No one likes dealing with acid reflux. The indigestion, the sour taste in your mouth, and the difficulty swallowing are all uncomfortable effects of reflux. But did you know acid reflux can even cause you to lose your voice? This is called reflux laryngitis. Charlotte Eye Ear Nose & Throat Associates, P.A. Otolaryngologist Darrell Klotz, MD, discusses reflux laryngitis in this month’s blog.
WHAT IS REFLUX LARYNGITIS?
Reflux laryngitis is caused by stomach acid coming up into the esophagus and irritating the larynx. This can cause chronic swelling of the vocal folds and hoarseness.
WHAT IS ACID REFLUX?
Acid reflux occurs when stomach contents and acid travel up the esophagus and possibly up into the throat. Common signs of acid reflux include regurgitation, indigestion, a sour or bitter taste in the mouth, nausea, burping, and difficulty swallowing. Less-common or “atypical reflux” signs are those manifesting higher up in the throat such as hoarseness, sore throat, a dry cough, a sensation of a lump in the throat and chronic throat clearing.
WHAT CAUSES ACID REFLUX?
Acid reflux occurs when the lower esophageal sphincter (LES) – the muscle that acts as a valve and normally prevents stomach contents from coming back up into the esophagus – loosens or fails, thereby allowing upward travel of stomach contents. It is mainly our eating habits that contribute to the loosening of this valve. Eating certain foods such as spicy, fatty or citrus foods can loosen the sphincter. Overeating is a major cause of acid reflux, as it places pressure on the valve. It can become worse when overeating is combined with alcohol – which relaxes the LES – or lying flat – which allows gravity to assist in the regurgitation of stomach contents. Likewise, eating too close to bedtime allows gravity to work in favor of stomach contents coming back up into your throat, so you should not eat for three hours before going to bed.
Other causes of acid reflux include:
· Being overweight or pregnant.
· Taking certain medications like aspirin, muscle relaxers, or blood pressure medicines.
A common condition causing reflux is a hiatal hernia. This is when the lower esophageal sphincter relaxes so much that the upper part of the stomach moves out of the abdomen and into the chest. This situation, if severe enough, often warrants surgery to wrap the sphincter tight again. This procedure is called a Nissen fundoplication.
HOW DO YOU TREAT REFLUX LARYNGITIS?
The best way to treat the laryngitis is to treat the reflux. Dietary and lifestyle changes are a good first step. They can:
· Avoid foods that promote acid reflux like fatty foods, citrus, tomatoes, chocolate, mint, garlic, onions, and spices.
· Drink water, which keeps reflux symptoms like hoarseness and a sore throat from getting bad.
· Eat smaller meals more frequently throughout the day.
· Quit smoking.
· Put blocks under the head of your bed to raise it 4 to 6 inches so you sleep at an angle.
· Not eat at least 3 hours before lying down.
· Not wear tight clothes or tight belts.
· If overweight, take steps to lose weight.
Medications like acid blockers or proton pump inhibitors are useful. Alginate therapy is an alternative to treating with oral medications that reduce acid. Alginate preparations such as Gaviscon, Esophageal Guardian and RefluxGourmet are seaweed products that are taken after each meal and before bed to form a barrier to prevent the stomach contents from coming back up into the esophagus.
Reflux is commonly referred to as a “lifestyle disease”. It is fairly easy to minimize reflux, and by following these few steps you have another way to help keep your voice healthy and strong.
This blog is for informational purposes only. For specific medical questions, please consult your physician.
Darrell Klotz, MD, is an Ear, Nose, and Throat doctor who works in CEENTA’s SouthPark office. He received his bachelor’s degree from Bucknell University. His medical degree, internship, and residency were from the University of Rochester School of Medicine and Dentistry. He received his fellowship in laryngology/voice disorders from the University of Washington School of Medicine.