symptoms include:
Neurologic conditions: stroke, Parkinson disease, dementia, motor neuron disease, myopathy, and head trauma are the most common causes of oropharyngeal dysphagia 3, 4.
Structural lesions: Zenker's diverticulum, head-and-neck malignancies, and prior chemoradiation for head-and-neck cancer 5.
Functional disorders: globus pharyngeus and functional dysphagia, which are linked to psychological stress and exacerbate during periods of high emotional intensity 1.
Medication-induced: anticholinergic drugs and certain medications that cause esophagitis 5.
Critical Diagnostic Pitfall to Avoid
Do not attribute dysphagia to "mold toxicity" without first ruling out the established causes listed above, as this may delay diagnosis of serious conditions such as malignancy, stroke, or neurodegenerative disease 1, 3.
Videofluoroscopic swallow study (modified barium swallow) is the initial test of choice for oropharyngeal dysphagia, allowing assessment of swallowing mechanics, aspiration risk, and functional abnormalities 6, 5.
Evaluation by a speech-language pathologist is critical for identifying specific biomechanical impairments and guiding rehabilitation strategies 5.
Upper endoscopy with biopsies should be performed to rule out structural lesions, eosinophilic esophagitis, and mucosal pathology 6.
The "Toxic Mold Syndrome" Controversy
"Toxic mold syndrome" is a controversial diagnosis not supported by established medical evidence; patients presenting with constitutional and systemic symptoms attributed to mold exposure typically have allergic rather than toxic responses 2.
Symptoms attributable to toxic effects of molds and not attributable to IgE or other immune mechanisms need further evaluation as to pathogenesis, but dysphagia is not among the recognized presentations 2.
Recommended Next Steps
Your symptoms warrant evaluation for functional dysphagia or an underlying neurologic, structural, or medication-related cause—not investigation for mold toxicity:
Undergo videofluoroscopic swallow study with a speech-language pathologist to assess swallowing biomechanics and rule out aspiration 6, 5.
Consult a neurologist if neurologic symptoms are present, as stroke, Parkinson disease, and other neuromuscular disorders are common causes 3, 4.
Review all medications, particularly anticholinergic agents, which frequently contribute to dysphagia 5.
Consider evaluation for functional dysphagia if structural and neurologic causes are excluded, as psychological stress and anxiety are well-documented triggers 1.