Chronic acid reflux can damage the tissues of your throat over time, leading to hoarseness and vocal changes.
Gastroesophageal reflux disease (GERD) is a chronic condition that occurs when stomach acid backflows into your esophagus, the tube connecting your throat to your stomach.
GERD — a more severe form of acid reflux — is associated with symptoms of hoarseness and voice changes, but when acid reflux reaches the throat, it may become part of a different condition known as laryngopharyngeal reflux (LPR).
GERD and LPR are both chronic acid reflux conditions.
In GERD, dysfunction of the lower esophageal sphincter (where the esophagus meets the stomach) causes stomach acid to enter the esophagus. This can cause symptoms of heartburn in the chest and can create difficulty swallowing (dysphagia).
In rare cases, dysfunction of the upper esophageal sphincter (located below the throat) can allow gastric acid in GERD to travel up into the pharynx (back of the throat).
GERD is common. Approximately
LPR — known as “silent reflux” — doesn’t always cause the same or noticeable symptoms as GERD. But it also occurs when there is esophageal sphincter dysfunction.
Unlike GERD, LPR always involves upper esophageal sphincter dysfunction, not just lower.
Can you have both GERD and LPR?
Yes, you can have both GERD and LPR and experience the full range of symptoms from both conditions.
Acid reflux can cause changes to your voice from irritation, inflammation, and damage to structures of the throat like your vocal cords.
How does acid reflux affect your vocal cords?
In LPR, stomach acid makes it past the epiglottis and into the larynx, where your vocal cords are located above the trachea.
Your vocal cords are actually two folded sections of muscular mucous membranes. They extend outward from the larynx wall and vibrate based on how air passes through them.
Research from 2020 suggests that when gastric acid spills into the larynx, it can damage the mucosal tissue, causing chronic laryngitis, throat ulcers, or scarring over time. Additional damage to the vocal cords can also occur through secondary coughing, the body’s natural response to irritation in the throat.
Why does acid reflux cause hoarseness?
Both GERD and LPR can cause throat irritation as stomach acid rises past the upper esophageal sphincter. This tissue inflammation and damage can make you hoarse.
However, hoarseness is far more common in LPR than GERD, affecting almost
Hoarseness is the key vocal change noted in acid reflux. It’s seen most often in people with LPR and less often in people who have GERD with pharynx involvement.
Voice change symptoms may include:
- vocal fatigue
- limited pitch range
- quieter speech
- impaired singing
- enunciation challenges
In addition to vocal changes, symptoms of LPR include:
- a choking sensation
- frequent throat clearing
- chronic cough
- mucous accumulation or postnasal drip
- sore throat
- feeling as though something is “stuck” in your throat
In rare cases, you may experience heartburn, indigestion, or regurgitation in LPR.
Non-vocal symptoms of GERD include:
- heartburn or a burning sensation in the chest or neck
- chest pain
- trouble swallowing
- nighttime discomfort
- an unpleasant taste in the back of your mouth
If left unmanaged, acid reflux can cause repeated injury to your vocal cords, resulting in permanent scarring.
If left untreated, you can also develop:
The best way to help relieve the symptoms of acid reflux is to seek treatment. GERD voice changes and LPR hoarseness (dysphonia) are directly related to the throat tissues being exposed long-term to stomach acid.
Treatment for both these conditions involves medications that reduce the amount of acid made by the stomach, as well as lifestyle changes such as:
- weight loss
- smoking cessation
- decreasing meal size
- avoiding laying down after eating
- reducing alcohol intake
- eating a low fat and low acid diet
- avoiding carbonated beverages
- limiting caffeine
- elevating your head 6 to 8 inches while sleeping
While you manage acid reflux treatment, you can help heal your voice and take future care of it by also:
- drinking plenty of water
- resting your voice
- using a humidifier
- avoiding medications that dry out mucous membranes
- skipping spicy foods
- eating foods with vitamins A, E, and C
- getting quality sleep
- avoiding harsh mouthwashes
- holding your phone rather than cradling it in your neck
How long does it take to heal your voice from acid reflux?
GERD voice or LPR dysphonia, however, can only improve if you can stop the exposure to reflux long enough for the tissue to heal.
GERD voice changes are possible when acid reflux affects the back of the throat, causing inflammation and soreness.
Sometimes, acid from the stomach makes it into the throat and past the epiglottis, affecting your larynx and vocal cords. When this happens, it’s known as laryngopharyngeal reflux (LPR).
LPR almost always causes hoarseness, but it can cause other voice changes too.
Whether your vocal changes are related to GERD or LPR — or both — treating acid reflux is the best way to help your voice heal before any damage becomes permanent.