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.
