Page 75 - 18-9 June 2, 2021

A common issue which can have varying degrees of effect on the voice is GERD
(Gastroesophageal Reflux Disease), often referred to as acid reflux. GERD refers to the passing
of stomach acid into the esophagus, a tube which connects the mouth to the stomach.

Symptoms of GERD may include heartburn, burning of the throat, burping up a liquid
which leaves a burning sensation of the throat, bad breath, and waking up to a dry mouth.
These symptoms may or may not be present. When the symptoms aren’t felt this is referred to
as silent reflux.

At times, the acid of the stomach may travel up higher than the esophagus and into the
pharynx; a disorder referred to as LPR (Laryngopharyngeal Reflux Disease). Symptoms of LPR
include red or irritated larynx, feeling of something stuck in the throat area, hoarseness, and
post nasal drip. These and other symptoms can have a significantly negative effect on the voice
as well as other issues with the larynx.

GERD and LPR can be diagnosed by an ENT (Ear, Nose, and Throat Doctor) though often
a GI (Gastroenterologist Physician) is consulted. Reflux is generally treated with medications
though various behavioral modifications may be helpful as well. Behavioral modifications may
include:
Avoiding spicy foods
Avoiding carbonated drinks and caffeine especially in the evening
Weight loss
Smoking cessation
Elevating the head while sleeping
Avoiding lying down within two hours of eating a meal
Reducing stress

In cases where an individual does not respond to the medication, laparoscopic surgery
may be an option.

As mentioned above, GERD or LPR can have a significant impact on the voice. And while
voice therapy does play a role in rehabilitating hoarseness or other dysphonias, it is pivotal that
GERD or LPR be treated appropriately before attempting voice therapy as the therapy may be
ineffective without the proper medical treatment of the reflux.