Acid on the Larynx?

Doctor's Corner with Anthony Jahn

Dear Doctor Jahn,

How does acid reflux actually irritate the voice? If acid is coming up in your esophagus, how does it irritate the vocal cords, given that they are in the wind pipe?

Connie

Dear Connie,

Thank you for your thoughtful question. You’re right, when stomach contents (acid and enzymes) reflux up the esophagus, they enter the throat behind the larynx.

Depending on the amount of material, it can spill over the ridge of tissue that separates the top of the esophagus from the larynx (the interarytenoid area), and cause irritation.

In fact, this tissue, between the arytenoid cartilages is often red and swollen with reflux, and this finding is one of the cardinal signs of acid reflux.

It is however extremely uncommon for acid to actually spill into the larynx or to damage the vocal folds directly.

For this reason, I’m always upset when a doctor scares a singer by saying “your vocal cords are burned by acid”. This is an unnecessary exaggeration, and does the patient a disservice.

The commonest vocal effect of acid reflux is an irritation of the pharynx. This causes irritation of the muscles around the larynx and results in an elevation of the larynx.

There are also neurologic receptors in the pharyngeal wall which, when irritated, cause the vocal folds to tighten and come together.

The net effect is an increase in muscle tension, which makes it more difficult to sing freely, causes problems negotiating the mix, and decreased resonance and power due to pharyngeal constriction.

-Anthony F. Jahn, MD, FACS, FRCS(C)

Dr. Jahn welcomes your questions. You can send these to editor@voicecouncil.com

This discussion is for general information and not to be construed as specific medical advice that you should obtain from your own physician.


  • Eric Fréget

    :The net effect is an increase in muscle tension, which makes it more difficult to sing freely, causes problems negotiating the mix, and decreased resonance and power due to pharyngeal constriction.
    Thank you for the info but is there a solution ?

  • JohnnyCNote

    I’ve been diagnosed with reflux laryngitis and over the years it’s gradually robbed my of my range and caused hoarseness to the extent that some days I can hardly talk at all. Mine is a serious case and the medications I take are losing their effectiveness. I’ve discussed surgical solutions and am preparing to undergo bariatric surgery as it’s similar to surgery for GERD.

    If you have any symptoms similar to what I’ve described, I strongly suggest consulting with a doctor. Good luck…

  • Kirbie

    Hey guys! I have acid reflux too. Can’t stand it! But check out with Dr. Axe says. It really helped me and helps 9/10 people with acid reflux! http://www.youtube.com/watch?v=ufrJoRc7KaY

  • Make your special wishes to your loving mother in very special and
    admirable way through delivery of gifts and flowers from online shopping store.
    Send Mother’s Day Gifts to Brazil and
    convey your special message of love and affection. Order online for Mother’s Day Flower Delivery in Brazil and create magical moments for your lovely Mother to
    cherish forever.