Here
we are discussing the relationship between acid
reflux and hoarse voice.
Hoarseness may
be caused due to many reasons like a bad cold,
persistent screaming, laryngitis and throat
cancer. It can even be caused from acid
reflux or more precisely gastro esophageal
acid reflux. Clinically termed as
LaringoPharyngeal Reflux or LPR, it addresses a
condition in which the refluxed acidic stomach
contents are believed to have reached the voice
box, thereby causing damage to
it.
However,
the human voice box is not such a flimsy organ as
to be injured by a few acid washes in a month,
considering that the person has habitual acid
reflux every month, or he or she is a chronic GERD
patient. Nevertheless, it may be pertinent to see
how the laryngologist reaches the conclusion that
the patient is suffering from LPR, following his
method of diagnosing.
When
there is a suspicion of acid reflux hoarse
voice, or due to some other reason, the
initial investigation comprises a look inside the
mouth with a fiber optic endoscope that reveals
the color of the mucosa lining the vocal chords as
typically “red”, suggesting injury or damage. But
what detracts the laryngologist is the fact that
the pixilated view and the mirror examination of
the larynx gives out only a blurred image of the
mucosa lining the voice box, which in fact is
translucent. It is the underlying tiny blood
vessels that provide the “red” coloring of the
mucosa, often misleading the
medico.
The
next course of investigation may also prove
ineffective as vocal abnormality is checked by
visual abnormalities appearing on the voice box or
the larynx – a method far from being perfect.
Although the formation of a benign growth in that
area may affect the vocal quality of the person,
it has very little or nothing to do with LPR and
so hoarseness may persist even after the expensive
‘treatment’.
The
third track of investigation is also likely to
provide deceptive results as people think that the
vocal cords work like string instruments (piano,
guitar, etc), creating sine waves, oscillating
about an axis whereas in reality, they are like
wind instruments (church organ) that leak air as
they vibrate. When air passes between the cords
without vibrating them, it flows turbulently,
producing white noise or whisper. In such cases no
vocal cord movement is involved at all. Hence the
hoarseness when a person talks, not whispers, may
be caused by something else than
LPR.
However,
reflux is also significant since the stomach acids
and enzymes that reach the larynx can cause
irritation and injury, resulting in hoarseness. It
is also a major factor in the formation of
granuloma and phonotrauma that affects the voice
to some extent. In fact, the larynx is more
susceptible to injury as it is more sensitive than
the esophagus in counteracting the effects of the
acidic reflux, affecting normal voice
quality.
Nevertheless,
its treatment may follow the usual line that
suggests change of lifestyle, keeping away from
fatty or spicy food, regular meal timings along
with regulated doses of proton pump inhibitors to
control the flow of stomach acids till the voice
becomes normal.
But
the problem is acid reflux hoarse voice
can only be temporarily treated with the above
approaches. That is because most of these remedies
only attempt to identify the symptoms and
generally fail to find the cause of these
symptoms. The ideal treatment should go deeper and
try to find out what the real cause is of acid
reflux and then try to solve the issue. And once
done, the symptom, that is hoarse voice, will also
be naturally treated. Holistic methods of
treatment are so effective because this is what
they do – they treat the body as a whole, and not
just the symptoms. The fact is, acid reflux is a
complex issue and the causes are also many. So a
holistic approach is often
desirable.
