Voice Problems and Throat Pain Might Mean Acid Reflux

Chronic cough, voice changes, throat pain, post-nasal drip. The feeling of a lump in the back of your throat. Do any of these symptoms sound familiar? If so, you may be dealing with acid reflux.  Although acid reflux affects millions of people worldwide, many don’t know that they have it. You might think of heartburn when you hear the term. But acid reflux can also be the hidden source of a hoarse voice, throat pain, difficulty swallowing, and pain associated with using your voice.  Acid reflux is very common among people seeking care for their voice. If you have any of these symptoms, here’s what you need to know–and the steps you can take to find relief.

What are the symptoms of acid reflux?

Acid reflux, also known as GERD, or gastroesophageal reflux disease, is a chronic digestive disease in which stomach acid continuously irritates the lining of the esophagus, or your food pipe. If you experience heartburn or regurgitation (stomach contents coming back up through your esophagus and into your throat or mouth) more than once or twice per week, you may have GERD. 

The symptoms of acid reflux aren’t limited to heartburn. They may include the following: 

• Hoarseness or voice changes

• Excessive clearing of the throat

• Excessive throat mucus or post-nasal drip

• Chronic cough, especially after eating or lying down

• Difficulty swallowing

• Difficulty breathing

• Sensation of a lump in the throat

• Heartburn, burning chest pain, or indigestion

Silent reflux can occur as well. This is when the stomach lining has been exposed to acid for so long that it becomes numbed by its effects. This can pose a dangerous risk for the esophagus long-term.

What causes acid reflux?

There are several diet and lifestyle factors that are likely to contribute to acid reflux: 

• Eating a lot of inflammatory, processed foods, such as fatty or fried foods

• Eating late at night, which can put pressure on the esophageal valve

• Eating too quickly, and/or overeating

• Smoking

• Stress, which triggers the release of hormones that produce increased levels of gastric acid

• Being overweight

How does acid reflux affect the voice?

There is an enzyme called pepsin that naturally occurs in the stomach. Its job is to break down food. If pepsin mixes with gastric acid, it can surge up into the esophagus, chest, vocal cords, and throat. And if this happens repeatedly, pepsin can spark inflammation throughout the body. 

Exposure to acid can cause irritation and swelling of the vocal cords, which can lead to a rough, “hoarse” vocal quality, reduced vocal range, sore throat, and/or difficulty swallowing. Acid that reaches the level of the throat is called laryngopharyngeal reflux (LPR).  

When a patient is seeking voice care, their speech therapist will help them get to the root of their voice changes. Acid reflux is very common among those with voice problems. The good news is that diet and lifestyle changes can help keep pepsin in your stomach where it belongs, away from the throat and vocal cords!

Learn more about voice disorders here.

I think I might have reflux. What steps can I take next?

You may want to seek care from an otolaryngologist and/or a gastroenterologist. These medical professionals can make a diagnosis and determine the best treatment approach for you. 

If you’re experiencing changes in your voice, reach out to a speech-language pathologist who specializes in the voice and voice disorders. A voice therapist understands the gut-voice connection and can provide guidance in making lifestyle changes to reduce your throat’s exposure to laryngeal irritants. If acid reflux is irritating your throat, these lifestyle changes may improve your vocal quality and your voice’s ability to heal. 

Before you make any changes to your diet, it’s always a good idea to consult a medical professional, such as a registered dietician, a nutritionist, and/or a health coach. These professionals can also help you get to the root of your GI distress.

Diet changes that can help acid reflux

Everything we eat has a number on the pH scale, which measures a food’s acidity. The pH scale runs from 1 to 14. Anything below 7 is considered to be acidic, and anything above 7 is considered to be alkaline. Pepsin becomes most active when exposed to foods with a pH from 1 to 4. 

The following foods are considered to be acidic. Some of them release pepsin, the enzyme that can eat away at and damage throat tissue: 

1 Fizzy drinks

2 Coffee and tea

3 Citrus fruits

4 Tomatoes

5 Vinegar

6 Wine

7 Caffeine

8 Chocolate

9 Alcohol

10 Mint

11 Raw onion

12 Raw garlic

The following foods have a pH of 5 or above. They are rich in compounds that can help repair the damage caused by acid: 

1 Fish

2 Poultry

3 A variety of organic vegetables

4 Fruits (with the exception of citrus fruits; berries can be triggering for some)

5 Nuts and seeds

6 Nut butters

7 Cheese

8 Whole grains

Do your best to reduce or completely remove highly processed foods from your diet. Highly processed foods are more acidic due to the chemicals and preservatives they contain. For example, high fructose corn syrup is added to so many of the common foods we eat, and it’s highly acidic! Watch out for foods that contain citric acid, too. That ingredient means it’s acidic. When in doubt, reach for whole foods or those with simple ingredients that are the closest to the source. 

Before changing your diet, be sure to speak with your health care professional. A nutritionist or registered dietician can help you adjust your diet in an individualized way. A food sensitivity test may even be recommended to test which foods might be causing inflammation in your body.

Lifestyle changes that can help acid reflux

Here are some other things you can do to manage acid reflux:

• Avoid exercising for approximately three hours after eating.

• Avoid lying down for approximately three hours after eating.

• Take steps to manage everyday stress. Stress can trigger the release of hormones that stimulate gastric acid.

• Eat more fiber to aid in overall digestion.

• Drink plenty of water. Water is detoxifying and helps with digestion!

Always talk with your doctor before starting or weaning off any acid reflux or GERD medication. Many are available over the counter. However, these must be taken with caution and under the care of a physician. 

This information may feel overwhelming, and diet and lifestyle changes aren’t always easy to make. However, if you’re dealing with bothersome symptoms, your throat, gut, mind, and body will thank you for taking these steps toward better health!