Hoarseness is the term for when the voice sounds strained, breathy, or raspy, or is quieter in volume or lower in pitch. Gastroesophageal reflux disease (GERD) and related disorders may cause hoarseness.
GERD is a digestive disorder in which stomach contents leak out of the stomach and into the esophagus.
The
Sometimes, the stomach acid may rise further up the throat, irritating the larynx and vocal folds. The medical term for this is laryngopharyngeal reflux (LPR).
GERD-induced hoarseness is typically worse in the morning and improves throughout the day, whereas LPR can occur during the day or night.
As a
This can lead to symptoms such as:
GERD vs. laryngopharyngeal reflux symptoms
The adult esophagus measures approximately
GERD and LPR affect
In GERD, stomach acid leaks out of the lower esophageal sphincter (LES) and into the lower esophagus. In LPR, stomach acid leaks out of the upper esophageal sphincter (UES) and into the larynx and pharynx. Despite these differences, GERD and LPR cause similar symptoms.
However, while hoarseness affects almost 100% of people with LPR, it affects almost no people with just GERD. Hoarseness may, therefore, be a defining feature of LPR, though many people have both GERD and LPR, making it difficult for researchers to fully differentiate the symptoms.
The best way to soothe hoarseness associated with acid reflux is to treat the acid reflux itself. Where necessary, the American College of Gastroenterology (ACOG) recommends the following lifestyle modifications to help prevent and treat acid reflux.
Raise the head of the bed
Elevating the head of the bead by around 6 to 10 inches can help reduce acid reflux at night. The best way to do this is to place wooden blocks or bed risers beneath the upper bed posts or a foam wedge beneath the head of the mattress. Simply using extra pillows will not prevent acid reflux.
Adjust eating and sleeping habits
Avoiding lying down within 2 hours of eating and avoiding eating within 2 hours of going to bed can help reduce stomach acid levels, making acid reflux less likely.
Avoid wearing tight clothing
Tight clothing around the waist can increase pressure on the stomach, pushing stomach acid into the esophagus. Wearing loose clothing around the waist can help to prevent this problem.
Maintain and achieve a moderate body mass index
A 2018 article notes that excess weight around the abdomen, called central obesity, can increase the risk of acid reflux due to the following:
- increasing pressure on the abdomen, which raises the risk of hiatal hernia — a risk factor for acid reflux
- increasing relaxation of the LES
- storing visceral fat, which secretes hormones that increase the risk of GERD
Make adjustments to diet
People who experience frequent acid reflux should avoid foods and beverages that can trigger it, such as fatty foods and caffeinated beverages. They should also avoid foods and beverages that can further irritate the damaged lining of the esophagus, such as spicy foods, and citrus and tomato juices.
Quit smoking
A 2017 article notes that tobacco smoking increases the risk of acid reflux and that quitting smoking reduces this risk. According to the review, smoking causes or contributes to acid reflux due to:
- increasing relaxation of the LES
- reducing levels of bicarbonate in saliva, which ordinarily helps to clear acid in the esophagus
- damaging the esophageal lining, which predisposes it to injury from stomach acid
Medical treatments for acid reflux should also help alleviate hoarseness and other symptoms.
According to the
- Antacids: Doctors and pharmacists may recommend antacids to help relieve mild acid reflux or GERD symptoms. These are available over the counter.
- H2 receptor antagonists (H2 blockers): These medications help reduce stomach acid production, alleviating acid reflux.
- Proton pump inhibitors (PPIs): Like H2 blockers, these medications reduce stomach acid production. However, they are more effective at treating the symptoms of GERD and help heal the lining of the esophagus.
Acid reflux is one of many potential causes of a hoarse voice. As such, anyone who develops hoarseness should consult a doctor to determine the cause and begin appropriate treatment.
Other potential causes of hoarseness
- laryngitis, which is temporary swelling of the vocal folds due to a cold, upper respiratory infection, or allergies
- misusing or overusing the voice, such as from:
- cheering, shouting, or speaking loudly
- talking for too long without resting the voice
- singing loudly
- speaking in a pitch that is too high or too low
- benign growths in or along the vocal folds, such as vocal nodules, polyps, and cysts
- vocal fold hemorrhage, which is where a blood vessel on the surface of the vocal folds ruptures, filling the tissues with blood
- vocal fold paralysis, which is where one or both vocal folds do not open or close properly
- stroke, Parkinson’s disease, or other neurological diseases or disorders that affect parts of the brain involved in controlling the throat muscles or larynx
- injury to the larynx
- thyroid problems
- cancer
How long does it take for vocal cords to heal from acid reflux?
For people who undergo medical treatment for LPR, general symptoms typically resolve after 2 to 3 months, though vocal symptoms may take 6 months or more to improve.
Can digestive problems cause a hoarse voice?
GERD with LPR can cause a hoarse voice. The
GERD is a digestive disorder in which stomach acid and other stomach contents leak out of the stomach and lower esophageal sphincter and into the lower esophagus.
Laryngopharyngeal reflux is a similar digestive disorder in which stomach acid leaks out of the upper esophageal sphincter and into the upper esophagus.
While GERD alone is unlikely to cause hoarseness, it can lead to LPR, which is very likely to cause hoarseness.
Besides hoarseness, LPR may cause symptoms such as a feeling of a lump in the throat, constant throat clearing, and regurgitation.
The best way to treat hoarseness from acid reflux is to treat the acid reflux itself. Lifestyle modifications to try include raising the head of the bed during sleep, losing excess weight, and limiting or avoiding alcohol. Doctors may also prescribe medications, such as antacids, H2 blockers, or proton pump inhibitors.
Acid reflux is one of many potential causes of hoarseness. Other possible causes include misusing or overusing the voice, laryngitis, and growths in or along the vocal folds. As such, anyone who experiences hoarseness should contact a doctor for a diagnosis and appropriate treatment.